Despite the tremendous resources invested in training Traditional Birth Attendants (TBA) over the past two decades, scientific evidence from around the world has shown that training TBAs has not reduced maternal mortality. Any improvement observed when TBA training programmes have been introduced was because of the associated supervision and referral systems, and because of the quality of essential obstetric services available at first referral level.  Since TBAs are highly regarded by their communities, it is critical that they still be encouraged and enabled to play a role in improving maternal health. The Kenya Safe Motherhood Demonstration Project (SMDP) has identified the contributions that TBAs can make, so that they are incorporated into a national plan for maternal and neonatal health during the transition to Skilled Attendance at birth.