Utilization of skilled maternal healthcare services during pregnancy, delivery and post delivery can reduce maternal deaths from preventable conditions.However, despite the usefulness of utilizing the skilled maternal healthcare services, utilization has remained low in Siaya County while women continue to die from preventable conditions.The aim of this study was to identify the correlates of utilization of skilled maternal healthcare services in Siaya County and consequently develop, pilot and evaluate a context specific framework for increasing utilization of skilled maternal healthcare services in Siaya County.Method:The study followed a three (3) phased approach, whereby baseline data was first collected from the study participants to ascertain their past maternal health services utilization experience ( antenatal, delivery and postnatal care services), followed by development and piloting of the framework which was informed by the findings of the baseline, and finally evaluation of the effectiveness of the framework.The framework was piloted through a longitudinal study involving 517 pregnant mothers with previous delivery experience from selected community health units in Siaya County.Statistical package for social sciences (SPSS) version 22 was used to analyze both descriptive and inferential statistics.Result: Indicate that both community and health facility factors affect utilization of skilled maternal healthcare services.Compared to the baseline, 4 th Antenatal visits increased from 58.7% to 63.9%, skilled deliveries from 55.7% to 64.6% and postnatal care services from 23.6% to 47.4%.Knowledge on available maternal healthcare services and danger signs also increased by 28.6% and 26.4% respectively.Of note is that compared to the baseline, continuum of care was also enhanced as the number of households visited by community health volunteers (CHVs) increased from 83.7% to 93.5%.an indication that there was increase in uptake of skilled maternal healthcare services. Conclusion:The framework was effective in increasing utilization of skilled maternal healthcare services in Siaya County and will be useful in providing guidance on designing and integrating context specific

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