Building Better Health Systems in Kenya and Guatemala through the Systems Enhancement for Transformative Health project

SETH project - Action Against Hunger

Health workers prepare the COVID screening station outside Naitili hospital in Kenya. Photo: Elphas Ngugi for Action Against Hunger, Kenya.

Every child deserves a healthy start in life, and this can happen only when women have access to quality maternal care. This means access to well-functioning health facilities and trained health professionals throughout pregnancy, childbirth and the post-partum period, as well as nutritious food and reliable information that allows women to make good choices for their own health and the health of their families.

Although maternal deaths have declined at the global level, they remain unacceptably high in many low-income countries. According to the World Health Organization, more than 800 women die every day from complications from pregnancy and childbirth. And while it is essential that preventing maternal deaths remain a top priority on the global health agenda, simply surviving pregnancy does not equate successful maternal care. In order for communities to thrive today and in the future, we must ensure that mothers and children can reach their full potential for health and well-being.

The Systems Enhancement for Transformative Health (SETH) project was designed to reduce maternal and child mortality and improve nutrition practices by strengthening local health systems, using a coordinated and collaborative approach to improving health for women and children. The $10.3-million, multiyear project was led by Action Against Hunger with funding from the Government of Canada, and targeted marginalized communities in Kenya and Guatemala shown to have high maternal and child mortality rates.

Watch the video to see how SETH has helped strengthen maternal, newborn and child health and nutrition services so new moms and babies can get a healthy start.

Improving training for healthcare workers

Most maternal deaths are preventable with prompt support by trained health professionals. SETH has helped equip frontline health workers with specialized skills to identify and manage difficulties during pregnancy and childbirth and promote healthy practices like breastfeeding. Read about one nurse’s experience here.

Making hospitals baby-friendly

The SETH project supported the construction of breastfeeding facilities and training of clinical staff on how to demonstrate the benefits of breastfeeding, share best practices, and foster the establishment of local support groups. These initiatives are helping hospitals in targeted communities work toward the Baby Friendly Hospital designation and implement the Ten Steps to Successful Breastfeeding.

Promoting gender equality

Promotion of gender equality was central to the SETH project. The project was designed in alignment with Canada’s Feminist International Aid Policy with activities targeting the needs and priorities of women and engaging female health workers, increasing their capacity to support improvements in women and children’s health.

Building strong partnerships

The SETH project brought Action Against Hunger together with partners including the Guatemalan Ministry of Health and Ministry of Agriculture, the Kenyan Ministry of Health, Doctors of the World, Helen Keller International and the Association of Research and Social Studies (ASIES) in order to realize our project goals.

Spreading knowledge and sharing key health messages

Education and access to reliable, high-quality health information is a powerful tool for influencing women’s health. Through the SETH project, Action Against Hunger implemented Maternity Open Days and community gatherings where expectant mothers and caregivers could meet health professionals, visit their local maternity ward, and learn about reproductive care, nutrition, disease prevention and other health topics in a supportive environment.

Going for the Goals

The SETH project supported a number of the Sustainable Development Goals, which provide a shared blueprint for peace and prosperity for people and the planet, now and into the future. SDGs supported by the SETH project include:

  • SDG 2: End Hunger through food security and nutrition programming
  • SDG 3: Good Health and Wellbeing through improving health service delivery at the local level, along with nutrition and sanitization practices
  • SDG 5: Gender Equality through activities targeting the needs and priorities of women and promoting gender equality as a cross-cutting theme for development programming
  • SDG 6: Clean Water and Sanitation through COVID-19 response, training and provision of handwashing stations and hygiene kits
  • SDG 16: Peace, justice and strong Institutions through a focus on health systems strengthening
  • SDG 17: Partnerships for Goals through active partnerships and memberships in Maternal, Newborn and Child Health and Nutrition networks


The SETH project was undertaken with the financial support of the Government of Canada provided through Global Affairs Canada (GAC).


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