Essential Obstetric and Newborn Care (EONC) Networks Project


URC’s non-profit affiliate, the Center for Human Services (CHS), is working with the Ecuadorian Ministry of Health (MOH) to meet the goals of the National Plan for Reduction of Maternal Newborn Mortality. The project focuses on Cotopaxi, a province in the Andes Mountains largely populated by indigenous people, where maternal, neonatal, and infant mortality death rates are significantly higher than national rates.

The project is (1) developing an integrated health care network to improve the continuum of care from community to provincial hospitals by creating referral mechanisms, (2) improving the quality of care at facilities, (3) forging or improving connections between facility-based health teams and community health leaders, and (4) ensuring the use of evidence-based practices.

The health network aims to ensure the use of evidence-based practices at all levels. At the community level, the project incorporates traditional birth attendants, who attend nearly half of all deliveries in communities. It works directly with the MOH, mobile community health teams, local community leaders, and community-level NGOs.

Key Activities

Develop an integrated network of public and private providers of community- and facility-based essential and obstetric newborn care, which includes traditional birth attendants and formal health care providers.
Strengthen the cultural acceptability and quality of health care in county and provincial health facilities
Increase community access to, demand for, and use of the network of essential obstetric and newborn care services 
Provide training for traditional birth attendants in recognizing danger signs and risk factors in mothers and newborns, counseling to mothers and families and how and when to refer patients to hospitals.
Conduct research on the role of traditional birth attendants in early postpartum visits to the newborn.


  • Significant increase in access to EONC by rural communities
  • Improvement of quality of care in participating facilities
  • Cultural adaptation of birth care in hospital
  • Referral mechanisms implemented and being expanded
  • Development of patient-centered advocacy organizations
2009 to 2013
US Agency for International Development (USAID)
Regions/ Countries 
Geographic Scope 
Cotopaxi province