Experts: Low contraceptives uptake in West Pokot behind high poverty

Low family planning uptake in West Pokot has caused a population explosion and resulted in high poverty levels in the county, experts now say.

They also say West Pokot women have high fertility, with a majority of them having seven to eight children.

The county has a fertility rate of 7.2 percent, with an average poverty level of 67 percent, compared to the national level of 45 percent.

Family planning uptake in the county is 26 percent per the 2014 Kenya Demographic Health Survey report.

The county is third in Kenya with a low uptake of child spacing methods, as traditional beliefs still hamper the efforts of women who want to practise family planning, a health meeting in Kapenguria heard on Saturday.

About 76 percent of women in West Pokot have not embraced family planning initiatives, and teenage pregnancies stand at 29 percent. Three of 10 teenage girls have either had their first child or are pregnant.

The county with a population of 800,000 receives Sh6.5 billion per year, meaning the allowance per capita is Sh8,350, where 70 percent of residents live on less than one dollar per day.

High fertility

Rapid population growth, fueled by high fertility, presents a barrier to reducing poverty levels and reaching internationally agreed development goals, said John Anampio, coordinator for the North Rift National Council for Population Development (NCPD).

“The high population growth rate is only a threat to the region's development if a large number of people are a liability rather than an asset to the country,” he said, citing research by NCPD in Kenya. It shows that poverty and other cultural, religious and social barriers are responsible for keeping two million boys and girls out of school. 

“Politicians also interfere, telling [people] to sire many children to raise the population so as to get more resources and funds because of the formula used in sharing resources,” he said.

Mr Anampio said high fertility strains the budgets of poor families, reducing available resources to feed, educate and provide healthcare to children.

Conversely, many characteristics of poverty contribute to high fertility-high infant mortality, lack of education for women and too little family income to “invest” in children.

“A large population is a problem if the county government has failed to mobilise its resources and has inadequate social services. Many children are being born in poor families, making it hard for parents to [support] them,” he said.

He expressed concern about the increase in population in Kenya due to its effects on amenities available to citizens.

“Giving birth to many children without taking cognisance of the negative impacts on socio-economic activities [is undesirable],” he said.

“Family size and child spacing is crucial in family management. Having many children is a burden, especially in West Pokot where there is food shortage and hunger. It becomes hard to take many children to school and look after their health,” he said.

Cultural and religious beliefs

Despite the government's commitment to providing reproductive health and family planning to all Kenyans, he lamented, cultural and religious beliefs and values pose persistent challenges, which hinders the realisation of goals on sexual and reproductive health and rights.

He said only one in 10 women in West Pokot uses modern contraceptives.

“Men in the Pokot community tend to believe that it is the duty of women to practise family planning as they stay away from the practice. Unplanned pregnancy is perceived as an achievement without [considering] that the life of the child is being put at risk,” he said.

West Pokot County is also among counties with the highest standing rate of malnutrition at 35.1 percent, according to a recent smart survey by the Ministry of Health and Action Against Hunger.

“A larger percentage of the Pokot community are pastoralists and many families depend on meat and milk as their staple food, which isn’t a balanced diet, hence contributing to malnutrition cases,” Mr Anampio said.

Managing population growth

Declares Inspirational Group Director Jefferson Mudaki said the goal of his and other groups is to attain a high quality of life for the people of Kenya by managing population growth to a level that can be sustained with the available resources.

“It will take years and the efforts of different organisations to educate the community on the importance of family planning as younger women and girls feel the burden of raising large families without the support of their husbands,” he said. 

“In the olden days, after women gave birth the husband ran away from home, but nowadays our men are about to accept family planning.”

He attributed the low use of contraceptives to poverty, high levels of illiteracy, ignorance and cultural influence, with the county ranking third in Kenya on the prevalence of female genital mutilation (FGM).

Access to health facilities 

“West Pokot has the least number of health facilities, a factor which contributes to low access to family planning services. The Pokot community still holds onto its cultural belief that a woman should give birth to children until the end,” Mr Mudaki said.

“The topography of West Pokot hinders women from accessing health facilities. Health centres like Endough, Chepnyal and Alale are far apart. We need health centres to be at least five kilometres apart.”

He also cited the poor doctor-to-patient ratio, which he said is still a major problem for residents of West Pokot compared to other North Rift counties. The ratio in West Pokot is 1:85,000, while in Turkana it is 1:52,000.

“The county government has tried to build health centres in remote areas of West Pokot, but the facilities lack doctors and nurses to render services to the patients,” he said.

FGM and early marriages

West Pokot Health and Sanitation executive Christine Apokoreng attributed the high population rate to FGM and early marriages and called on the community to do away with the retrogressive practices.

“Because of these practices, girls in West Pokot cannot complete their education as scheduled. We want to form strong networks to end teenage pregnancy in the county. We are committed to make sure every child goes to school, but the many cases of teenage pregnancies are dragging us back,” she said.

Governor John Lonyangapuo said the county government allocated resources for family planning, mostly for advocacy and community mobilisation, services, capacity building and other family planning services like abortion care.

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