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As a result of the commitment of Ebonyi State government to addressing the high maternal mortality, the FMCHCP was introduced in the State in 2003 under the leadership of Governor Sam Egwu. The programme was however limited to the Ebonyi State University Teaching Hospital located in Abakaliki, the State capital. Although the package was comprehensive and consisted of complete obstetric care including emergency obstetric care (EOC) to the beneficiaries, unfortunately the target group, poor rural dwellers, were missed due to lack of awareness, bad road networks, poverty, first and second level delays, etc. His Excellency, Governor Martin Elechi, in a bid to revamp the FMCHCP and make it more functional and accessible, extended the services to all the major secondary health facilities located in the 13 local government areas in the State.

The project targeted specific communities in the respective states, working with the Minjibir community in Kano, the Agbowa community in Lagos, and the Gwoza community in Borno to engage stakeholders in local-level problem solving to address barriers to quality health care service delivery and behaviors related to positive maternal health outcomes.

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The original Project consisted of three Parts - Part A: Strengthening Capacity for System Management at State Level. Each state was to receive US$1.5 million to strengthen capacity at State Ministries of Health to improve budget management processes, develop health accounts, increase the autonomy of local health facilities through service agreements, and carry out annual performance reviews to discuss results and share lessons learned with stakeholders. Human resources were to be developed through training on maternal and child health and communicable disease control, and improved quality of training programs in schools of nursing, midwifery and health technology. The health management information system (HMIS) was to be strengthened to improve access to information for decision making. Access to information technology and communications was to be enhanced through improvements to internet and technology access . Studies and technical audits were to be implemented. Part B: Strengthening Delivery of Priority Health Services. The delivery of primary health care services and disease control were to be improved through the provision of training and equipment. Essential drugs were to be supplied to health facilities. The quality of training in nursing, midwifery and health technology schools was to be improved, and selected schools were to be rehabilitated. Part C: Capacity Strengthening at Federal Level and Project Coordination, Monitoring and Evaluation. This Part was to support the formulation of health policies and strategies and the implementation of health reforms; the implementation of the National HMIS and annual health sector performance assessments; promotion of research on health care financing, and research, studies and audits on key systemic issues; and Project Management, coordination and evaluation, including assisting Participating States, consolidation of annual work programs, reports, and accounts, monitoring progress in Project implementation, and providing information to the National Project Steering Committee. Additional Financing: Project restructuring in 2005 changed the fund allocation to States, and funds were pooled for all States in one pool. However, some States had overspent their allocations, leading to a funding gap that was financed by Additional Financing in 2008. Roughly 50% of the Additional Financing was to support civil works (completing the rehabilitation of health training institutions and primary health care (PHC) centers and provision of water); 30% was for service delivery, including commodities and equipment; and 20% was for systems development (e.g. M&E) and capacity building at the state and facility level .