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Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya

Mannah, Margaret, Warren, Charlotte, Kuria, Shiphrah and Adegoke, Adetoro (2014) 'Opportunities and challenges in implementing community based skilled birth attendance strategy in Kenya'. BMC Pregnancy and Childbirth, Vol 14, e279.

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Availability of skilled care at birth remains a major problem in most developing countries. In an effort to increase access to skilled birth attendance, the Kenyan government implemented the community midwifery programme in 2005. The aim of this programme was to increase women’s access to skilled care during pregnancy, childbirth and post-partum within their communities.


Qualitative research involving in-depth interviews with 20 community midwives and six key informants. The key informants were funder, managers, coordinators and supervisors of the programme. Interviews were conducted between June to July, 2011 in two districts in Western and Central provinces of Kenya.


Findings showed major challenges and opportunities in implementing the community midwifery programme. Challenges of the programme were: socio-economic issues, unavailability of logistics, problems of transportation for referrals and insecurity. Participants also identified the advantages of having midwives in the community which were provision of individualised care; living in the same community with clients which made community midwives easily accessible; and flexible payment options.


Although the community midwifery model is a culturally acceptable method to increase skilled birth attendance in Kenya, the use of skilled birth attendance however remains disproportionately lower among poor mothers. Despite several governmental efforts to increase access and coverage of delivery services to the poor, it is clear that the poor may still not access skilled care even with skilled birth attendants residing in the community due to several socio-economic barriers.

Item Type: Article
Additional Information: The electronic version of this article is the complete one and can be found online at:
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
WQ Obstetrics > Childbirth. Prenatal Care > WQ 152 Natural childbirth
WQ Obstetrics > Childbirth. Prenatal Care > WQ 160 Midwifery
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):
Depositing User: Lynn Roberts-Maloney
Date Deposited: 27 Mar 2015 10:20
Last Modified: 07 Jun 2022 11:10


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