The clash between counties and the Kenya Medical Supplies Agency (Kemsa) has eroded family planning gains, with four of 10 pregnancies now being accidental.
Most public hospitals fail to stock family planning commodities, leading to an increase in unintended pregnancies, a survey released Thursday has revealed.
Most hospitals ordered the supplies but did not receive them because of logistical and payment issues.
“If you have pending bills with Kemsa, then you don’t get the supply of family planning commodities,” Prof Peter Gichangi, the principal investigator for Performance Monitoring Action (PMA) in Kenya said.
This could be the reason the country has recorded a decrease in the number of women using family planning methods from 30 per cent to 21 per cent on short-term methods, and the high rate of unintended pregnancy that stands at 44 per cent, Prof Gichangi said.
“This has a ripple effect — many women are becoming pregnant, abortion cases are rising, leading to more complications during childbirth. We need to make the commodities accessible,” he said.
The data, collected in 11 counties between November and December last year from 9,478 females aged 15 to 49 years, revealed that the number of unintended pregnancies was highest in younger people (15 to 19 years) at 60 per cent.
It also showed that slightly less than 50 per cent of young people between 15 to 18 years are sexually active and only about 11 per cent of them are using a family planning method, although they want to prevent pregnancy.
“There is a huge disconnect between the desire to use (a family planning method) and availability in terms of access, and this puts the women at risk of becoming pregnant,” Prof Gichangi said.
A review of the data by the PMAs phase 1 results revealed that out of the 784 public hospitals, 86 per cent of facilities ordered for the implant but did not receive shipment.
Additionally, 86 per cent did not receive injectables, 80 per cent did not recieve pills, 66 per cent did not get IUDs and 68 facilities ordered for male condoms but did not receive the shipment.
The implant was found to be the most preferred method of contraception among married users, with usage significantly increasing from 20 per cent in 2014 to 41 per cent in 2019.
It is, therefore, no surprise that one in 10 public health facilities did not provide at least three modern contraceptive options in 2019 as shown by the survey.
The male condom is the dominant method among unmarried adolescent contraceptive users at 33 per cent, followed by implants at 30 per cent and injectables at 20 per cent
The survey also indicated that health facilities and pharmacists offer more family planning methods at 100 per cent, hospitals and health centres at 96 per cent, while dispensaries offer the lowest at 89 per cent.
On the other hand, dispensaries are the most preferred sources of contraceptives among adolescents and young women.
“Unfortunately, most young women and adolescents frequent dispensaries more for family planning services, yet they are the least stocked facilities in the country,” Prof Gichangi said.
In Kenya, as in many other African countries, sustainable and prosperous families have been the aim of a strong family planning drive, grounded on the constitutional right of access to health services, including reproductive healthcare.
Kenya has the lowest fertility rate per woman in the East African Community (3.7), according to "The Power of Choice: Reproductive Rights and Demographic Transition", a report by the United Nations Population Fund. This is a drop from 4.45 in 2012.
Preliminary results from the 2019 census show that the average annual population growth rate dropped to 2.2 per cent from 2.9 per cent a decade ago, and the average household size also dropped to 3.9 from 4.2 in the same period.