Women drop permanent family planning as men shun vasectomy
Fewer women are choosing sterilisation, and almost no men are choosing vasectomy. In 1998, about one in 16 married women had been sterilised. Today, it is about one in 60.
According to the new Kenya Mini Demographic and Health Survey (KMDHS) 2025–26, from the Kenya National Bureau of Statistics (KNBS), women now choose other methods, with Implants as the most used method among married women, at 23 per cent. Overall use of any method has slipped since 2022, and unmet need has risen.
The report also indicates that men are not taking up the permanent method, vasectomy; too few married women reported a sterilised partner to count. It is either that the men are going for the method and not telling their wives, or they have shunned it completely.
The report’s note says: “Male sterilisation is not shown due to too few cases.” Indicating that male sterilisation is at 0.0 per cent, against 1.6 per cent for female sterilisation.
Among married women, female sterilisation has fallen from 2.3 per cent in 2022 to 1.6 per cent. It peaked at 6.2 per cent in 1998.
It is mostly a choice for older women. Among married women, it is 0.5 per cent at ages 30 to 34, 2.0 per cent at 35 to 39 years, 3.7 per cent at 40 to 44 and 5.8 per cent at 45 to 49.
The report says: “The median age at sterilisation among women age 15–49 is 33.7 years.”
It is more common in the countryside, at 2.3 per cent, than in towns, at 0.8.
The survey that measured the share of women currently sterilised found out that women in Vihiga are leading in taking up the method at (4.6 per cent), Bomet (4.4) and Murang’a (4.3) among married women.
When asked about male sterilisation, only about 47 per cent of all women have heard of male sterilisation, compared with 66 per cent for female sterilisation. Among married women, it is 53 per cent against 73 per cent.
However, according to the Economic Survey released this year, it showed that about 248 men went for vasectomy in 2021, 557 in 2022, 389 in 2023, 380 in 2024 and 415 in 2025, a rise of 9.2 per cent last year.
For every man who had a vasectomy in 2022, about seven women had a tubal ligation. In 2023, it was about twelve.
Tubal ligation, commonly known as “tying your tubes,” offers almost absolute protection against pregnancy.
Why so few? Dr Samuel Ogombe, a urologist, in May 2026 puts the fee at Sh40,000 to Sh100,000, and says myths such as castration and lost libido keep men away. The Ministry of Health, MSI Kenya and UNFPA are running awareness campaigns, and the ministry is recruiting male champions aged 20 to 35.
He said vasectomy does not harm a man’s sex life: “It does not, in any way, affect his sexual functionality adding that men in their 30s and 40s among those having it link it to better education, more liberal thinking and a hard economy, which has made men want only the number of children they can raise comfortably.
Among currently married women, 61 per cent use a method, down from 62.5 per cent in 2022. Modern contraceptive use is at 56 per cent, down from 56.9 per cent. Another 4.5 per cent use traditional methods.
Kenya’s goal is to “increase modern contraceptive prevalence from 58 per cent in 2017 to 64 per cent by 2030.
The report says knowledge of contraceptive methods is nearly universal and nearly 99 per cent of married women know a modern method; the problem is that need is not being met.
“Total demand is 76 per cent, unchanged since 2014, with 38 per cent wanting to space births and 39 per cent wanting to stop. “16 per cent of currently married women have an unmet need for family planning. This is up from 14 per cent in 2022. Among all women, unmet need is 11 per cent against a 2030 target of 10,” says the report.
Sexually active unmarried women have the highest demand, at 91 per cent.
“The greatest gains were in the use of implants,” which went from under 1 per cent before 2003 to 23 per cent among married women. Injectables follow at 19 per cent, then pills at 7 per cent.
Injectables fell from 26.4 per cent in 2014 to 19.9 per cent in 2022 and 18.7 per cent now. Implants rose from 18.5 per cent to 22.8 per cent since 2022. Intrauterine devices (IUDs) fell from 4.4 per cent to 3.5 per cent. Pills fell from 8.1 per cent to 7.1 per cent. Male condoms fell from 1.8 per cent to 1.4 per cent.
Age shapes the choice. Among married women, implants peak at ages 30 to 34, at 27 per cent. Injectables peak at 35 to 39, at 22 per cent. Pills and IUDs peak at ages 40 to 44, at 9.3 and 7.1 per cent. Married girls aged 15 to 19 use implants (20.6 per cent) and injectables (13.2 per cent).
Where a woman lives matters. Rural married women use injectables (21 per cent) and implants (25 per cent) more than urban women (16 and 21 per cent). Urban women use pills more, at 10 per cent against 5 per cent.
Unmarried women choose differently. Among those who are sexually active aged 15 to 19, male condoms are the preferred method at 16.9 per cent, injectables 15.7 per cent, and implants 15.4 per cent.
Emergency contraception is used by 5 per cent of women, and by 8 per cent of those aged 20 to 24.
Modern use among married women is highest in Murang’a (76 per cent), Makueni and Meru (72 per cent) and Kirinyaga (71 per cent). It is lowest in Mandera (under 1 per cent), Wajir (1 per cent) and Garissa (5 per cent).
Kakamega County leads in implant usage at (35.9 per cent), Vihiga (35.3) and Homa Bay (32.4). Injectables lead in Kisii (31.0), Nyamira (30.5) and Meru (29.2). Pills lead in Kirinyaga (20.9) and Nyeri (18.2). Tharaka-Nithi led in IUD uptake (9.0) and Kirinyaga (8.9).
In the north, there is almost nothing. Wajir records no implant use, and Mandera records 0.2 per cent.
Follow our WhatsApp channel for breaking news updates and more stories like this.
