Women suffer as contraceptive shortage bites

A biting shortage of family planning commodities in the country is putting millions of women at risk, forcing many to resort to unsafe alternatives or go without contraception altogether. 

With Kenya requiring Sh2.5 billion annually to sustain its family planning programmes, the government now has to struggle to bridge a 46 per cent funding gap.

The situation has been made worse by the recent stop-work order affecting US government-supported supplies, which account for 24 per cent of Kenya’s family planning needs. With no waiver granted for continued distribution, health facilities are running out of essential contraceptives, leaving women, especially in rural and underserved areas, without options.

According to health officials, the shortage may result in unplanned pregnancies, unsafe abortions, and increased maternal health risks.

For Alice Achieng, a mother of three from Kakamega County, finding her preferred contraceptive has turned into a frustrating, exhausting journey. With her husband working far from home, she had hoped to get the three-month contraceptive injection to space her children and avoid an unplanned pregnancy. But after visiting three public health facilities in the county, she left empty-handed.

At the county referral hospital, a nurse shook her head apologetically. “We haven’t received stock in months. Maybe you try next week”. Alice moved to another dispensary in Shinyalu, then to a health centre in Butere, and got the same disappointing response.

With only Sh300 in her pocket, she had a difficult decision to make: use the little money she had to buy food for her children or pay for a family planning method at a private facility. Desperate, she walked into a private clinic, where she was told she could get the injection but at a cost three times higher than what she would have paid at a public hospital. She hesitated but eventually paid, knowing the alternative would be even more costly.

Many women, particularly in rural areas, are facing the same struggle. Some are being forced to go without protection, risking unplanned pregnancies, unsafe abortions, and maternal health complications. 

Others, like Alice, use their limited finances to purchase contraceptives from private providers, if they can afford it.

Mr Sham Musyoki, Health Systems strengthening supervisor at Marie Stops International Kenya, explained that there has been an erratic supply of family planning commodities across all counties in the past six months.

“The most affected products include implants and combined oral contraceptives. The impact of this shortage will be an increased rate of unintended pregnancies. We may also have complications that arise out of unsafe abortions, leading to death.

“For rural women, there is an economic strain since they have to look for these services in private facilities. Already, they are burdened by the current economic hardships,” he added.

He explained that even though the country has had low allocations for family planning commodities over the years, the pullout of USAID has left a funding gap, affecting the procurement of the commodities.

“We are encouraging women to go for the long-term methods. This will help them as they last longer compared to the short-term methods and hopefully by the time they need another method, we will have adequate supplies. We also enlighten the communities on the benefits of modern methods over the traditional methods."

He noted that they are advocating allocation of resources both at national and county levels. “We are also assisting in redistribution of the available commodities to where they are most needed.”

As the demand for family planning services grows, reproductive health advocates are calling for urgent funding solutions to protect the gains made in reducing maternal mortality and safeguarding women’s reproductive rights. 

According to Nelly Munyasia, the executive director of Reproductive Health Network Kenya, the USAID funding freeze has reduced access to family planning services for over 6.2 million clients annually, disrupted procurement and distribution of commodities and increased unmet need for contraception, potentially reversing gains in contraceptive prevalence rate.

The funding freeze has also resulted in inadequate resources for warehousing and distribution of family planning supplies, and reduced capacity-building opportunities for healthcare providers, affecting the quality of services.

“The government is saying that the stock it has is for the next five months, but we know that some contraceptives are in shortage. Family planning is critical in terms of preventing unplanned pregnancies and planning the number of babies that one wants. We anticipate scenarios where women will have unwanted pregnancies and unsafe abortions.

“We will lose the gains we have made as a country in improving the contraceptive prevalence rate. When we have babies we have not planned for, women are disempowered, and this contributes to population development issues like adding strain on healthcare, education, and other essential services,” said Ms Munyasia.

The executive directed noted that Kenya requires Sh2.5 billion annually for family planning commodities, out of which Sh504 million is funding from the government, Sh222 million from the Global Fund, and Sh598 million from the US government support. “The deficit is Sh1.7 billion,” said Ms Munyasia  in an analysis report on the impact of the US government's stop work order. 

According to the 2022 Kenya Demographic and Health Survey, injectable contraceptives and implants are the most commonly used contraception methods among women of reproductive age in Kenya. Fourteen per cent of married women in Kenya aged 15-49 have an unmet need for family planning, which limits their ability to prevent unintended pregnancies and plan their families.

mchelangat@ke.nationmedia.com