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Shortage of qualified staff and irregular supply of essential equipment, drugs and consumables were considered by 91% and 64% of the respondents respectively as the major underlying factors for substandard ANC (Table 3).
Prospective surveillance detected at least one trigger in 73 (52%) patients and identified 22 AEs, including 15 (68%) that were preventable, 41 potential AEs and an additional 31 errors or cases with substandard care (table 2).
Tablets were the formulation most frequently reported to be substandard (see online supplementary table S1).
Table 3 illustrates substandard care during delivery and the risk of a low Apgar score.
Of the audited maternal deaths in 2007 at Amana, Mwananyamala, Temeke and Aga Khan hospitals 69% (43) were associated with substandard care at the facility (Table 2).
Students tell me that they – not unreasonably – don't like their substandard dining rooms with filthy tables, unswept floors.
Manufacturers held the marketing authorisation for 611 substandard medicines and distributors for 38 (table 4).
The two most frequent problems, with the substandard medicines, were packaging and contamination (table 2).
Substandard antibiotics carried the labels of six manufacturers (Table 2).
Table 3 indicates geographical distribution of substandard and counterfeit products, which suggests higher numbers in Africa and Asia.
The distribution of substandard medicines by therapeutic indication, as shown in Table 7, indicates that antimalarial (52.5%), antibiotic (18.9%), and antituberculosis (12.4%) medicines had the highest occurrence of all substandard medicines found in the database.
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com