Maternal and reproductive health outcomes in Kenya require improvement. There is policy interest in community-led health initiatives, particularly those from West Africa, to address systemic gaps in service delivery and access. This policy analysis critically examines the structure and outcomes of community-led health initiatives in West Africa to derive evidence-based recommendations for adapting similar models within Kenya's maternal and reproductive health policy context. A qualitative policy analysis was conducted, involving a systematic review of published programme reports, policy documents, and grey literature on West African community-led initiatives. Thematic analysis identified key operational components, enablers, and constraints. Successful initiatives consistently featured structured community health worker programmes with formal linkages to primary care facilities. Sustainable local funding mechanisms were critical, as opposed to reliance on short-term external grants. Initiatives that integrated training for traditional birth attendants reported higher proportions of facility-based deliveries. West African community-led models offer valuable lessons for Kenya, particularly in formalising community health roles and financing. Direct replication without significant adaptation to Kenya's distinct socio-cultural and health system architecture is unlikely to succeed. Kenyan policymakers should prioritise: 1) developing a national framework for accrediting and remunerating community maternal health volunteers; 2) piloting locally-managed health fund initiatives at the county level; and 3) integrating community dialogue structures into existing reproductive health outreach programmes. community health, policy analysis, maternal health, reproductive health, Kenya, West Africa, health systems This analysis provides a structured comparison of West African community health models, translating specific operational insights into actionable policy recommendations for Kenyan programme designers and government stakeholders.
Mwangi et al. (Thu,) studied this question.