Evidence from a number of studies globally has shown a reduction in maternal and perinatal mortality when women have a skilled attendant present at birth. In Kenya, a skilled attendant assists at only 42 percent of births. In Central Province, over 70 percent deliver with a skilled attendant compared to 28 percent in Western Province. Results from one district in Western Province where midwives were given the necessary equipment and support to assist women during birth at home, showed a significant increase in home births attended by skilled health workers between 2001 and 2003 and a similar decrease in utilization of traditional birth attendants. As noted in this brief, this an indication that skilled attendance in the community is possible and a good alternative for women who are unable to reach a health facility. Building on these results, a Community Midwifery Model was developed that focuses on empowering midwives living in the community to assist women during pregnancy, childbirth, and the postpartum period in their homes, manage minor complications, and facilitate referral when necessary and transfer to the hospital
