This brief is an overview using PMA (Performance Monitoring for Action) Ethiopia data. Women-friendly respectful care is essential for reducing maternal and child mortality, and fulfilling women’s rights. Ethiopia has made tremendous progress in saving women’s lives during childbirth by increasing the proportion of women delivering in facilities. The maternal mortality ratio has decreased drastically from 953 in 2000 to 267 per 100,000 live births in 2020, largely due to a substantial increase in the percentage of women delivering in a facility, from 10% in 2011 to 48% in 2019. However, too many women are still dying in childbirth with approximately half still not delivering in facilities. Women may not be delivering in facilities because they lack access or because of prior or perceived poor experience in the quality of care that diminishes women’s trust in health facilities for this important life experience.

To reduce maternal deaths, therefore, policy makers need to ensure the quality as well as the availability of facilities. One element for good quality maternity care includes clinical standards and skills. An equally critical element is women’s perceptions and trust of facilities regarding how they are treated during this defining and important event in their lives. While access to more and better facilities is an essential starting point, women will continue using them only if they have a positive birthing experience in these facilities.