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Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels. In addition, the project focused on strengthening referral practices and addressing factors responsible for delays by pregnant women in making decisions on when, where, and how to seek care. Findings show that the project has made substantial progress in the area of maternal health as well as in the broader health system issues through building partnerships, supporting and strengthening community action, use of skilled attendance at birth and having in place a strengthened and supportive health management system at all levels. The report includes recommendations based on the project’s experience on ways to increase utilization of maternal services in order to improve maternal health in Kenya, especially for poor women.