Local voices know best: how community-led, locally-relevant adaptation is transforming maternal health in Narok, Garissa and Meru in Kenya.
Kenya is not one health story, it’s many. From the arid lands of Garissa, to the culturally rich plains of Narok, and the fertile slopes of Meru, each county paints a unique picture of the maternal health landscape. Yet across these diverse settings, a shared truth persists: too many women still face life-threatening barriers when trying to access maternal and child health services.
At Child.org, we believe that sustainable change starts with the community. By embracing community-led adaptation, we are supporting local solutions that reflect the lived experiences of women, aligning with Vision 2030, Sustainable Development Goals (SDGs) 3 and 5 and the Maputo Protocol.
Sustainable Development Goals
The Sustainable Development Goals (SDGs) are a universal call to action for “peace and prosperity for people and the planet”. There are 17 goals and Child.org works primarily towards two of them:
- SDG 3 focuses on ensuring healthy lives and promoting wellbeing for all at all ages.
- SDG 5 aims to achieve gender equality and empower all women and girls.
Vision 2030
Vision 2030 refers to the global goal of achieving Universal Health Coverage (UHC) by 2030. UHC means everyone has access to quality health services without financial hardship.
Maputo Protocol
The Maputo Protocol – known as the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa – aims to promote and protect the rights of women in Africa across political, social and economic spheres.
Maternal health landscapes: three counties, three contexts
Meru
Meru, more agriculturally stable, shows progress but still faces maternal health gaps. Teen pregnancies are rising and rural areas continue to lack well-resourced facilities. Community Health Promoters are active but often under-supported.
The county has seen positive momentum in integrating youth-focused reproductive health programming, yet systemic support and consistent supervision remain challenges.
Garissa
In Garissa, the environment is harsh. With an arid climate, water scarcity and scattered nomadic populations, pregnant women often travel over 10 kilometres to reach a health facility. Weak health systems means limited staffing, few supplies and minimal supervision of Community Health Promoters (CHPs).
Social norms also influence care-seeking; many women must seek permission from male family members, and early marriage is still common. Yet CHPs remain a crucial link, offering essential antenatal advice and acting as first responders in emergency referrals.
Narok
Narok, home to predominantly pastoralist communities, faces its own maternal health challenges. Cultural practices like female genital mutilation (FGM) and early marriage increase maternal health risks, while the vastness of the county and poor infrastructure limit access to care.
Women may choose to deliver at home due to cultural expectations or the fear of discrimination in health facilities. In this context, community-led dialogue and culturally sensitive health promotion are essential.
Community-led adaptation – local voices know best
Child.org’s work in these counties is rooted in the belief that local voices know best. Through community-led adaptation, we co-design interventions that respond to real, on-the-ground needs in the different counties:
- In Garissa, we integrate climate-resilient health solutions, such as mobile outreaches.
- In Narok, we partner with traditional leaders and women’s groups to shift harmful norms through respectful, inclusive dialogue.
- In Meru, we support Community Health Promoters with data tools and health education materials tailored to mothers, alongside a male participation component to engage men in offering support to pregnant women.
Across all three counties, we see overlapping systemic issues: fragile referral systems, underfunded community health networks, climate-related health access disruptions and gender inequality in decision-making. These barriers demand cross-cutting solutions that strengthen the foundations of the Community Health Strategy and foster collaboration between government, civil society and the private sector.
Pathways to Vision 2030 and the SDGs
True progress toward Vision 2030 and the achievement of Universal Health Coverage (UHC) requires more than policy – it demands investment in people. Community-led adaptation ensures that maternal health interventions are locally relevant, sustainable and equity-driven.
Our work supports SDG 3 by improving maternal and child health outcomes and SDG 5 by empowering women as health leaders and decision-makers. It also brings to life the Maputo Protocol’s call for the right of women to health and reproductive care.
Maternal healthcare for all – one step at a time
Kenya’s counties may differ in culture, climate and infrastructure, but the commitment to better maternal health can be shared. Through community-led adaptation, Child.org is building systems that listen to women, empower Community Health Promoters and strengthen health networks from the ground up.
This is how we turn commitments into action and action into impact – one mother and one community at a time.
Banner image: ‘Afya ya mama, ubora wa jamii’ means ‘Healthy mums, healthy communities’ in Kiswahili. Photo shot by Jeff Mbugua at a health outreach in Narok, Kenya.