Kenya’s married and sexually active unmarried women have increased their use of contraceptives in the last decade with the most preferred methods being implants and injectables for family planning.
But unmarried go a step higher and include condoms into the mix, according to the latest statistics for 2019-2020 that also indicate that besides increased uptake, there has also been increased investment in the area.
Despite the progress, data shows unintended pregnancies-mostly unplanned and mistimed than desired- are still recorded across the globe.
In Kenya, unintended pregnancies stand at 41 per cent, 34 per cent were mistimed while seven per cent were unwanted as per the latest report by Performance Monitoring Action (PMA) under the International Centre for Reproductive Health.
The Covid -19 pandemic affected health programs and services delivery for about three and a half months with the consequence being 1.4 million unintended pregnancies, according to the World Health Organisation (WHO).
Prof Gichangi, the PMA principal investigator, explained that contraceptives were 75 per cent obtained from public health facilities while 25 per cent of women went to private facilities but about “13 per cent of facilities surveyed were either stocked out of supplies,” between 2020 and 2021.
There were huge stockouts for implants stood at 34 per cent between 2019 and in 2021 and “injectables also faced stockouts at nearly 30 per cent in 2021,” explained Dr Gichangi and “male condoms too faced stockouts at 16 per cent in 2021 and we see a similar pattern in private facilities.”
The income levels matters as the report indicate that while 81 per cent of wealthy women met their demand for family planning but demand stood at 69 per cent for the poorest women.
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The report further reveals that four out of 10 adolescents in Kenya have had sex out of curiosity while 15.9 per cent are forced and at least 64 per cent used a contraceptive method.
“We see adolescents are left behind, we need to look at programs which can help them access and use the methods when they require those methods,” said Prof Gichangi.
The Ministry of Health maintains that it’s illegal to offer family planning methods to children below 18 with severe consequences for culprits. The report, however, shows “16 per cent of adolescents reported discussing family planning with a health care provider or community health worker in the past year.”
Women who had similar discussions on family planning stood at 34 per cent for those aged between 20-24, and 32 per cent of those aged 25-49.
Violence against women and other harmful practices were to be reduced to zero but the report revealed that about “25 per cent experienced a form of violence in the last year with 80 per cent being emotional and seems to be overriding between intimate and non-intimate partners,” noted Prof Gichangi.
Interestingly, the majority of the abused at 59 per cent reported to their own families, 38 per cent spoke to in-laws, 15 per cent to friends or neighbours, and 14 per cent to religious leaders with police, lawyers, and doctors only receiving 12 per cent of the cases.
According to the United Nations Population Fund (UNFP), over 60 per cent of unintended pregnancies end in abortion be it safe, unsafe, legal or illegal.
Dr Stephen Kaliti, head of Reproductive and Maternal Health at the Ministry of Health said family planning is pivotal in cascading social determinants of health and “unmet needs for contraception decreased by seven per cent among all women in Kenya from 19 per cent in 2014 to 12 per cent estimated in 2021.”
Dr Kaliti adds that while at one time the government had zero budget for family planning today “we spend roughly Sh3.5 billion-Sh5 billion every year on matters dealing with family planning.”
The family planning report focused on 11 key counties representative of Kenya’s demographic including Nairobi, Nandi, Nyamira, Siaya, Bungoma, Kakamega, WestPokot, Kiambu, Kericho, Kilifi, and Kitui.
Prof Gichangi and his team obtained key information from the same women and households over three years. Besides regular tracking of progress, the researchers also studied the drivers and dynamics of contraceptive use.