Just two years ago, Masimba Sub-County Hospital in Kisii County faced a crisis. The rural facility struggled with high stillbirth rates and frequent emergency referrals, with staff feeling unprepared for life-or-death moments in the maternity ward.
Between 2021 and 2023 alone, the hospital recorded 18 stillbirths. Nurses often faced obstetric emergencies, like postpartum hemorrhage (PPH) or pre-eclampsia, without the confidence to act.
“You’d get obstetric emergencies like shoulder dystocia while on call and not know where to start,” recalls Beatrice Kwamboka, a nurse with 20 years of experience. “You’d do your best, but without proper knowledge, we often had to refer critical mothers to higher-level hospitals. Often, it was too late.”
The trajectory changed with the introduction of MENTORS, a sustainable initiative by Jacaranda Health designed to support mastery of Emergency Obstetric and Newborn Care (EmONC) through in-facility, on-the-job training, with learning data being fed in real-time to a dashboard called PULSE for resource management.
Today, the story is different. Through direct, targeted mentorship, the hospital has achieved a remarkable milestone of zero stillbirths and no maternal deaths in 2024 and 2025. Nurses who once referred cases now confidently manage emergencies, ensuring mothers and newborns receive timely, life-saving care close to home.
Bringing Mentorship to the Frontline
The turnaround began when eight nurses at Masimba joined the mentorship program under the guidance of in-facility mentor Caroline Murori, who has led the initiative for over 18 months.
“In-facility training saves time and money,” says Nurse Christine. “Everyone learns together, and we apply the lessons immediately.”
Nurse Caroline takes a one-on-one approach, mentoring each nurse individually to build confidence and accountability. “It opens honesty, respect, and teamwork,” she says. “We used to refer cases that could be managed internally. Now, our nurses handle them independently.”
The impact of this autonomy is tangible. “One night, a mentee on duty handled a postpartum hemorrhage case alone.” Nurse Caroline recalls proudly, “She stabilized the mother, led clinical officers in treatment, and saved her life. Before, that mother might have died waiting for the doctor.”
Through drills, bedside coaching, and debriefs, the mentees practiced what they learned in real time, often while managing real emergencies.
“Since joining the mentorship program in January, I’ve gained the skills to handle emergencies I once couldn’t manage. In April, I was the only nurse on duty when I encountered a case of shoulder dystocia. Using what I’d learned, I guided even the subordinate staff on what to do and safely delivered the baby. That moment gave me so much confidence.” Nurse Beatrice recalls.
Graph Source: Jacaranda Health PULSE Dashboard
From the PULSE data, the evidence is clear. As a result of the 37% increase in staff knowledge and skill set improvement, preventable stillbirths also dropped from seven in 2022 to zero in 2024 and 2025, reflecting both improved competence and renewed confidence among the team.
Data Driving Change for Better Maternal and Neonatal Outcomes
According to Elizabeth Nyabicha, the County Reproductive Health Coordinator, data from Jacaranda’s PULSE dashboard is helping facilities act faster and smarter.
“We monitor indicators like Postpartum Hemorrhage, obstructed labor, among others, then target mentorship where it’s needed most”, says Elizabeth.
Using dashboard insights and feedback from mentors and mentees, the county has improved how resources are distributed, ensuring that every facility is equipped to respond to obstetric emergencies.
“The county has allocated resources to ensure that every facility has at least one NASG (Non-Pneumatic Anti-Shock Garment, a medical device used in emergency obstetric care to manage severe hemorrhage) to assist in the practical drills done during the mentorship training,” says Elizabeth. They currently have 15 NASGs and are working on getting them to each county facility.
For Masimba, the biggest win is sustainability. “Mentees become mentors, and the skills never leave the building,” says Caroline.
What once felt like a crisis has turned into confidence. Masimba Sub-County Hospital is now a model for how frontline mentorship saves the lives of mothers and babies.