Pharmacists, like Christine Atieno from Mediway Healthcare and doctors say women and men in Kenya are more open to contraceptive use now. CREDIT: Wilson Odhiambo/IPS
By Wilson Odhiambo
NAIROBI, Aug 28 2023 (IPS)
According to a family planning brief, more than 370 million women in middle and low-income countries were finally embracing modern contraception to help curb unintended pregnancies.
This statistic suggests that one in every three women from middle and low-income countries use contraceptives today.
Africa, which had the lowest number of family planning users in 2012, had registered a 66 percent increase, from 40 million to 66 million girls and women by 2022. Eastern and Southern Africa recorded the highest increase in family planning users at 70 percent.
Kenya was ranked among the sub-Saharan nations that had effectively managed to tame the population growth rate by educating and empowering women and young girls through family planning initiatives.
According to Kenya’s Ministry of Health, by September last year, at least 54 percent of women in the country had access to contraceptives, and the use of modern methods of family planning had increased from 18 percent in 1989 to 57 percent in 2022. This went a long way in helping it meet its FP2030 commitment plan.
The Kenya Demographic and Health Survey last year reported that there was a decrease in the fertility rate in women from 3.9 children per woman in 2014 to 3.4 children per woman in 2022. This decrease resulted in a slowed population growth rate from 3.4 percent in 2014 to 2.2 percent in 2022.
The report stated that amongst married couples, 47 percent of women wanted to have more children, while the case was 57 percent for men. Another 30 percent of women and 37 percent of men wanted to wait a while longer before having children. This showed that more women preferred to wait and decide when and how many children they wanted to have through family planning.
From the report, more women in rural areas were also opting to limit the number of children they were having as opposed to the past, where the decision was not easy for them to make due to factors like lack of education, traditions, and limited access to health facilities.
Among the educated group, 84 percent of married women with primary school education and 94 percent of married women with secondary school education did not want more children. This showed how big a role the level of education played in the use of contraceptives.
A look at the counties showed that urbanised areas, where more people had access to education, had a low fertility rate in comparison to the marginalized counties with limited access to proper education.
For instance, the counties with the lowest fertility rates included Nairobi, Nyamira, Machakos, Kirinyaga, Mombasa and Kiambu, which recorded 2.6, 2.7, 2.8, 2.8, 2.9 and 2.9 children per woman. The opposite was true for the marginalised counties like Mandera, West Pokot, Wajir and Marsabit, which recorded high fertility rates of 7.7, 6.9, 6.8, and 6.3 children per woman.
Some of the common family planning methods being used today include sterilization, condoms use, implants, injectable drugs, and pills. The use of these modern contraceptives, however, varies by region.
Christine Atieno, a pharmacist technician at a local clinic, agrees that there has been a significant rise in the number of contraceptive users amongst married people over the years.
‘’Married women, mostly aged between 25 years and above, form the majority of our patients at Medway Healthcare,’’ Atieno told IPS.
‘’We receive at least five patients, on a daily basis, who come to seek professional assistance on what sort of contraceptives to use. Many of them prefer taking the oral pills, which we restock two to three times a week,’’ she said. We offer all forms of modern family planning services at our facility apart from sterilisation.
Research work published in the National Library of Medicine agrees that community pharmacies and clinics have also played a big role in ensuring the delivery and easy access to family planning services in both rural and urban areas.
According to the findings, the public health system accounts for 60 percent of patients, while the private sector, made up of pharmacies and clinics, takes up 34 percent.
These private facilities have been authorised to conduct family planning services such as providing oral contraceptives, male and female condoms, injectable intramuscular and subcutaneous depot medroxyprogesterone acetate (DMPA), and emergency contraceptives.
“Being a developing country, Kenya stills lags behind in terms of adequate facilities in its public health system, which makes pharmacies and clinics very important in providing medical assistance, especially to young people between the ages of 10 and 24 years,’’ says Wilson Opudo, a public health specialist.
‘’While it is true that there is an increase in usage of contraceptives amongst women, there is still the matter of teenage girls between the ages of 14 and 18 years who are increasingly becoming sexually active but cannot afford or are unwilling to visit public health facilities for various reasons,’’ Opudo explained to IPS.
According to Opudo, these teenage girls usually avoid going to public health facilities, most of whom will expect them to be accompanied by their parents or guardians because of their young age. Due to this, they prefer community pharmacies and clinics where they can get help on their own.
‘’Being young, these girls are usually embarrassed by their parents finding out that they are sexually active, and most will therefore avoid visiting hospitals,’’ Opudo said. For this reason, it is important to also have professional counsellors in these community clinics and pharmacies.
During the onset of the COVID-19 pandemic, Kenya recorded one of the highest cases of teenage pregnancies, which experts linked to the fact that many children were left unattended at home with little to occupy their free time. Easy access to uncontrolled and uncensored social media has also been a contributing factor to the increased sexual activity among teenagers.
“Teenage girls mostly visit our facility during the weekends, and they usually come looking for emergency contraceptive (plan B) pills, unlike the case for the older married women,’’ said Atieno. ‘’My colleagues and I are also qualified counsellors, and we always insist on offering advice to these teenagers before letting them make any big decisions on their own.’’
The DHS data also showed that, while still low, more men were also taking part in the family planning process as the number of married men getting sterilised had doubled in comparison to the previous years.
Initially, women mostly did family planning, most of whom preferred hiding it from their spouses to avoid conflict or backlash from society, as having many children was considered a blessing in many African households.
Today, however, many men understand the importance of family planning, especially on women’s health and are even accompanying their spouses for the services.
The DHS data indicated an increase in the number of men getting a vasectomy from 248 in 2021 to 557 in 2022.
Dr Alex Owino, Medical Superintendent, Katulani Sub-County Hospital, Kitui, advises that while family planning has become accessible to many, it is also necessary to understand the importance of having a medical specialist to help you decide on the best type of contraceptives.
‘’I have seen cases of women reacting negatively to injections and implants, which makes it necessary for one to be able to know what works for them. Some have complained of side effects such as headaches and uneven menstrual flow, which makes it hard for them to go about their daily business,’’ Owino told IPS.
‘’Pregnant women, breastfeeding mothers and those using ARVs, for example, have different needs in terms of the kind of contraceptives that is best for them,’’ he added.
From the data gathered in the FP2030 report, the following were some of the key findings:
Injectables were the most favoured method of contraception in sub-Saharan Africa, followed by oral pills and implants, respectively.
Pills and male condoms were predominantly used in Europe and Northern America.
Female sterilisation and male condoms remain the most used family planning methods worldwide.
Most family planning users across the globe also prefer short-term methods as opposed to long-term.
In summary, the increased use of contraceptives had helped avert 141 million unintended pregnancies, 150 000 maternal deaths and 30 million unsafe abortions worldwide.
IPS UN Bureau Report
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