Women have the right to decide if and when they will have a child. In Kenya, the right to reproductive health services for every individual is enshrined in our constitution for this reason. Access to modern contraceptives is critical in ensuring that this right is upheld.
Access to a full range of modern contraceptives is essential; however, supply and demand side barriers continue to affect access. Insufficient health care financing and poor supply chain management are among the major barriers that limit access to contraceptive choice.
Although Kenya has made significant progress in modern contraceptive uptake to 53% in 2014 (1) government commitment in policy formulation, programme implementation and budget allocation to financing Family Planning commodities that allow for increased contraceptive choice attributed to the gains before the advent of devolution of health services.
With an emerging youthful population comprising of about 24% of adolescents, with some regions at the sub-national levels having as high as 40% aged between 15-19 who have begun child bearing, nearly 23% of the teenagers do not want to have a child and are not using an Family Planning method (1).
Unmet need for Family Planning (spacing and limiting) and unmet need for spacing is higher for 15-19-year-old married females than older married females, 23.0% and 21.8% respectively. Additionally, vulnerabilities related to unintended pregnancies that result in unsafe abortions, such as vesicovaginal fistula are among some of the challenges that the health care system undergoes (1).
The costs related to the treatment of some of these conditions are enormous. Investing and prioritising increasing contraceptive choice and targeting interventions among the adolescents and youth are essential in reducing costs associated with unintended pregnancies within the health care system.
Inadequate funding for Family Planning commodities reduces contraceptive choice and may consequently reverse the gains made for Kenya. Currently, efforts are being made to close the Family Planning commodity gap through the Global Financing Facility (GFF). The procurement process for the current financial year (2017/18) is ongoing.
Despite this development, a recent assessment of the availability of modern contraceptive methods in health facilities shows that 94.0% of them had at least three modern contraceptive methods, whereas as the modern contraceptive choice increased to five methods, the number of health facilities decreased to 79.8%.
In Eastern Africa, 1.2 million unintended pregnancies would be averted annually, including 478,000 births, if the unmet need for adolescent modern contraception was met (2).
In Kenya, if more investment is put in increasing contraceptive choice to more long-acting and reversible contraceptive (LARCs) methods which are more cost-effective with higher efficacy; targeting adolescents and increasing modern contraceptive to an ambitious mCPR of 64,7% by year 2020, Kenya would avert 7.75 million unintended pregnancies, avert 1.4 million unsafe abortions as well as 20,670 and 144,175 mothers and children respectively would be saved from death (3).
In terms of health care costs savings related to the treatment of some of the conditions associated with pregnancy and child health, Kenya would save Kes 61.49 billion which can be reinvested back in increasing access to contraceptive choice.
These funds can be used in the following ways:
- Ensuring provision of age and developmentally appropriate contraceptive services;
- Ensuring adequate stocks of the modern methods at the health facilities. This would expand method choice, pre-service and in-service training of health care workers to be able to effectively communicate and counsel young people, including dispelling myths and misconceptions around long-acting and reversible contraceptive (LARCS) methods and partnering with the adolescents and youth to design appropriate, contextually-relevant and effective strategies to increase their self-efficacy (4).
Engagement of the community will be essential in addressing social norms and dispelling stigma and discrimination.
E4A-MamaYe ask the Kenya government to increase financing for procurement of modern contraceptives to ensure expanded method choice for women including adolescents and youth.
Access to family planning (FP) is a universal human right that is enshrined in Kenya’s constitution.
Provision of expanded contraceptive method choice will not only saves lives, but also improve the lives of girls, mothers, and children.