2017 Lwala Annual Report
In 2007, Kenya faced the compounded crises of HIV, maternal death, and post-election violence. In that vulnerable time, a community banded together to build health solutions that could combat these threats. Our co-founder, Milton Ochieng’ captured his community’s spirit when he declared:
“We dared to have hope in the dark.”
Through a combination of local ingenuity and allegiance with world-class partners, Lwala Community Alliance was born. And today, our organization is so much more than just a hospital - it is an entire community-led health model making drastic improvements in health outcomes: a 64% reduction in child mortality, 97% skilled delivery rate, virtual elimination of mother-to-child transmission of HIV, and a 300% increase in contraceptive uptake.
This success has shown that when we put our faith in bottom-up solutions, we can create light in the midst of darkness. And so, Lwala is driving forward in our effort to build a county model of community-led health. In the next few years, we’ll reach a population of one million people, slash maternal and child mortality, and position ourselves for nationwide scale.
Once again, we have an opportunity to prove that when communities lead, change is drastic and lasting.
Every Mother Deserves Health
Central to our model is the recruitment of traditional midwives. These women have delivered healthcare to their communities for generations. But because traditional midwives have been cut off from the formal health system, these births are often dangerous for mothers and babies.
We leverage the deep connections of these midwives and train, pay, and supervise them as professionalized Community Health Workers. Lwala Community Health Workers identify pregnant women as they proactively visit homes in their village. Then, they link mothers to the formal health system by identifying early symptoms of high-risk pregnancies, ensuring adequate maternal nutrition, and encouraging safe delivery at a facility. They also follow-up on postpartum care, provide breastfeeding support, and counsel new mothers on a wide range of contraceptive options.
Percentage of Skilled Deliveries
Contraceptive Prevalence Rate
Percentage of Women Using Contraceptive
Couple Years Protection
A Measure of Birth Control Provided, Based on the Number of Years of Pregnancy Prevention it Provides
Every Child Deserves a Fifth Birthday
In rural Kenya, 8% of children die before their 5th birthday, a rate 12 times higher than the United States.
Community Health Workers enroll children at birth, track child growth, and manage immunization timelines. They provide home-based screening for the most deadly childhood conditions, including malaria, pneumonia, respiratory infection, malnutrition, and diarrhea. When a child does get sick, Community Health Workers provide care and treatment in the home and refer complicated cases to the local clinic - making certain that no child slips through the cracks.
Infant Mortality Rates
Percentage of Children Who Received All Specificed Vaccines
1. Kenya Demographic Health Survey (2014)
2. Unpublished data. Starnes JR, Chamberlain L, Sutermaster S, Owuor M, Okoth V, Edman W, Moon TD: Under-Five Mortality in the Rongo Sub-County of Migori County, Kenya: Experience of the Lwala Community Alliance 2007-2017 with Evidence from a Cross-Sectional Survey.
Every Child Deserves Nutrition
Adequate nutrition is crucial during the first 1,000 days between conception and a child’s second birthday:
- 45% percent of child deaths are linked to malnutrition.
- Stunting due to malnutrition in early years of life leads to poorer cognitive skills and educational outcomes.
- Maternal malnutrition has a direct correlation with an increased risk of infant death.
We screen households for vulnerability, provide therapeutic food and supplements, enroll families in gardening and nutrition training, and follow up regularly to monitor growth.
Building a Ladder to Nutrition Security
Clean Drinking Water
Every Family Deserves Safe Water
In Kenya, water-borne illness is the number one cause of premature mortality.
Improved sanitation reduces diarrhea morbidity by 38%. Therefore, village level Water, Sanitation, and Hygiene (WASH) teams promote the adoption of safe water and sanitation infrastructure. Through Lwala’s community-led process, community members construct latrines and secure water sources, which ultimately lead to village-wide declarations of Open Defecation Free status.
Percentage of Population Treating Water Prior to Drinking
Every Family Deserves an AIDS-Free Generation
97 youths in Kenya are infected with HIV daily.
Lwala provides comprehensive HIV programming aimed at empowering people with HIV to lead healthy and productive lives, while eliminating new infections.
Participants in a Lwala program called HAWI (“Good Luck” in Dholuo) provide psychosocial support to each other and launch their own community health initiatives. Each participant in these groups is also visited regularly by a Community Health Worker.
“I’m proud of our invention because we are helping other young people avoid becoming HIV positive.”
Youth Peer Providers, comprised of young people across every Lwala community, are trained to provide reproductive health services and HIV prevention information to their peers. They are also encouraged to develop their own initiatives, which is exactly what Michel did.
Michel and his fellow YPPs launched Dial-a-Condom, which they describe as “Uber for Condoms.” Two young people in each village are stocked with condoms and their cellphone numbers are distributed to a network of youth who can request condoms on demand.
Center of Excellence
Every Community Deserves a Center of Excellence
Every Child Deserves Quality Education
Girls’ education is a powerful lever of community health.
For every year a girl remains in school, the likelihood of an unwanted pregnancy or HIV infection decreases. And, studies show that children of educated moms have better health outcomes.
We work with 13 government primary schools, partnering with communities to launch their own solutions and advocate within the education system.