In South Africa in the 1990s Prof. Robert Pattinson asked the minister of health to establish a CEMD based on the UK model. The first Report appeared in 1998. During the AIDS epidemic the president and officials were denialists and tried to alter the Reports. The Enquiry developed a system to report 'great saves'. Politicians were supportive and maternal mortality fell to 97/100,000 in 2019. In India, Dr VP Paily is the coordinator of Kerala’s Confidential Review of Maternal Deaths. The KFOG was founded in 2002 and the Review began in 2003, stimulated by the WHO. The government authorised hospitals to give the KFOG anonymised records of maternal deaths. Quality standards were developed, helped by NICE International. In 2019 the maternal mortality rate was 28/100,000. In the USA Prof. Elliott Main is the medical director of the California Maternal Quality Care Collaborative (CMQCC), established when mortality rose in the 2000s. It produced toolkits to tackle the leading causes and in 2012 established the Maternal Data Center, combining social and hospital data. Severe maternal morbidity is scrutinised. Mortality fell and similar initiatives have spread across the USA.