Afya kwa Ukoo (Health of the Clan): The Effect of Cultural Institutions and Culturally-Sensitive Facility-Based Delivery on Maternal and Newborn Health Service Utilisation and Outcomes Among Pastoral Dropout Populations in Garissa, Kenya

Project Period

August 2017 - April 2019

Project Partners

  • County Innovations Challenge Fund (CICF)

The Afya Kwa Ukoo (Health of the Clan) project is a collaborative formative study between the African Population Health and Research Center (APHRC), Sisters Maternity Home (SIMAHO), and Preventative Health Care and Epidemiology Consultancy (PHCEC).

The study aims to test strategies that may increase the number of births that take place in health facilities  and improve uptake of other maternal and child health services in Garissa Township, Kenya. The study is testing a package of two innovative community-and facility-based interventions to:

  • Increase demand for maternal and newborn health services working with the traditional clan system; and
  • Improve the birthing experience in institutions by providing culturally and socially sensitive and acceptable delivery services at health facilities.

The interventions are designed to increase demand through influencing clan, religious and community leadership to break social barriers to seeking health services. Additionally, we involve men to champion use of maternity services and encourage women to take up services through mass-media health education, and a network of Community Health Volunteers. We also hope to improve quality of care through improving the cultural competency of health providers and making improvements to health facilities themselves.

The project uses a quasi-experimental design with one community with two health facilities as the intervention site and another community with one health facility as the control site. To be able to measure outcomes, we are using a rigorously monitoring and evaluation framework with before and after surveys, service data, qualitative interviews, and process evaluation.


  • Start date: August 2017
  • End date: April 2019


  • County Innovation Challenge Fund (CICF) with funds from the UK Department for International Development


  • Abdhalah Ziraba
  • David Wambui
  • Coralie N’Gbichi
  • Isaack Kisiangani