Sherry Wamunyenga, a mother of two residing in Ebutanyi village, Vihiga in Kenya, was first introduced to her local mother-to-mother support group while pregnant with her first child. Now, several years later, Sherry has assumed the role of “lead mother” – the designated person who helps facilitate the group’s activities. She’s paying it forward by empowering other women in her community with the knowledge they need to embark on a positive pregnancy experience, setting the stage for a mom to have the support and know-how to take care of their own health and that of a newborn.

Mother-to-mother support groups are community-based initiatives that harness the power of peer support to equip mothers and pregnant women with knowledge and skills to ensure healthy pregnancies, safe childbirth and optimal postnatal care. Led by a “lead mother”, the group offers a safe haven where members are able to learn, share experiences and challenge societal myths surrounding motherhood and childcare.

In Kenya, where preventable deaths among mothers and newborns still occur due to delayed interventions, these support networks emerge as lifelines, bridging gaps in access to timely care and accelerating maternal and newborn health and nutrition. The most recent Kenya Demographic Health Survey highlights a marginal improvement in the reduction of neonatal mortality rates, with a minor decrease from 22 to 21 deaths per 1,000 live births observed between 2014 and 2022. Additionally, maternal mortality remains a concern in Vihiga County, as indicated by the 2019 Kenya Population and Housing Census, which reported a ratio of 393 deaths per 100,000 live births attributed to pregnancy-related causes.

Sherry’s mother-to-mother support group is supported through domestic funding from Nutrition International’s joint partnership agreement with the County Government of Vihiga. The partnership connects advocacy and nutrition financing efforts to build political will for nutrition, as well as mobilize increased resources and formulate policies and legislation to guide key nutrition interventions. Nutrition International supported the development of Vihiga County’s County Nutrition Action Plan (CNAP) – a five-year strategic roadmap to tackle county-specific nutrition issues.

“Nutrition International provides technical support so that counties can develop evidence-based nutrition action plans,” said Stephen Mwangi, Senior Program Officer, Maternal and Newborn Health and Nutrition, Nutrition International. “This is the basis upon which resource mobilization happens.” Each CNAP identifies prioritized interventions to achieve county-specific key objectives and estimates the cost of implementing these interventions. Subsequently, the interventions and activities are financed through the domestic resource mobilization model, where county governments and Nutrition International engage in a mutually agreed commitment to match funds, with each party contributing 50% of the program budget.

“Nutrition is important to us because nutrition constitutes what life is,” said Hon. Wilber Ottichilo, Governor of Vihiga County, recognizing the pivotal role of timely quality nutrition in improving maternal and neonatal health outcomes. “If you want to deal with health matters in a prudent manner, nutrition should take the front stage. It’s nutrition that dictates the wellbeing and health of a human being.”

Vihiga’s CNAP outlined scaling up maternal, infant and young child nutrition through intensified advocacy, nutrition education, communication and social mobilization using community support groups to promote positive nutrition behaviours as a priority. Alongside funding mother-to-mother support groups, the program provides capacity building, including refresher training sessions, educational resources and job aids.

Sherry is responsible for recruiting new members to the group, facilitating meetings and sharing key messages to foster awareness and enhance care-seeking behaviours among members. She takes great pride in her role as “lead mother”, a position she assumed following rigorous training sessions supported by Nutrition International and the county. These sessions equipped her with a wealth of knowledge on fostering healthy habits from conception through the first 1,000 days.

“I was so happy to teach other mothers what I had learned from the training and that is how I became their leader,” Sherry reflected. Beyond the initial training, she continues to receive ongoing support through coaching, mentorship and follow up training from healthcare workers at the community and facility level. This ensures that the support group’s activities and messages align with globally accepted recommendations for maternal infant and young child nutrition.

