Lwala Community Alliance

In Kenya, 70,000 mothers and children die each year. Marginalized communities bear the highest burden of loss–just 15 of Kenya’s 47 counties contribute to 98.7% of maternal deaths. Many women in rural areas must travel great distances to access health care for themselves and their families, but they are often met with undertrained, underequipped staff who cannot provide the lifesaving care they need. This has led to a breakdown in trust between the community and the health system, and a hesitancy to seek services. When women forgo antenatal care or deliver at home, the risk of maternal and infant death drastically increases–and most of these deaths are preventable.

Communities are the largest untapped resource in improving health for all. For too long, health programs have been designed from the top down by international organizations, technical experts, and donors who lack context-specific knowledge. Instead, communities should be in the driver's seat–they can identify challenges and solutions that are rooted in lived experience. Community-led health is uniquely positioned to transform health outcomes for all, especially women, children, rural populations, and other marginalized communities.

Lwala was founded by a community that dared to fight back against health inequity. In 2007, the community of Lwala, Kenya was suffering from the dual burden of high maternal mortality and HIV prevalence. Rather than wait for help to come, village members donated their own land, resources, labor, and expertise to build Lwala Community Hospital. Over time, one hospital in one community has grown into a full-scale movement for community-led health–a movement poised to transform Kenya’s health system. We are enabling community health workers (CHWs) to bring services to every household, improve the quality of care at health facilities, strengthen community accountability and decision-making, and partner with governments to adopt policies and practices that strengthen the health system.

Our evidence demonstrates how community-led health improves health outcomes, especially for women and children. In Lwala-supported communities, for example, the skilled delivery rate is consistently 99%, under-5 mortality has significantly decreased, and CHWs are 5 times more likely to be knowledgeable of danger signs in pregnancy and infancy. As we expand community-led health across 5 counties, we will see increases in skilled delivery, antenatal and postnatal care, and immunization coverage.

We are also on a mission to transform health care for all 47.5 million people in Kenya by changing systems and policies that improve community-led health. Through evidence and advocacy, our consortium has already seen great success in advancing this cause–including Presidential statements on paying CHWs, county legislation to strengthen community health, and policies that increase access to lifesaving care for obstetric hemorrhage. With your support, we will expand this work to save lives, secure healthy futures, and demonstrate our core belief: when communities lead, change is lasting.