County health teams across Kenya face similar challenges: how to finance maternal health systems, strengthen referrals, and ensure facilities are ready to manage emergencies. Kenya has a devolved health system, meaning that counties are responsible for delivering health services, managing facilities, hiring health workers, and allocating budgets. This allows counties to tailor systems and services to local needs, but it also means that solutions often emerge in one county without easily spreading to others facing similar challenges.

The Kenya Quality Ecosystem (KQE) project works with counties to improve maternal and newborn health outcomes by strengthening how resources are allocated, how data is used, and how quality of care is monitored. Bringing counties together to share experiences has become an important part of this work, helping health leaders learn from one another and adapt solutions that have already been tested in similar settings.

In February 2026, health leaders from Mombasa, Kisii, and Makueni counties gathered in Mombasa for the third annual cross-county learning exchange. The meeting brought together County Executive Committee Members, Chief Officers, technical teams, and facility leaders to reflect on progress and share lessons from the past three years.

Ideas into action

Over the course of the project, counties have adopted a number of approaches first introduced by their peers and surfaced in the cross-country exchanges. As a result, cross-county learnings have: 

1. Strengthened emergency care systems. After learning from Kisii’s experience strengthening blood availability, Mombasa began working toward establishing its own county blood satellite. Kisii strengthened its referral processes by adopting standardized referral forms first introduced in Makueni.
2. Implemented clinical interventions. Mombasa introduced newborn monitoring equipment at a major county hospital after learning from Kisii’s approach to strengthening newborn care. The county also adopted Proximie, a tele-mentorship platform that allows surgeons to receive real-time support in the operating room, following a demonstration by Makueni. Makueni adopted the use of Non-Pneumatic Anti-Shock Garments (NASGs), a lifesaving intervention for postpartum hemorrhage, after seeing how other counties had implemented them. Heat-stable carbetocin, a medication used to prevent postpartum hemorrhage, was first introduced in Makueni and has since been rolled out in both Kisii and Mombasa.
3. Informed health financing. Discussions during the exchanges have helped counties strengthen how they track and manage resources for maternal and newborn health. In Makueni, county leaders introduced routine monitoring of Social Health Authority (SHA) reimbursements, including tracking the percentage of facilities receiving payments each month. The county has also begun automating parts of the facility budgeting process, improving visibility into how funds flow through the system and helping ensure resources reach priority services.
4. Reinforced the role of data in improving care. Both Kisii and Makueni strengthened their maternal and perinatal death surveillance and response (MPDSR) processes after learning from Mombasa’s approach to regular review meetings. 

The exchanges have shown how valuable it can be for counties to learn directly from one another. Many of the approaches shared during the convenings are now being adapted within county health systems. We look forward to continuing to strengthen systems as the Kenya Quality Ecosystem project expands to include Murang’a, Nakuru, and Kakamega counties.