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Published: April 5, 2024

Change in the Kenyan Health System: Lwala Co-CEOs reflect on 2023

The story of 2023 was one of change and growth–change in the Kenyan health system to prioritize community health, and the growth of Lwala to support more communities in making better health a reality. When we reflect on Lwala’s founding story, rooted in the dream of one community in Western Kenya to create access to health care where there was none, we can’t help but recognize how big this dream has grown–and the ripple effect it’s had on communities across Kenya.

We know that community health workers (CHWs) are the backbone of health care. For many years, Lwala and our partners have been advocating with CHWs to ensure that they are professionalized and recognized by the health system. This means paying CHWs and giving them the tools, training, and support they need to do their jobs well. Through Community Health Units for Universal Health Coverage, a coalition we co-founded, we made this a priority for candidates during the 2022 Presidential elections and then continued to build momentum through advocacy–culminating in the biggest legislative changes for community health in generations. 

These sweeping changes were threefold. In September, the national government began to distribute standardized kits to equip CHWs with supplies and medications needed for daily services. The government also launched new digital tools, which Lwala helped develop, to support CHWs in collecting household data. And finally, in October, we celebrated the passage of new legislation that codifies CHW payment and community leadership in health. But our work does not end here–it’s up to partners like Lwala to translate these policies into real change for communities across Kenya. 

At the same time, these national changes have enabled Lwala to grow faster and dream bigger, reaching even more geographies than we had planned for 2023–and we are on pace to reach all 1.1 million people in Migori County by the end of 2024. Additionally, we are now implementing an emergency obstetric care initiative in 5 counties, where we are ensuring that health facilities have the training and tools they need to respond to obstetric hemorrhage, the leading cause of maternal death. Over the next few years, we will be expanding this work on emergency obstetric care to 15 high-burden counties and the community-led health model to 5 counties, starting with Homa Bay and Baringo in 2024.

As always, we thank you for being on this journey with us. Together, we have improved health for communities near Lwala–and that has unlocked better health for all of Kenya.

In solidarity


Agency, health, and wholeness of life.

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