Increasing Antenatal-to-Maternity Transition at Mater Hospital, Kenya | ACQUIRE QI-PS 2026

Anna Kahwai shares how the Mater Hospital team in Nairobi is increasing the proportion of mothers who move from the hospital's antenatal clinics to delivering in its maternity unit. Only 53% of antenatal mothers were confirmed to have delivered at the hospital. For the other 47%, the outcome was simply unknown, leaving a gap in follow-up and outcome tracking. The team set a SMART goal to raise antenatal-to-maternity transition from 53% to 75% between July and December 2026. Mapping the maternal care pathway, from birth planning through referral and handover to maternity, and a fishbone analysis and Pareto chart highlighted gaps in tracking expected delivery dates (EDD), reinforcing birth plans, following up mothers who missed appointments, and referral. The team standardised birth plan counselling from the first antenatal contact, reinforced at 28 and 36 weeks, strengthened EDD tracking with clear responsibilities and regular review, and introduced defaulter tracing. Their biggest surprise: counselling alone was not enough without reliable EDD tracking and follow-up. Transition improved to about 63%. Daily tasks now have clear owners in maternity and the antenatal clinic, with monthly reviews by the QI-PS team, and the team plans to extend the learning to other units. The hospital's sponsor praised the teamwork between nurses, doctors and heads of department. Team leadership: Anna Kahwai Sponsorship: Teresa Omoding Mentorship: Teresa Omoding Team: Ann Muchiri, Elsie Njambi, Judy Maina, Lucidiana Tabani, Maria Musa, Tony Opar Chapters 0:00 Introduction 0:14 Problem statement 0:43 Process map and root causes 1:24 Prioritisation and target 1:58 Changes made 2:46 What we learned 3:19 Sustain plan 3:46 Results and next steps 5:06 Feedback and celebration This project is part of the 2026 ACQUIRE Quality Improvement-Patient Safety (QI-PS) Experiential Leadership Program, where frontline health workers across sub-Saharan Africa learn improvement science by leading real change in their own facilities. Quality takes a team! Learn more: https://acquirefrontline.org #QualityImprovement #PatientSafety #MaternalHealth #Kenya #ACQUIRE