A series of new safe motherhood midwifery education modules was evaluated in nursing and midwifery education institutions, regional training centers, acute care hospitals, and community settings in Ethiopia, Fiji, Lesotho, Mozambique, and Nepal in 1995. The series was developed by the World Health Organization's Maternal Health and Safe Motherhood Program. A total of 36 teachers, 82 midwives or nurse-midwives, and 60 post-basic midwifery students were enrolled in a 2-week clinical skills course and an 8-day training in module use. In subsequent questionnaires and focus group discussions, participants indicated the modules were understandable, relevant, easy to use, and of high quality and the guidelines for assessing competence were adequate. Difficulties encountered included insufficient recommended time frames for some of the sessions, a limited availability of clinical cases for teaching the specific skills in the modules, difficulties obtaining data for a community profile, and a lack of resources to support application of skills learned. Participants indicated they would benefit from having copies of the technical material used in the modules for reference after the course. Overall, these findings indicate the modules have the potential to strengthen the education of midwives in developing countries and thereby to make motherhood safer. Weak health system infrastructures, including regulatory measures, represent the major obstacle to successful program application.