The American College of Nurse-Midwives International Project for Traditional Birth Attendants is working with the Ministry of Health in Tanzania. This paper describes the approach and process used to initiate and implement a maternal child health and family planning program for traditional birth attendants in the Arusha Region. The first step was a needs assessment, followed by the initiation of a planning group. Implementation began with training Maternal Child Health Aides who in turn trained traditional birth attendants. The findings and lessons learned from this pilot project will be used to formulate guidelines and models for programs in other regions of the country.