Bernadette Samura remembers the tears in the maternity ward. Not the tears of pain or fear during delivery, but the tears that came later.

After being discharged with healthy babies, some of the mothers she had cared for would break down instead of celebrating.

“Weren’t you happy to go home with a healthy baby?” she recalls asking one of them.

“They were tears of worry, fear and anxiety,” she says. “This is a baby that was born but put in a machine.”

It was those moments that inspired Samura to start Mom and Me Home Care, a company that sends trained midwives and nurse assistants into people’s homes to support mothers during the weeks after childbirth.

Samura trained as a nurse in Kenya before moving to Australia in 2010, where she continued to work in healthcare. There, she came across a government-funded postnatal care programme in which a community health worker visits every new mother the day after she returns home, regardless of her financial situation.

The workers checked breastfeeding, screened mothers for depression, and assessed homes for safety.

“They will look and say, “Are you sleeping with the baby in your bed or is the baby in their cot?”’ She says.

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In Kenya, she says, this responsibility has traditionally been taken on by extended family and the community, leaving many mothers without organised support when these networks are unavailable.

This issue became deeply personal to Samura when she returned to Kenya, and her own babies were admitted to intensive care. As she observed other mothers in the neonatal unit becoming overwhelmed as their discharge date approached, her friends and former colleagues, who knew her as a midwife, began contacting her for advice on breastfeeding, formula feeding, and newborn care.

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“That was actually the beginning of me thinking, wow, we need a whole service to support mothers,” she says.

What began as informal help for friends gradually evolved into a business.

“First, you provide informal support, then you provide formal support,” says Samura.

She officially registered Mom and Me Home Care in 2024, the same year that she returned to Kenya permanently. Her first clients came through word of mouth, including referrals from a doctor who remembered her from her earlier nursing career. Since then, growth has largely been driven by referrals, church networks, and mothers recommending the service to one another.

Currently, the company primarily serves clients in Nairobi, Kajiado, Machakos and Kiambu counties, but Samura says her team will travel anywhere in the country if support is needed.

Most caregivers are locums, mainly midwives and nurse assistants, who indicate their availability each week. There is also a small permanent team responsible for administration, scheduling, IT and marketing.

“If I have an influx of mothers, I have more staff,” she says. “If they drop down, the team goes down.”

Client assignments are managed through dedicated software, while Zoom is used for consultations and Calendly for bookings.

Samura says that every caregiver must be a mother herself because “none of this will resonate with those without children”.

Midwives and certificate-trained nurse assistants undergo additional training under her supervision, covering infection prevention, newborn care, and recognising the early signs of postnatal depression, such as withdrawal, guilt, fatigue, and a loss of interest in the baby or surroundings.

Care is tailored to each family rather than being sold as a standard package.

After consulting with the family, support can range from a few hours a day to round-the-clock care for several weeks. Daily rates generally range between Sh7,000 and Sh9,000, but vary when a registered nurse is required, for example, for babies discharged from intensive care.

Learning to price the service sustainably was one of Samura’s earliest business lessons.

Initially, she charged too little, often paying for client care out of her own pocket while still covering staff salaries and office expenses.

“I forgot that I still needed to pay the market,’ she says. “I still need to pay the office overheads.”

She also realised that one- or two-day engagements rarely solved families’ problems, with many returning weeks later to face the same issues.

“It’s too hard work,” she says. “It doesn’t support the ecosystem of women, and clearly it’s breaking the continuity of care.”

Each client receives a written care plan before services begin, while the company tracks complaints and outcomes throughout the engagement.

Samura has also built a referral network that includes psychologists, doctors, a cleaning company, and even a travel agent. This allows families to access trusted providers without having to search for them themselves.

“You don’t want to second-guess other service providers,” she says. “You go to the people you trust.”

She is also keen to distinguish her service from that of a nanny, a comparison that people often make.

“I have never seen a nanny who is trained in postpartum care,” she says, noting that her staff can identify symptoms of depression, maintain infection control standards, and establish routines that allow mothers to rest and recover.

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She recalls one family who nearly fell apart after the birth of their child.

The mother became critically ill after an early induced delivery and was admitted to intensive care, leaving the first-time father alone with a newborn.

“The father was so scared of carrying this baby,” says Samura.

Her team helped to establish routines at home, sourced newborn-sized nappies, and guided the father through basic baby care, supporting the family for more than four weeks. They also taught the baby’s grandmother how to use equipment such as electric sterilisers, which she had never used before.

“The baby has done very well,” says Samura. “The father was feeling very confident by the time we handed over.”

She is particularly proud that none of the mothers cared for by Mom and Me has developed severe postnatal depression.

Samura also says that fathers who initially feel overwhelmed often become confident caregivers by the time her team has finished working with them.

Studies estimate that postpartum depression affects between 10 and 27 per cent of mothers in Kenya. A study at Kenyatta National Hospital (KNH) found a prevalence of 10.6 per cent six weeks after delivery, while research at Aga Khan University Hospital (AKUH) reported a rate of 13.8 per cent.

Mom and Me operates within a growing postnatal support industry in Kenya, where services are increasingly offered by doulas who assist women during pregnancy, childbirth, and the weeks afterwards.

Kenya recognises two types of doula: birth doulas, who support mothers through pregnancy and labour, and postnatal doulas, who provide care after delivery.

Looking ahead, Samura hopes the model will influence public policy.

“If we don’t start opening these conversations with people in positions of power, this will only be a service for the rich,” she says.

She believes that programmes such as Linda Mama, which she wishes could be reinstated, could eventually incorporate structured postnatal home support while still allowing private providers such as Mom and Me Home Care to serve families seeking additional care.

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lowoko@ke.nationmedia.com