Tens of kilometres away from Kapenguria town, navigating its pristine hills, heading North West, you will come to Kongelai Centre.
A few shops run parallel to the tarmac road – a slice of modernity in a village still steeped in culture. At an open-air market, we find Cheposangiy*, a “mama mboga” (vegetable vendor), as she refers to herself. In her community, she is in the minority in using family planning. In fact, Cheposangiy secretly took up a permanent family planning method.
“Only my doctor knows,” she told us, asking that we should protect her identity.
“And your husband?” we prodded.
“That’s the point: he is never to know. If he knows he will mistreat me. He will hate me.”
Her husband has three wives. Cheposangiy is wife number two. Together, they have borne him 15 children, and counting. Of the 15, Cheposangiy’s are five.
To understand just how drastic Cheposangiy’s decision was, one only has to look at statistics.
West Pokot is among five counties that recorded the highest fertility rates in the Kenya Demographic Health Survey (KDHS) 2014.
Performance, Monitoring and Accountability 2020 (PMA2020) survey data from 2014 – 2018, show contraceptive prevalence– the proportion of women using (or whose sexual partner is using) contraception – in the county at 31 per cent.
Compare these to the national numbers: Kenya’s contraceptive prevalence as of 2020 was 60 per cent as per the same data. The national total fertility rate (TFR) – the average number of children each woman has during her lifetime – was 3.9 as of 2014, as captured by KDHS.
The latest data, contained in the 2022 World Population Data Sheet (WPDS 2022) by the Population Reference Bureau (PRB), released on the 8th of this month, shows that Kenya’s TFR has come down further to 3.3.
In West Pokot, TFR was at 7.2 in 2014 as per KDHS. “Right now it should be about 7.0,” Wilson Ngaren, the county Reproductive health coordinator, says.
As the world marked World Contraception Day yesterday, it is becoming clear that Kenya has made tremendous progress.
Dr Anthony Wanjala, an Obstetrician and Gynaecologist at Kapenguria County Referral Hospital, explains the importance of these numbers. “All over the world, a lower TFR usually corresponds to better health indicators like lower infant mortality as well as lower maternal mortality. West Pokot had infant mortality of 80 deaths per 1,000 live births compared to 39 in the nation. Maternal mortality ratio is at 565 maternal deaths per 100,000 live births compared to 362 nationwide,” he says.
WPDS 2022, which is released annually, shows that Kenya is ahead of its neighbours when TFR is used as a yardstick. Kenya’s TFR is better than Burundi’s (5.1), Somalia’s (6.3), Mozambique’s (4.6), Tanzania’s (4.7), Uganda’s (4.6), Malawi’s (3.9), Rwanda’s (3.8), and Zimbabwe’s (3.5).
The report further shows that at least 65 per cent of married women and girls in Kenya, ages 15 to 49, are currently using a modern family planning method. However, as already demonstrated, the numbers are far from homogenous. West Pokot County is one of the places lagging behind.
“After marriage, the goal of a Pokot woman – in the eyes of her husband and society – is to give birth,” says Cheposangiy, who dropped out of school in Class three.
The concept behind family planning, she says, hasn’t gained much acceptance in her community. “Not many women are on contraceptives. And even those using, the majority are doing so secretly – like myself,” she says.
Roseanne Kashor, well past menopause, says that the average Pokot man does not entertain the concept of family planning. “A man will beat you to a pulp if he knows that you are on contraceptives. Our society is still patriarchal.”
Kashor says she has witnessed many of her peers suffer such beatings. “I know a lady whose husband bumped into a family planning clinic card in the house. He beat her thoroughly.”
Why would men hate family planning? We posed the question to a few men in the streets of Kapenguria.
“For what?” one responded.
“Because God said we fill the earth. Why block God’s creation from emerging?” another said.
“Those are western ideas: it is not African,” another answered.
Dr Wanjala says that medics, as a matter of policy, talk to every woman who attends an antenatal clinic about family planning. “We usually ask the women to tag their husbands along. However, a typical Pokot man wants many children: the majority are against family planning,” he says.