This program is brought to you by Emory University. >> Welcome to the last module of Childbirth: A Global Perspective. Today, I will give an overview of the Maternal and Newborn Health in Ethiopia Partnership, that I will from this point on refer to as MaNHEP. I will describe the Ethiopian context regarding maternal health and newborn health, the overall goal of the MaNHEP project and its key partners and supports, where the project was situated within Ethiopia, the assumptions that serve as a basis for the project's intervention, and the project evaluation. Finally, I'll give a summary of the results. Then I will step back to examine the strengths of the project and it's potential for scale up and possible application elsewhere. Ethiopia is an exceptionally beautiful country with a diverse landscape and population. It is a developing country associated in many people's minds with food insecurity and famine with a poor and agrarian peoples. It is also known as the Cradle of Mankind. I mean, it truly is this incredible place. The country has great needs in the area of maternal and newborn health. The most recent estimates of maternal mortality in 2011 for Ethiopia range from 350 to 676 deaths per 100,000 live births. Estimates for newborn mortality are also high at 37 deaths per 1,000 live births. These maternal and newborn deaths occur in a context characterized by limited access to formal health services. For example, 85% of the population resided in the rural areas often distance from health services. Only 44% of pregnant women received antenatal care from a skilled provider, that is a doctor, nurse, or midwife, or health extension worker. However, at the time of birth, only 10% of women had their babies with a skilled provider in attendance and only 10% of births occurred in a health facility. In addition to limited access to health services, women also prefer home birth with family members in traditional birth attendance. This creates both challenges and opportunities for improving maternal and newborn health. To reduce high levels of maternal and newborn mortality, MaNHEP, a three and a half year learning project, was designed to demonstrate a community-oriented model of maternal and newborn health care, which I will call CMNH, that focused on birth and the early postnatal period when the risk of death is greatest. MaNHEP was funded by the Bill and Melinda Gates Foundation and operated under auspices the Ethiopian Ministry of Health. The project was designed to fit within existing government initiatives rather than trying to replace them with new policies and approaches brought in from the outside. It complimented and strengthened the Federal Ministry of Health Flagship Health Extension program, which seeks to expand health care delivery in rural areas by delivering a core package of maternal and newborn health care to achieve millennium development goals four and five to reduce child and maternal mortality. MaNHEP was led by Emory University in collaboration with the Amhara and Oromiya regional health bureaus, John Snow Research and Training Institute, University Research Company, and Addis Ababa University. Together with the Ministry of Health and the Regional Health Bureaus, the project selected six woredas equivalent to districts or counties. Three in each of two regions, to participate in the learning project. The project focused on a vertical cut of the health system in each woredas, to create a support system linked to existing organizational structures. The cut involved key personnel from each level of the formal health system. The regional health bureaus, zonal health departments, woreda health offices, two health centers within each woreda and seven to ten kabeles, or subdistrict health post linked to the health centers. A total of 51 kabeles and health posts. These key personnel were responsible for ensuring that childbearing families received CNMH care in their respective service areas. Overall, the MaNHEP implementation area encompassed a population of about 350,000 residing in 51 kabeles. There was an estimated 12,000 births per year.