Why Sakaja should rethink decision to tax family planning services

Governor Johson Sakaja. [PCS]

Access to affordable family planning services is a crucial component of public health and social development, yet it remains a challenge for many women and girls in Kenya. Family planning empowers individuals and couples to make informed decisions about the number and spacing of their children, ultimately improving maternal and child health and promoting economic stability.

Kenya has a high unmet need for family planning, and although this has been a priority for the government, recent developments in the political arena have threatened to worsen the situation. Unfortunately, these challenges are compounded by ill-informed and misguided policies and actions by lawmakers and decision-makers, which threaten to further exacerbate inequalities and widen disparities in family planning access and usage.

For instance, in its Finance Act, 2023, Nairobi County has introduced charges for family planning services at its Level Four hospitals. 

Traditionally, family planning services have been considered essential and provided free or at a minimal cost to ensure accessibility. However, changes in tax policies have led to an increase in the cost of contraceptives and related services. This move is not only retrogressive but also does a disservice to the millions of young people who need accurate and age-appropriate information on sex and reproductive health.

One of the immediate consequences of taxing family planning services is reduced accessibility. Many Kenyans, particularly those in low-income communities, rely on these services to plan their families effectively. With the proposed financial burden of taxes, access to contraceptives and family planning counselling becomes more difficult for those who need it most. By denying young people the tools and knowledge to make informed decisions about their sexual and reproductive health, we risk exposing them to unintended pregnancies, unsafe abortions, STIs, increased maternal mortality rates, and overburdened healthcare facilities.

While the intention may be to raise revenue, the unintended consequence is to make vital reproductive health services more expensive and therefore less accessible to the very people who need them the most. We are not even ready for how that would affect the health sector. This policy would have a disproportionate impact on low-income women and girls, who are already struggling to make ends meet and may have to choose between buying food or paying for contraception.

The impact of these policies and actions can be seen in the stubbornly high levels of unmet need for family planning in Kenya.

According to the 2019 Kenya Demographic Health Survey, 19 per cent of married women aged 15-49 have an unmet need for family planning, which translates to over one million women. This means they want to avoid pregnancy but are not using modern contraception due to various reasons, including lack of access, fear of side effects, opposition from their partners, and misinformation.

The impact of taxing family planning services extends beyond accessibility. It directly affects the health and well-being of women and children as they often bear the primary responsibility for contraception. Reduced access to these services can hinder women’s ability to make decisions about their reproductive health and limit their educational and economic opportunities.

The cost barrier may limit access to contraceptives and reproductive health services, particularly for low-income families, perpetuating cycles of poverty. Research indicates that when women have access to family planning services, maternal mortality rates decrease, and child health improves. Taxation can hinder progress in achieving these vital health outcomes, potentially reversing the gains made in recent years.

Nairobi Governor Johnson Sakaja should reconsider the decision to tax family planning services. Instead, his government should work towards making these services more affordable, especially for low-income individuals.

Ms Kathia is a sexual and reproductive health and rights and youth advocate at NAYA Kenya