Linking Communities, Health Systems, and Policies

A Comprehensive Approach

The primary goal of the Ending Eclampsia project is to expand the use of antihypertensives and MgSO4 to prevent and treat pre-eclampsia and eclampsia (PE/E). Collaborating with national policymakers, ministries of health, community leaders, and health providers to increase access to high-impact, low-cost interventions, Ending Eclampsia works to reduce maternal deaths related to hypertensive disorders during pregnancy. Ending Eclampsia informs scale-up strategies and strengthens the capacity of local institutions in low-resource settings by generating and sharing high-quality evidence through global networks and knowledge centers.


Working with community leaders, health workers, and male partners, Ending Eclampsia breaks down barriers to accessing services for the detection and treatment of PE/E. The project raises awareness through campaigns that share warning signs and symptoms and stress the importance of antenatal and early postnatal-care visits at community health facilities.

Health System

To introduce and scale up the use of underutilized interventions, such as aspirin prophylaxis for high-risk women and calcium supplements (in regions with low-calcium diets), antihypertensives, and MgSO4, Ending Eclampsia works with ministries of health to build health service delivery processes; systems for information, procurement, and financing; human resources capacity; and medical products and technologies at each level of a health system.


Following global standards that allow more cadres of health workers to safely administer MgSO4 requires an introduction and scale-up strategy mainstreamed within a country’s maternal newborn and child health program. Ending Eclampsia researches the barriers to implementation, designs appropriate and effective health systems and community solutions, and supports the institutionalization and scale up of these systems and solutions.

Local partnerships

Partnering with national obstetrician/gynecologist and midwifery societies, Ending Eclampsia:

  • Expands successful interventions in Bangladesh, Nigeria, and Pakistan. These interventions include improving community health providers’ ability to identify pregnant women at risk of PE/E and prevent pre-eclampsia from progressing to eclampsia by expanding access to prophylactic drugs that can manage high blood pressure, and establishing effective linkages between primary and referral facilities for PE/E management;
  • Identifies and addresses barriers—in policies, programming, and service utilization—to expand the use of MgSO4 and other medicines for managing PE/E in selected African and South Asian countries;
  • Aligns project efforts with the World Health Organization, USAID-supported maternal health projects, and other major initiatives, such as the UN Commission on Life-saving Commodities, the Bill & Melinda Gates Foundation’s PRE-EMPT project (Pre-eclampsia and Eclampsia Monitoring, Prevention, and Treatment), the Maternal Health Task Force, and the Partnership for Maternal Newborn and Child Health; and
  • Coordinates a global coalition that shares lessons and informs strategies to introduce and increase the use of antihypertensives and MgSO4 and to prevent, detect, and manage PE/E within routine maternal health care visits.

Other development partners working in Maternal and Newborn Health: