Qualitative Analysis of Maternal Mortality Reporting Gaps and the Emerging Fourth Delay in Garut Regency, Indonesia

Maternal mortality in Garut reflects systemic gaps across health and reporting systems, including the newly identified fourth delay (digital barriers), rather than individual lapses. To achieve SDG targets, Indonesia must invest in digital resilience, integrated chronic disease services during ANC, equitable transport infrastructure, and respectful maternity care. A robust, real-time MPDSR system that includes maternal deaths outside of facilities is essential. Maternal survival depends on aligning national commitment with district-level readiness and action.