From 2008 to 2012 the MacArthur Foundation supported the Population Council to pilot an innovative, community-based approach to postpartum hemorrhage prevention in the Amhara region of Ethiopia— lay youth mentors and health extension workers were trained to bring misoprostol information and services to women in their rural communities. This case study describes the findings of a process evaluation of the MacArthur Foundation’s work to scale up community-based distribution of misoprostol in Ethiopia. This collaborative model was only somewhat effective in reaching women with misoprostol at the time of delivery and policy changes and structural barriers prevented the project from being replicated or scaled up.


Takele Geressu, Senait Tibebu, Francine Coeytaux, and Elisa Wells, Public Health Institute, December 2014