Mildmay Kenya: Safe Motherhood Project
Donor support funded an emergency tuk‑tuk ambulance to serve the 12,000 inhabitants of Mageta Island, improving access to maternity care, HIV services and outreach across difficult terrain.
Context and need
Pregnant women on Mageta Island, off the eastern shores of Lake Victoria near Siaya County, faced basic, overstretched healthcare and dangerous delays in emergencies. With no hard roads or cars, and the health facility far from most homes, women often walked miles or rode precariously on motorbikes. Evidence showed a 7% drop in facility use for every kilometre of distance, and two‑thirds of women living with HIV were unlikely to access vital pre‑ and postnatal care. These barriers contributed to preventable deaths of mothers and newborns.
Intervention
With community support and donations, Mildmay Kenya purchased and deployed a modified tuk‑tuk ambulance in 2018, in partnership with the Siaya County Health Management Team. The vehicle navigated Mageta’s terrain safely, provided on‑the‑road emergency obstetric care, and acted as a mobile treatment room between emergencies. The project anchored on Kenya’s Community Health Strategy, with Community Health Volunteers (CHVs) as frontline providers, and integrated maternal, child health and HIV services.
What the project provided
Safe transport for pregnant women to Mageta’s community health facility, enabling skilled/facility deliveries (about 234 deliveries within ~24 months).
Postnatal care including HIV testing and linkage to treatment and PMTCT (Prevention of Mother‑to‑Child Transmission).
Training for 30 CHVs in emergency obstetric care; each CHV covered ~100 households.
Increased access to antenatal and postnatal care (ANC/PNC) and general services through regular outreach.
Stronger referrals, with the ambulance coordinating transfers to mainland facilities for complications.
Health education for households on the importance of dedicated maternity services and HIV testing.
Ongoing outreach and health gains
Monthly outreach ran at four beaches: Kabraua, Sika, Kuoyo and Mahanga, bringing services to where women worked, prioritising pregnant and lactating women and children under five. The ambulance supported HPV vaccination (rolled out nationally in 2019) by ferrying vaccines to schools, ensuring high uptake among 10‑year‑old girls, and later delivered long‑lasting insecticide‑treated nets as part of malaria prevention campaigns. Community health workers used the tuk‑tuk as a mobile clinic to extend care into villages.
Community impact:
More than 6,000 women were reached annually through programme activities.
Maternal deaths and mother‑to‑infant HIV transmission decreased, improving health across the island’s 12,000 residents.
Trained CHVs provided maternity and emergency care, shared knowledge, and strengthened household‑level adherence and follow‑up.
The ambulance became community property, with local structures supported to run it sustainably.
Visibility of the service prompted local political action to improve roads from villages to the health centre.
Practical changes
Women in labour could call the driver directly, reducing home births and risk. Complicated cases were stabilised and transferred in time for evacuation to mainland care. The ambulance’s presence improved routine access, and its mobility enabled rapid responses during outbreaks and campaigns.
This photograph is of a cervical cancer screening and vaccination outreach where we gave out Information, Education and Communication materials about HIV and other healthcare issues to schoolgirls.
About Mageta Island
Home to ~12,000 people, Mageta’s economy centred on fishing and subsistence farming. Communities faced isolation, minimal infrastructure, high HIV prevalence, child mortality, widespread malaria and TB, and maternal mortality exceeding national averages. Scarce resources and harmful practices, including wife inheritance, early marriage, and “sex for fish”, increased infection risks.
The main health facility, adapted from colonial‑era detention cells, served the entire island amid devolved health system gaps in drug supply and investment.
Outcomes
A more robust maternal healthcare system able to manage emergencies and achieve successful births the majority of the time.
Continuous support for mothers throughout pregnancy and childbirth.
Improved health literacy and access among high‑risk groups.
Tangible progress toward healthier, longer lives across the community.