Even though availability of malemal heallh care service is essenlial for improvemel1l ofrnmaternal heallh, lillie is known aboul the utilization in rural areas where lhe HealthrnExtension Program is implemented. This sludy is aimed al assessing lhe sign.ificance ofrnhealth extension program in improving Ihe lIliliZaiion of maternal health service in ruralrnAdama towards the maier/wi health care services.rnThe study utilized quantitative and qualitative data collecled in the month of March 2010.rnThe study is cross-sectional by design and applying a mullistage sampling technique arntotal of 582 women who had at least one live birth in lhe five years preceding the studyrnandlor pregnalll al lhe time of the sludy were selected from four kebeles. A univariale,rnbivariale and multivariale analyses were done using frequencies, x2 and binary logisticrnregressions, respeclively.rnAmong all women, 51.9%, 7.9% and 10.4% received antenatal care, professionalrnussisted delivery and postnatal care servias, respectively. From antenatal care servicernallen danis, about 35% of women received the service from health extension workers.rnWomen in Ihe health extension program il1lervenlion kebeles were more likely to receivern({menmal care service (OR= 7.090, 95% Cl= 4.450-11.297) and gave birth emended byrnprofessionals (OR = 3.018, 95% Cl1.019 - 8.939) than those in non interveillion kebeles.rnWithin women in the inlervention kebeles 75% were antenatal care allendant and 12.3%rnreceived professional aI/ended delivery care service whereas of women in nOllrnintervention kebeles - only 28.6 % and 3.4% of women were received antenataL andrnprofessional allended delivery care service, respeclively.rnThe overall impression given by this study is lhat, wOlllen in intervel1lion kebeles utilizedrnservices beller Ihan in non-intervention kebeles. The findings suggest that improvement ofrnmaternal health in rural areas would require the introduction of several measures, thernmOsl effeclive being the expansion of community level program interventions whilernstrengthening the available programs 10 provide quality service.