Inadequate health care and long delays in obtaining care during obstetric emergencies are major contributors to high maternal death rates in Tanzania. Formative research conducted in the Mwanza region identified several transportation-related reasons for delays in receiving assistance. In 1996, the Cooperative for Assistance and Relief Everywhere (CARE) and the Centers for Disease Control and Prevention (CDC) began an effort to build community capacity for problem-solving through participatory development of community-based plans for emergency transportation in 50 villages. An April 2001 assessment showed that 19 villages had begun collecting funds for transportation systems; of 13 villages with systems available, 10 had used the system within the last 3 months. Increased support for village health workers and greater participation of women in decision making were also observed.