Boda girls save mothers one free ride at a time

Motorbikes branded "Boda Girls" are used by women riders in Ukwala to transport pregnant women from across Ugenya Sub-County, in an initiative supported by Matibabu Foundation Hospital. [Maryann Muganda, Standard] It's a hot, windy afternoon in Ukwala, Ugenya Sub-County in Siaya County. Trees sway lazily along clean roads, their branches whispering in rhythm with the wind. Motorbikes hum through the streets, weaving between locals seated under sheds escaping the sun. I am riding on a boda boda or as they call themselves here, a Boda Girl, as we make our way to Nyaholo. My rider, Faith Achieng', is a mother of one and among the few women in Ukwala operating an electric motorcycle taxi. Her pink motorbike, boldly branded Boda Girl, glimmers in the afternoon sun. As we ride, she tells me how she is helping reduce maternal deaths in Ukwala. Working with the Matibabu Foundation Hospital, Faith offers free transport to pregnant women, ferrying them from their homes to the hospital for antenatal clinic visits. "I started this in 2024," she says. "We carry the women for free, we don't charge them anything. It's only for pregnant women. In a month, I carry around 35 of them for their ANC visits. When their babies are about six weeks, 14 weeks and three months old, we still carry them to the clinic always for free." The Boda Girls are more than just riders, they are agents of change. Supported by organisations such as the Matibabu Foundation and the Tiba Foundation, this initiative is improving access to maternal healthcare while advancing women's economic empowerment in the region. As the sun shines brighter overhead, we arrive at the home of Veronica Adhiambo in Nyaholo. Her house sits quietly by the roadside, half-hidden among trees. Her four-month-old son, cradled in her arms, is the child she almost lost, the one she carried for 10 months and two weeks. Veronica gave birth to her first child at 18, her second at 21 and her third baby, Scavian, at 25. "With my second-born daughter Esther, I had some complications," she recalls, "but nothing compared to what I went through with this one," she shares. "When I got pregnant, I started feeling unwell very early," she says softly. "Within two months, I was sick almost every day. By the sixth month, I nearly had a miscarriage. I was admitted at Ukwala Sub-County Hospital Level 4 for one week." Tracy Nicole Otieno, 23, a mother of two at her home in Siranga. [Maryann Muganda, Standard] Later, when doctors did another ultrasound, they said her baby had "knelt" inside her stomach. "It was painful and uncomfortable. The doctor even recommended an operation, but I didn't go for it. Luckily, things improved with time." Unlike her previous deliveries, Veronica gave birth at Matibabu Foundation Hospital. "It was safer there," she says. In Siranga village, Tracy Nicole Otieno, 23, sits outside her house, her three-month-old daughter resting in her arms. Her first pregnancy was smooth, but the second was different. "At first, I didn't even know I was pregnant. I just kept getting sick," she says. "When I went to the hospital, the doctors tested me for typhoid. For four months I was terribly sick-I even got admitted at some point. The doctors never really explained what was wrong." Before her second month, Tracy started bleeding. At Ukwala Sub-County Level 4 Hospital, she felt dismissed. "The doctors and nurses dismissed my symptoms. They didn't do thorough checkups. I felt ignored, so I stopped going there." Veronica Adhiambo Onyango, 25, a mother of three at her home in Nyaholo, Ugenya Sub-County. [Maryann Muganda, Standard] With the help of Boda Girls, she sought care at Matibabu Foundation Hospital, where doctors took her concerns seriously. "They did screenings and an ultrasound and found that my baby was lying on my ribs. That's why I was in so much pain." At eight months pregnant, Tracy contracted malaria. "My whole body was aching," she says. Despite her weakness, she delivered safely. But recovery wasn't immediate. "A week after giving birth, I got malaria again." Now, Tracy faces another challenge: low breast milk supply. Maternal health complications remain a major concern in Kenya, with recent trends showing persistent challenges despite progress in reducing maternal mortality. The Kenya Health Information System (KHIS 2024) shows that maternal health complications remain a major concern nationwide with Postpartum Haemorrhage PPH and Obstructed Labour emerging as the top contributors. Between 2022 and 2024, cases of Postpartum Haemorrhage rose from 19,584 in 2022 to 17,962 in 2024, showing only a slight decline after peaking in 2023 at 18,152 cases. This persistent high burden underscores the slow progress in controlling PPH, especially in rural counties like Siaya, where access to emergency obstetric care remains uneven. Increased facility-based deliveries and community health programmes have improved outcomes, but gaps remain in emergency obstetric care, timely