Guided by the Anzilisha, or Right Start booklet that outlines key messages for mothers during the first 1,000 days, Sherry and her fellow lead mothers work in tandem with community health volunteers to disseminate accurate and standardized information. Group members meet regularly to discuss various topics related to maternal and newborn child health and nutrition, including the importance of early and frequent antenatal care visits, iron and folic acid supplementation, delivery under a skilled birth attendant, exclusive breastfeeding and more.

The members and their families are experiencing positive changes at home. Guided by Sherry’s leadership, the mothers in her group have been cultivating and maintaining kitchen gardens to introduce an array of nutrient-rich vegetables into their family’s diet and support their children’s development. Emphasizing variety, group members reciprocally exchange their yield with each other to address any nutritional gaps. “This way everyone gets something. If someone gives me what I don’t have, I give them what they lack,” Sherry shared. Moreover, if a mother’s produce flourishes abundantly, she can sell the surplus yield and use the proceeds earned to purchase protein-rich foods to include in their family’s diet.

Taking personal responsibility for overseeing the progress of this community initiative, Sherry visits each mother’s home, ensuring not only the existence, but also the functionality of their kitchen gardens. “As their lead,” she asserted, “I need to know if they are well and if their children are well.”

Acknowledging the pivotal role men play as champions of gender equality, Sherry actively fosters an environment within her group where mothers are prompted to engage in open discussions about maternal health and nutrition matters with their partners. Reflecting on her personal experience, she shares how conveying the significance of male involvement to her own husband resulted in a notable shift – he began accompanying her to antenatal care visits and assumed additional household duties, such as cooking and cleaning. “That has helped the community,” she said. “When people see that Sherry was taken to the hospital by the baby’s father, they also try to go with their partners.”

Susan Koli agrees. Currently seven months pregnant with her second child, she finds immense support in her husband, who faithfully accompanies her to her antenatal care visits at Emuhaya Sub-County Hospital in Vihiga County, emphasizing their joint commitment to a healthy pregnancy and safe delivery.  For Susan, this shared experience has been invaluable, as it allows her husband to directly receive the same knowledge, empowering him to be an even more supportive partner. “It’s important to have my husband with me when going for antenatal care. He gives me the confidence to have him there and he can also provide encouragement,” she explained.

The program is delivering measurable results. “We have seen the frequency of women attending antenatal care in Kenya has gone up,” said Mwangi. “In the country, close to 90% of pregnant women are giving birth in health facilities.”

The 2022 Kenya Demographic Health survey revealed improvements in the coverage of maternal and newborn health and nutrition interventions. Over the years, the percentage of women receiving at least one antenatal care visit from a skilled health care provider has climbed steadily from 87% in 2003 to 98%. Similarly, attendance at antenatal care visits during the critical first trimester has increased from 10% in 2003 to an 29%. Equally encouraging is the rise in the proportion of women completing four or more antenatal care visits, increasing from 47% in 2008-09 to 66%.

Enhancing maternal and neonatal outcomes remains a priority for the County Government of Vihiga as the county works towards reducing the number of preventable deaths among mothers and young children. At the heart of the domestic resource mobilization initiative lies county ownership, a principle that not only demonstrates a long-term commitment to addressing local issues, but also fosters sustainability beyond the lifespan of external funding sources, driving change from within.

“We have established a nutrition coordination unit, meaning that this is now a permanent program within our county,” underscored Governor Ottichilo. “We are looking forward to continue working with Nutrition International and other partners, but when they are all gone, we will continue and we will not stop because we have put a solid foundation in place on which to operate forever.”

With Nutrition International’s support, Vihiga County will continue building the structures and required capacities essential for planning, implementing and monitoring maternal health and nutrition interventions long after development partners end their support.

As for Sherry, her determination to continue spreading awareness and knowledge within her community burns brighter than ever.  “My greatest joy is seeing children and pregnant mothers healthy,” she said. “It motivates me to continue impacting them, giving them the strength to keep going. That’s what truly motivates me to be a lead mother for my group.”

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