Since the 1980s, URC has worked in Ecuador to strengthen heath outcomes across a range of issues. In 1981, our non-profit affiliate, the Center for Human Services (CHS), launched the Primary Health Care Operations Research Project (PRICOR), undertaking multi-country research to guide developing countries in strengthening their primary heath care services. Ecuador was one of several countries that received support through PRICOR. URC has since implemented other major public health initiatives in the country, such as the Quality Assurance Project, Global Fund Consulting Services, and the Health Care Improvement Project, which collaborated with the Ministry of Health to conduct research on the spread of improved maternal and newborn care practice and continuous quality improvement methods to multiple regions, building on successful results of an earlier essential obstetric care improvement collaborative. URC’s work has also addressed the serious maternal and infant mortality rates in Ecuador.  From 2009–2003, CHS collaborated with the Ecuadorian Ministry of Health to meet the goals of the National Plan for Reduction of Maternal Newborn Mortality, which focused on Cotopaxi, a province where maternal, neonatal and infant mortality death rates are significantly higher than national rates. The project, known as the Essential Obstetric and Newborn Care (EONC) Networks Project, ran from 2009–2013 and aimed to (1) develop an integrated health care network to improve the continuum of care from community to provincial hospitals by creating referral mechanisms, (2) improve the quality of care at facilities, (3) forge or improve connections between facility-based health teams and community health leaders, and (4) ensure the use of evidence-based practices.