On September 26, Kenya will be among the nation-states commemorating the World Contraception Day.
World Contraception Day is an international campaign that focuses on the importance of contraception, child spacing and reproductive health.
The day aims to educate the population about the available family planning methods, and how and where to access family planning services.
While Kenya has made notable advances in family planning, the journey ahead demands a closer look at both the triumphs and the gaps that remain.
For starters, family planning is one of the best and most cost-effective investments to ensure the health and well-being of women, children, communities and the country.
It is an important intervention that can help contribute to key health benefits and spur economic development by empowering people to manage their family size, increasing women’s participation in the workforce, improving maternal and child health, enhancing education and increasing disposable income which can be invested in other vital sectors such as housing, healthcare and education among others.
In the last two decades, Kenya has made significant progress in promoting access to family planning and increasing the modern contraceptive prevalence.
Comparing the Kenya Demographic and Health Surveys over the years to the last one held in the year 2022, modern contraceptive prevalence rose from 39 per cent in 2003 to 57 per cent in 2022 for currently married women.
Unmet need for family planning, that is, those expressing a need for family planning yet are not using it, has reduced from 24 per cent to 14 per cent; teenage pregnancy from 23 per cent to 15 per cent and the total number of children on average per woman (total fertility rate) from about five children to about three children over the same period.
This progress in family planning has contributed to the reduction of maternal, infant and child deaths, with maternal deaths declining from 414 deaths in 2003 to 355 deaths for every 100,000 live births in 2019.
Infant deaths (deaths to children less than one year old) have declined from 77 to 32 deaths for every 1,000 children born alive and the deaths of children below the age of five declined from 115 deaths in 2003 to 41 deaths to every 1,000 children born alive in 2022 (KDHS 2022).
In 2022, the country reached 6,320,000 users with family planning services and as a result, it averted 2,380,000 unintended pregnancies, 591,000 abortions and 9,900 maternal deaths (FP2030 Annual Report 2022).
It should be noted however that this progress is still characterised by lack of equity and geographical disparities across the country, with the modern contraceptive prevalence among married women varying from as low as two per cent in Mandera county to as high as 75 per cent in Embu county (KDHS 2022).
The government of Kenya has made several global commitments touching on family planning including the Sustainable Development Goals target 3.7.1 to ensure universal access to sexual and reproductive healthcare services including for family planning, information and education, the ICPD25 commitment on zero unmet need for family planning and zero preventable maternal deaths and the Kenya FP2030 commitment to reduce unmet need for family planning from 14 per cent to 10 per cent by 2030. The country also aimed to increase domestic funding for family planning commodities procurement to 100 per cent by 2026.
In addition, Kenya is party to the African Union Agenda 2063, which recognises the need for a high standard of living, quality of life and well-being for all through expanding access to quality health care services, particularly for women and girls as a way of ending poverty, addressing the inequalities of income and opportunity, and facing up to the challenges of rapid population growth and urbanisation.
The legal and policy environment is favourable for family planning in Kenya. Both the Constitution and the Health Act provide the right to access reproductive health services, including safe, effective, affordable, and acceptable family planning services.
The Kenya Health Policy 2014 to 2030 recognises family planning as a strategic reserve for public health commodities and advocates ensuring access for all people to their preferred contraceptive methods as part of advancing human rights.
Over the years, the government has progressively increased domestic financing allocation for family planning commodities by allocating Sh785,863,863 and Sh1,190 million in the financial years 2019-2020, 2020-2021, 2021-2022 and 2022-2023 respectively (Kenya Medium Term Expenditure Framework).
The family planning programme is however faced with several hurdles including changing donor priorities leading to lowering aid to support the programme, global health emergencies disrupting service provision and sociocultural barriers that hinder the widespread acceptance and adoption of family planning particularly in marginalized communities.
It is important to note that every shilling spent on family planning saves Sh4.48 in direct healthcare costs. The annual cost of pregnancies is approximately Sh24.9 billion.
Investing in family planning could potentially lead to Sh1.94 billion in savings associated with healthcare costs for the management of unintended pregnancies. Universal access to family planning has the potential of saving the country nearly Sh7.85 billion annually.
Contraceptive use reduces maternal and child deaths and improves women's health by preventing unintended and high-risk pregnancies.
The use of contraception prevents pregnancy-related health risks for women and associated infant risks and complications. When births are separated by less than two years, the infant mortality rate is 45 per cent higher than when births are spaced two to three years.
Further, it has been proven that family planning contributes to savings that can be channelled towards achieving other development goals. Rapid population growth increases the demand for housing, especially in urban areas, resulting in the proliferation of informal settlements and associated challenges.
As the country celebrates World Contraception Day 2024, it is imperative to take into cognisance that family planning is to women what immunisation is to children, in ensuring health and quality population for the country.
There is, therefore, a need to not only preserve the gains made in family planning but also to scale up access to high-quality, accessible, equitable and acceptable family planning services across the country since family planning is a key contributor to Kenya’s broader development agenda.
Director general, National Council for Population and Development. www.ncpd.go.ke. [email protected]