When you arrive at Lwala Community Hospital, you may first notice the local businesses that have blossomed around the hospital’s front gates: you’ll find women selling fresh fruit, a hairdresser (or kinyozi) shop, corner stores, and a motorbike (or boda boda) stand providing patients transportation to and from the facility. Upon entering, you pass a youth-friendly corner–a safe space for young people to learn about sexual and reproductive services. On your left is a farm (or shamba), modeling all the nutritious food an expectant mother needs to fuel her pregnancy. Before you even reach the hospital itself, you’ll already have seen an ecosystem where neighbors come together to build a healthier community.
“Lwala Community Hospital is not just a place for people to come when they’re sick,” says Robert Kasambala, Lwala’s Hospital Director. “It’s a place of hope for the people that walk in here.”
As Lwala advances community-led health across Kenya, our founding hospital is an exemplar of our values. The hospital remains deeply-rooted in the community while constantly pushing itself to reach the next level of quality service delivery. As a Centre of Excellence, it is devoted to continuous learning for Lwala staff and knowledge sharing to strengthen the wider health system. And our clinical team is driven by neighborliness and integrity, ensuring that the 88,000 patients who visited the hospital in 2024 feel their voices are heard and receive the quality care they deserve.“Lwala Community Hospital was the beginning of a movement,” explains Dr. Chad Ochieng, Lwala’s Medical Officer In-Charge. “We have created a system in which our community has the power to govern their health issues, and we are their catalyst for change.”
Rooted in community
What started as a two-bed clinic and an uphill battle against health inequity has since transformed into a full-scale movement for community-led health. In response to a crisis of HIV and maternal and child deaths, community members donated their land, labor, and resources to build their village’s first hospital. Just as this project was starting, its leader Eratus Ochieng’ passed away. Out of grief, two of his sons, Fred and Milton Ochieng’, joined the community project, and soon after helped to establish Lwala Community Hospital.
“The hospital and the community are one in the same,” says Karen Lisa Akinyi, Lwala’s Clinical Officer In-Charge. “We are here because of the community–one does not exist without the other.”
Since our inception, the community has been a critical part of Lwala Community Hospital’s success. Feedback mechanisms between the hospital and community members create space for feedback and discussion, pushing the hospital to higher levels of quality and excellence. The hospital launched a 24-hour hotline in 2023 to ensure that feedback, as well as emergency medical advice and ambulance services, are just a phone call away. The Lwala Village Development Committee has served as an important local advisory board, linking community interest and hospital leadership for nearly 17 years. When consultation is needed, the committee and hospital work together, negotiating a best course of action. Hospital staff also participate in monthly forums and host annual Community Dialogues, which draw together hundreds of community members and Lwala’s leadership team–fueling nearly two decades of creative, community-led solutions.
When the community calls
During a Community Dialogue in the summer of 2023, community members expressed the need for a full-time doctor to lower the number of patient referrals. By October 2023, Dr. Chadwink Ochieng Omondi–who grew up a stone’s throw from Lwala Community Hospital–joined as the Medical Officer In-Charge. Over a year later, patient referrals have dropped from an average of 160 monthly patients to just 61 per month. “I came here as a result of a Community Dialogue, so I’ll always appreciate them. They gave me a job!” jokes Dr. Chad.
Dr. Chad’s expertise in maternal and newborn care strengthens the hospital’s service delivery for mothers and children. One of his first initiatives at Lwala Community Hospital was instituting a weekly high-risk pregnancy clinic, which invites women with higher-risk medical histories to meet with Dr. Chad and receive specialized care for their conditions. Since the program's inception, the hospital has identified and mitigated further complications for 95 mothers with these personalized care plans.
As a champion of safe and skilled delivery, the hospital continues to be a first choice for expectant mothers, with 775 successful deliveries in 2024 alone. A patient satisfaction survey conducted in 2024 revealed that 100% of women who delivered at Lwala Community Hospital reported receiving respectful and compassionate care. “This is big,” says Dr. Chad, crediting the hard work of the facilities’ birth companions and clinical training on respectful maternity care. “It shows that our investments are paying off, and it’s a reflection of our commitment to true quality improvement.”
The Centre of Excellence
Lwala Community Hospital emerged as the “Centre of Excellence” when its proven success in maternal health outcomes and HIV care started drawing attention–neighboring public facilities began to reach out, expressing interest in shadowing our clinical team and learning from our community engagement structures. Over the past 18 years, this curiosity has evolved into a strong working partnership with the Ministry of Health. “We are not just a hospital. We are a place of learning,” Robert says. “Our successes can and are being scaled.” Lwala tests innovations and generates evidence of impact by piloting programs, including on-site at Lwala Community Hospital–based on our learnings, we work with government to expand these pilots to new geographies. The hospital has been a testing ground for successful, evidence-based training initiatives, such as our Obstetric Hemorrhage and Help Babies Breathe Initiatives, and we’ve partnered with leading North American and Kenyan universities to evaluate their impact.
Sylvia Rita, a newly hired nurse, reflects on her first six months at the hospital: “Lwala Community Hospital supports us to go to trainings, they provide fair transport reimbursement, and pay session fees if we are unable. It’s something I haven’t seen in other facilities–we really learn a lot.” In exchange for this support, staff members are responsible for sharing their new expertise with colleagues at the hospital’s weekly Continuous Medical Education meetings. Last year, the hospital also introduced Grand Rounds–a quarterly evaluation of the facility's most complex cases, where clinical staff study rarer diagnoses ranging from brain tumors to lymphoma. During these discussions, the clinical team assesses how to detect, handle, and refer these unique clients–sensitizing the staff on how to treat patients beyond the daily battles of malaria and HIV.
“The hospital leadership empowers us to think outside the box,” says Karen Lisa. “They fight for the professional growth of the clinical team.”
Supportive mentorship does not end with Lwala clinical staff. At Lwala Community Hospital, we welcome medical students from all over Kenya as well as our longstanding partnership with Vanderbilt Medical School. In 2024, over 100 nursing students from the Kenyan Medical Training College joined Lwala for their one-month rotations, receiving active training from our Clinical team and gaining hands-on experience providing high-quality care.
A lifelong commitment to quality
As we test new initiatives to train and equip health workers across the country, Lwala Community Hospital has become a training ground for innovative, high-quality primary health care. To evaluate the quality of our services, Lwala has turned to SafeCare–a third-party certification system that enables health care facilities to measure and improve the quality, safety, and efficiency of their services. Christine Onyango, Lwala Hospital Administrator, celebrates the success of Lwala’s most recent quality improvement initiatives: “In 2024, we received our highest SafeCare score to date.” This score marked an 18% increase in our rating since our 2023 assessment, ranking our performance as 34% percentage points higher than the average Kenyan facility. SafeCare’s international accreditation recognizes the facility's achievement of advanced performance in medical care and patient safety standards, reflecting the hospital's dedication to continuous improvement.
Even still, Lwala Community Hospital has eyes toward the future–achieving higher-quality of care, expanding our hospital campus, optimizing sustainability, training the next generation of primary health care workers, and equipping them with the best medical equipment possible. By looking inward to ensure all patients who walk through our doors receive high-quality, dignified care–and by looking outward to exchange lessons learned with partner facilities across Kenya–Lwala Community Hospital continues to transform the lives of patients and the health system nearly two decades after its founding.
