Busia County, a vibrant border region in Kenya, once struggled with high rates of home deliveries assisted by untrained Traditional Birth Attendants (TBAs), putting mothers and newborns at risk of complications like postpartum hemorrhage and neonatal deaths. Poverty, cultural beliefs, and logistical challenges, such as long distances to health facilities and fears of mistreatment by medical staff kept many women away from skilled care.
But through a community-driven approach, the County achieved a remarkable change, eliminating unskilled home deliveries in Kamuriai Location and creating a model for others to follow.
This began by recognizing that TBAs, though untrained, held deep trust within the community. Instead of sidelining them, the County engaged them as allies, offering training on safe delivery practices and transitioning them into roles as birth companions. These TBAs now escort mothers to health facilities, bridging the gap between tradition and modern medicine. At the same time, local chiefs, Community Health Promoters (CHPs), and religious leaders spearheaded village dialogues and public forums to educate families on the dangers of home births and the benefits of facility deliveries. Men were actively involved, helping to shift household attitudes and ensure women had support throughout pregnancy.
Collaboration between the County, DANIDA Primary Healthcare (PHC) Program, and local stakeholders provided resources for training and health worker incentives. Community Health Committees and village elders reinforced accountability, ensuring the message reached every household. The results were transformative: Kamuriai location saw a complete shift to skilled facility deliveries, with TBAs playing a key role in referrals and building trust in the healthcare system.
What initiative has your County taken to encourage safe childbirth deliveries?
Visit https://maarifa.cog.go.ke/ to learn more about the successful initiatives on service delivery our Counties are undertaking.