A total of 123 maternal deaths were recorded in these facilities with 103 (83.7%) from KCH, 6 (4.9%) from Mitundu and 4 (3.3%) from Kabudula community hospitals. Out of the 103 MDs from KCH, 18 (17.5%) were referred from Mitundu and 12(11.7%) from Kabudula CHs. Overall, major cause of death was infection at 29% for KCH and other causes at 100% for both Mitundu and Kabudula. Death audits were not done at Mitundu and Kabudula community hospitals while at KCH, the audits were done but very late up to three months from the time the deaths occurred. KCH did not provide feedback to the referring facilities on patients’ outcome.