The government of Jharkhand (GOJ) has placed strategic importance on First Referral Units (FRUs) to improve the maternal and child health indicators in the state. But evidence suggests that the FRUs in the state are not functioning at an optimal level. Public Health Foundation of India (PHFI) has been providing technical assistance to the state health department with support from MCH STAR, to operationalise 12 selected FRUs. The first phase of the project was over by September 2009. Phase-II of the project was initiated and conceptualised to build upon the lessons learned and experiences of Phase-I of the project. By the end of the phase I, various improvements were observed in the 12 selected FRUs, though it was also felt that more effort and resource mobilisation was needed to bring those FRUs to functional level. The Government of Jharkhand sought further technical assistance and capacity building support from PHFI to fully operationalise the 12 FRUs. The objective of the project is to facilitate the government functionaries, to upgrade 12 selected facilities to functional FRUs in a stipulated period, which would guide the government functionaries towards operationalisation of rest of the FRUs in the state. The project also aims to enable government functionaries to maintain and track progress of the FRUs in the state through an accreditation/scoring system and monthly-FRU performance report generation. Building capacities of the government functionaries to render quality MCH services in FRUs has been considered to be key to achieve the goals of the project. The expected results of this project would be improved functional levels of all selected FRUs through, implementation of monitoring and process indicators, institutionalisation of accreditation system at facility level, shared learning across the FRUs and better co-ordination between facility/district and the state government.  Improved government capacity for problem solving is being seen as a sustainable resource that can be utilised for better management of health service delivery institutions within and outside Jharkhand to improve maternal and child health.