referrals and access to blood transfusions. Dr Moses Obimbo, a consultant obstetrician and gynaecologist, describes cases like Veronica's as "classic examples of how small complications can quickly spiral into life-threatening conditions if not properly managed." In Veronica's case, the prolonged pregnancy and breech presentation signal major risks. "When someone says the baby is kneeling, it usually means the baby is presenting with the buttocks or legs first instead of the head," Dr Obimbo explains. "This is called a breech presentation. When this happens, delivery can become dangerous." Obstetric emergency He adds that pregnancies should never exceed 41 weeks and three days. "Beyond that, we consider it dangerous for both mother and child. Post-term pregnancies can lead to fetal distress, stillbirth or excessive bleeding during and after delivery." On Veronica's prolonged bleeding during labour, Dr Obimbo says such symptoms should have triggered emergency intervention. "Bleeding before delivery is known as antepartum haemorrhage, and it's always treated as an obstetric emergency. If real bleeding occurs and the mother is left to continue labouring for hours, both lives are in danger." Turning to Tracy's case, Dr Obimbo notes that malaria in pregnancy is extremely dangerous. "It can cause inflammation of the placenta, what we call placental malaria, which affects blood flow to the baby. This can result in low birth weight, preterm delivery or even stillbirth." On Tracy's intermittent milk production, he lists several likely causes: poor nutrition, dehydration, stress and hormonal imbalance. "Low milk supply can result from poor diet or iron deficiency, especially in mothers who suffered from anaemia during pregnancy." Kenya faces a maternal health crisis that disproportionately affects rural women. According to UNICEF's 2022 report, approximately 5,360 women die annually during pregnancy or childbirth in Kenya, a maternal mortality ratio of 355 deaths per 100,000 live births. While this represents a 52 per cent decline since 2000, the rate is not falling fast enough to meet the Sustainable Development Goals target of less than 70 deaths per 100,000 by 2030. Matibabu Foundation Hospital sits on the outskirts of Ukwala town, along the rough, dusty road to Lifunga. Within the compound, a group of women stands out, their pink-branded motorcycles parked neatly together. These are the Boda Girls, coordinating with hospital staff to ensure expectant mothers reach the maternity ward safely. Brian Omondi, a Registered Community Health Nurse, has worked at Matibabu for four years. "When it comes to maternal health, our facility is linked with the Boda Girls," he explains. "We are well-prepared because they help bring expectant mothers from even the most remote areas." Before the Boda Girls Initiative, many women struggled to reach the hospital. "Previously, we had what was called the MAMA Link, a referral system that helped ferry mothers in emergencies," he says. "Now, the Boda Girls have taken over that role." The partnership has made a huge difference. "When I joined, many women still gave birth at home," Omondi recalls. "But now, most come to the hospital. The Boda Girls bring them for ANC visits and during emergencies, they call the facility directly for help." According to Omondi, the hospital handles between 70 to 80 deliveries a month. "We've managed to keep cases of postpartum hemorrhage low," he notes. "In my four years here, we've had only about eight serious cases and all of them survived." Still, challenges persist. "Some mothers are afraid to come to the hospital because they think it's expensive," he says. "But our services are affordable. The problem is awareness and sometimes poverty." For Daniel Ogola, Founder and CEO of Matibabu Foundation Hospital, the idea behind Boda Girls is deeply personal. "When I was seven years old, I lost my younger brother, who was just two months old," Ogola recalls. "He died of severe malaria because we couldn't reach a health facility in time. My family couldn't afford care and accessibility was a major issue. That experience has haunted me all my life and it's the reason Matibabu exists." During the Covid-19 pandemic, the Foundation noticed troubling patterns. "We realised some girls were being exploited, offered pads or rides in exchange for sex by male boda boda riders," he says. "A few came back pregnant. That's when we thought: what if we trained women to provide safe rides for women and girls?" According to Faith Muasya, Programme Coordinator, the Boda Girls Initiative was launched in 2022 to address both healthcare access and gender-based exploitation. "We had incidents where male boda boda riders would take advantage of young girls," she explains. Since the introduction of the Boda Girls, cases of sexual exploitation by male riders have greatly reduced. "Now, the women of Ukwala can travel safely and confidently to the hospital," she says.

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