Skip to content

Rebekah McKay-Smith


Maternal and Newborn Improvement Project

Strengthening the health system to deliver quality services, and improve access for women in Western Kenya


Kenya has some of the highest rates of maternal and newborn mortality in the world, and the poorest women and children are the most affected. More than half of women give birth at home without skilled care. Only one in three health facilities provide basic maternity services and only one in ten hospitals provide basic emergency obstetric care. Access to services depends on where women live and their socio-economic status, and the lack of transport and finances often prevents many women from utilising care.

The Maternal and Newborn Improvement (MANI) project aimed to increase the survival of mothers and newborns by improving the delivery of health services, increasing the uptake of these services, and testing new innovations to catalyse change.

We worked in partnership with the Government of Kenya, health workers, community members, the media and partner organisations to improve health outcomes for mothers and newborns.

Strengthening the health system in Bungoma county

We supported the county government to manage and deliver quality health services for women and newborns, and to promote their use. This included improving health planning and budgeting, building leadership and governance capacity, increasing capacity to reach universal health coverage, and improved human resources management. We trained and supported health workers to provide high quality services and to use data to drive quality improvement and decision making. At the community level we provided vouchers for poor women to access free transport to a health facility for delivery, and we re-oriented traditional birth attendants to become referral agents for facility delivery. Aligned to national approaches, we engaged Community Health Volunteers to provide education and support, and increased dialogue between service providers and communities to promote accountability.

Testing innovations and taking proven approaches to scale

We managed the County Innovation Challenge Fund (CICF), which invested in novel ideas that offered life-saving solutions for mothers and newborns. The fund supported scaling up successful innovations that demonstrated impact in reducing maternal and newborn mortality. The CICF was open to international and national NGOs, civil- and faith-based organisations and the private sector. It operated in six counties; Bungoma, Garissa, Homa Bay, Kakamega, Turkana, and Embakasi and Kamukunji in Nairobi.

Increasing the visibility of priority maternal newborn health issues in the media

We built the capacity of local TV, radio and print journalists to disseminate key health information to the public, and to build informed dialogue through accurate health reporting and solution-based storytelling. We also worked closely with government officials to help them build effective media engagement strategies and communicate with the public more effectively.

Programme impact


Facilities able to provide EmONC services in 6 sub-counties in Bungoma, in 2018, up from 1 in 2014


Deliveries assisted by skilled birth attendants in 6 sub-counties in Bungoma increased from 41% in 2014 to 82% in 2018


Women received transport vouchers to reach health facilities for delivery

Focus areas
Maternal and Newborn Health
Quality Improvement Scaling Solutions
East Africa

Related content