USAID Health Care Improvement Project (HCI) | Mali


With core support from USAID's Maternal and Child Health group, URC and the Ministry of Health worked to improve essential obstetric and newborn services at the health facility and community levels. The project sought to reduce maternal and newborn morbidity and mortality through the application of effective quality improvement approaches to services ranging from antenatal to postnatal care and family planning services, including institutionalizing active management of the third stage of labor (AMTSL).

The USAID Mission in Mali engaged URC to work in three additional areas:

  • Management of pre-eclampsia and eclampsia,
  • Maternal anemia, and
  • Family planning counseling and post-partum care.

Read more about the HCI Project.

Key Activities

  • Assessed compliance with standards in facilities;
  • Assessed community-based service delivery, household knowledge and health practices, and community health resources;
  • Trained trainers, facility-based providers, and community midwives in quality improvement methods and AMTSL;
  • Implemented collaboratives at the facility and community levels and strengthen referral processes between those levels; and
  • Strengthened community initiatives for birth preparedness, access to delivery care, and support for community emergency transport of obstetric and newborn complications.


  • Compliance with the three key AMTSL components rose from 0% in October 2009 to 100% in June 2010 at 37 of 41 sites participating in a collaborative, while the postpartum hemorrhage rate fell to zero; these rates were sustained or nearly sustained for the next several months (see figure).
  • Compliance with essential obstetric and neonatal norms rose from 43% at baseline to 92% in 2010 at 37 of 41 sites participating sites.

AMTSL coverage and post-partum hemorrhage rates

2009 to 2013
US Agency for International Development (USAID)
Regions/ Countries 
Geographic Scope 
Five districts in the Kayes Province