The community midwifery model in Kenya: Expanding access to comprehensive reproductive health services at the community level

Abstract

The ‘community midwifery approach’ is an innovation involving the engagement of skilled midwives residing in communities to take critical maternal health services to women's homes, thus improving maternal, newborn and infant health. This paper is based on a study that aimed to assess the effect of expanding community midwives’ mandate to go beyond the provision of delivery services alone, to incorporate a more comprehensive package of reproductive health and HIV services. This operations research project involved pre- and post-intervention data collection without a comparison group to assess intervention effects. The project was implemented in the Bungoma and Lugari Districts of Western Province, Kenya. Findings from the project indicate that the expanded community midwifery model improved clients’ access to a comprehensive package of family planning, reproductive health and HIV services at the community level. However, the intervention was less successful in improving the provision of a continuum of care by community midwives.