On average a Nigerien woman faces a 1 in 7 risk of dying from pregnancy complications over the course of her lifetime, one of the highest maternal mortality risks in the world. Post-partum hemorrhage (PPH) is the leading cause of maternal mortality in Niger followed by sepsis and eclampsia. For every maternal complication, there is a high rate of newborn death and morbidity. In 2006, USAID’s Quality Assurance Project launched the Essential Obstetric and Newborn Care (EONC) Collaborative in Niger to improve quality of maternal and newborn care services according to evidence-based best practices.