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Effective maternal and child health services at the community level in developing countries are rarely available. In many developing countries the health systems cannot provide quality maternal and child health care services due to lack of adequate human resources; shortages of equipment, drugs, and supplies; and absence of proper referral mechanisms. Strengthening health systems is central to improving maternal and child health. A variety of targeted interventions have been implemented in the health systems of developing countries. This study was conducted to identify the health service delivery models that have contributed to the reduction of maternal, infant, and child mortality in five selected developing countries, and to identify the strengths and limitations of these models. The countries studied, Bangladesh, Cambodia, Ghana, Tanzania, and Pakistan, were selected according to level of maternal and infant mortality, initiatives undertaken in the health sector to improve maternal and child health, and level of progress toward achieving the health-related Millennium Development Goals. Based on a set of selection criteria, several successful service delivery models implemented in the selected countries have been identified.