Migori County suffers from some of the highest rates of maternal & child mortality and HIV prevalence in Kenya, including a maternal mortality rate of 673 per 100,000 live births, an under-5 mortality rate of 82 per 1,000 live births, & an HIV prevalence of 16-20% (compared to the national rate of 6%). The majority of the population is cut off from the formal healthcare system which results in dangerous home deliveries and lack of access to essential services, such as vaccinations & medication.
Lwala catalyzes the capabilities of communities to tackle the multidimensional drivers of poor health. In 2007, western Kenya faced the compounded crises of rampant HIV transmission & drastically high maternal & child mortality rates. This community donated community land & resources to build their region’s first clinic & develop holistic health solutions. Early in its founding, Lwala teamed up with the research prowess of Vanderbilt University, & began to rigorously measure its interventions.
Lwala serves a community of 90,000 people in rural western Kenya with an innovative community-led health model. The innovation brings community- and facility-based healthcare to the entire community, with a focus on vulnerable populations including women, children under 5, and people living with HIV. Lwala is in the midst of a rapid scale-up and will soon directly serve 150,000 people in Rongo Sub-County and influence how over 1 million people in Migori County access healthcare.
Mission and Vision
Lwala's mission is to empower rural communities to advance their own comprehensive wellbeing. By putting communities at the forefront of developing and implementing solutions to their own pressing challenges, Lwala seeks to create wholeness of life for the people we serve. By scaling our model countywide, we are expanding our community-led health model to over 1 million people. We plan to leverage our success in Migori County to influence the wider health system in Kenya.
Lwala is much more than a hospital—it is a community-led health model creating a drastic reduction in child mortality (from 105 to 29.5 deaths per 1,000 live births), a 98% skilled delivery rate, virtual elimination of mother-to-child transmission of HIV, gender parity in primary school completion, and a 300% increase in contraceptive uptake. Lwala works by placing communities at the forefront of the design, implementation, and evaluation of their own solutions to the multi-dimensional causes of poverty. Based on community demand and bottom-up program design, we develop public health, education, and economic initiatives that provide integrated services.
Our community-led health model includes four key pillars: community committees, health centers, Community Health Workers (CHWs), and data. The model is uniquely positioned for systems change and we are on track to influence how one million Kenyans access healthcare.
Based on the evidence of impact, we are focused on leveraging our learnings to build a county model of community-led health, and ultimately position the model for nationwide scale. We’ll start by scaling our community-led health model throughout all of Migori County – which represents one million people. Through a three-pronged approach – direct service expansion, peer replication, and government adoption – Lwala will support the Ministry of Health in building a “model county” for community-led health, ultimately influencing the wider health system in Kenya.
Lwala's model is unique because we combine grassroots organizing with robust data and rapid scale. Conventional wisdom dictates that locally-led solutions are inherently unscalable. However, we are proving that grassroots solutions are uniquely positioned for scale. We are demonstrating this principle by scaling our community-led health model countywide, influencing how over 1 million people access healthcare. Even while rapidly expanding our reach and impact, we continue to put communities at the forefront of everything that we do - engaging community committees as governance structures, hiring former traditional birth attendants as Community Health Workers, and partnering with the local government.
In addition, Lwala partnered with Vanderbilt University early in its history and we continue to engage the experts at Vanderbilt to rigorously measure our outcomes and design robust surveys. In fact, we recently published a study in the journal PLOS ONE on our impact on under-5 mortality.
Planned Goals and Milestones
We are in the midst of scaling our community-led health model throughout Migori County, influencing how over 1 million people access healthcare. In 2019, we will expand our direct reach from 60k to 90k & partner with the county government to implement countywide initiatives on obstetric hemorrhage & neonatal care. In 2020, we will expand our direct reach to 150k and partner with the county Ministry of Health to support government adoption of our community-led health model for the entire county.