USAID Health Care Improvement Project (HCI) | Ecuador


With global health research funding, URC collaborated with the Ministry of Health (MOH) to conduct research on the spread of improved maternal and newborn care practices and continuous quality improvement (CQI) methods to multiple regions, building on successful results of an earlier essential obstetric care improvement collaborative.

Key Activities

  • Studied strategies that were developed and implemented by the MOH to spread improvements in maternal and neonatal care throughout the country
  • Conducted operations research to determine how well new facility-based teams, supported by provincial spread teams, can monitor indicators of quality and implement changes in their processes to ensure compliance with essential obstetric and newborn care standards 
  • Documented the costs of spread and compare them to the costs of the demonstration phase of the previous collaborative


  • Best practices in essential neonatal and obstetric care (EONC) spread to the majority of more than 100 hospitals in the 24 provinces of Ecuador.
  • MOH fully leading the QI program and EONC with its own resources, independently of the support provided by HCI.
  • MOH scaling up the QI methods from EONC to new technical areas.
  • Creation of website as a knowledge management tool to support spread of EONC which had more than eighty thousand visits in three years of operation.  See
  • MOH manages a national database, originally developed by HCI, which produces monthly reports on compliance with standards from all participating hospitals.
2007 to 2012
US Agency for International Development (USAID)
Regions/ Countries 
Geographic Scope 
Provinces of Guayas, Pichincha, Manabi, Napo, and Los Rios