Kenya moves closer to global family planning commitments

As part of its strategy to reduce maternal mortality, Kenya has selected four counties to intensify family planning among women.

Data from the counties show that the country is already reporting an increase, six years before the 2030 deadline. Kenya Health Information System study shows early successes in Isiolo, Makueni, Kwale, and Kakamega Counties.

The uptake of immediate postpartum family planning—the contraceptives offered to women within 48 hours after they deliver—increased fourfold on average, from 3.8% in January 2023 to 13.9% at the end of 2023. Kakamega (19%) and Makueni (17%) Counties recorded the highest uptake.

Isiolo, Makueni, Kwale, Kakamega, and other nine counties were once ranked as having the highest burden of maternal mortality, accounting for 98.7% of maternal deaths in Kenya. The counties have maintained their overall modern contraceptive uptake despite the COVID-19 pandemic interruption.

The Kenya Demographic Health Survey showed Isiolo’s modern contraceptive uptake increased from 26% in 2014 to 29% in 2022, and Kakamega from 60% to 63% in the same period. Kwale’s stagnated at 35%, while Kakamega declined slightly from 65% to 63%.

The positive statistics indicate Kenya is moving closer to achieving one of its eight global commitments: to increase the modern contraceptive rate for married women from 58% to 64% by 2030.

In the strategy, the National Council for Population and Development (NCPD)—the government body coordinating all population activities in the country—targeted counties where family planning use was below 35%.

In the commitment document, Dr. Mohamed Sheikh, Director General for NCPD, said family planning is much more than women delaying childbirth.

“The counties with the low mCPR also are among the counties contributing to the highest maternal and neonatal mortalities, hence will contribute to the improvement of maternal and child survival,” Dr Sheikh said.

A 2012 study published in the medical journal Lancet showed that family planning prevented 44% of maternal deaths in the world. The World Health Organization (WHO) recommends spacing pregnancies by two years or more following childbirth, and at least six months following an abortion, to allow the woman’s body to heal and prevent future complications.

Yet, studies have shown that half of all pregnancies in Kenya occur within short intervals of less than two years after the preceding birth. 15% occur within very short intervals of less than 12 months.

Isiolo, a county that recorded an increase in postpartum family planning from 0% to 6.3%, has taken unconventional methods such as including men in family planning discussions in health facilities and community gatherings. However, inadequate expertise and finances are often a stumbling block to counties’ efforts in providing postpartum family planning. The Council of Governors has encouraged counties to set up offices to look for and work with partners.

One of the partners that responded was the John Hopkins Affiliate, Jhpiego, through the project Accelerating PPFP Integration into Primary Healthcare in Kenya (APIP) to work in Isiolo, Makueni, Kakamega, and Kwale counties to train healthcare workers on how to give patients a wide array of family planning methods. The projects also purchased the latest tools for healthcare workers.

Dr. Njeri Nyamu, a public health specialist and the director of one of the projects that have supported the counties, Accelerating PPFP Integration into Primary Healthcare in Kenya (APIP), stated that successful family planning uptake is much more than clinical services.

“Counties are making all the effort to follow the WHO recommendations for family planning, but they need support for resources for training healthcare workers to enable them to provide adequate and comprehensive counselling to mothers and couples on the contraceptive options available, so they can make a choice that best fits their needs and intention for family size,” Dr Njeri said.

“This is not a healthcare workers’ affair alone; we work with community leaders and groups to address socio-cultural constructs, myths, and misconceptions that often negatively influence family planning uptake,” Dr. Njeri said.

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