Kenya’s poor rural households have defied the well-oiled birth control campaigns to retain their position as drivers of the country’s rapid population growth, a newly released demographic report says.
On average, a rural woman has nearly twice the number of children as her urban counterpart while the poorest family in Kenya today has three times as many children as a rich one, according to the Kenya Demographic and Health Survey (KDHS) report that was released on Wednesday.
The survey, conducted by the Kenya National Bureau of Statistics (KNBS), however shows that the country’s birth rate has dropped from 4.6 children per family five years ago to 3.9 by end of 2014 — mainly driven by a decline in the number of children in rich and urban families.
The KNBS said the survey, which covered 40,300 households across the 47 counties, found that urban households on average raise three children compared to nearly five by their rural counterparts.
The poorest families are, however, struggling with high level of dependency, each having as many as seven children (fertility rate of 6.5) compared to just three (fertility rate of 2.8) for rich families.
The statistics cast doubt on the effectiveness of birth control measures that the authorities have been using to try to bring population growth rate down to three per cent or 1.5 million births annually.
High birth rate is among the factors identified as slowing down Kenya’s economic take-off.
Besides its stress on household incomes, a large number of children compels the government to allocate substantial amounts of resources to the social sector to run schools and primary health centres at the expense of development spending.
The Ministry of Health has spent billions of shillings in tax and donor funds to promote family planning through a string of campaigns in the mass media in the past five years.
The rural and poor households are likely to be isolated further in the wake of a recent government directive to its departments and agencies to restrict advertisement to online platforms.
While the number of Internet users in Kenya grew to 26.1 million or 64.3 per 100 citizens by October to December 2014, according to data prepared by the Communication Authority of Kenya, the users are mostly urban and affluent.
“I’m looking forward to presenting the finding to governors,” said Director of Medical Services Nicholas Muraguri during the launch of the sixth edition of KDHS in Nairobi. “I hope we all agree with us that it is time for smaller families.”
With an average size of eight people per household, Wajir tops the list of counties with big families. The combination of cultural practices among the mainly pastoralist communities of West Pokot and Turkana have kept family sizes high at an average of seven children each.
Families in Kajiado, Migori, Homa Bay, Bungoma, Samburu, Trans Nzoia, Mandera, Garissa and Tana River have at least five children each, according to the survey.
By comparison, rich counties such as Kiambu, Nairobi, Murang’a, Kirinyaga, Nyeri and Nyandarua have no more than three children each – lower than the national average rate of 3.9 births per woman.
Nearly all the counties are grappling with teenage pregnancies, led by those in Nyanza, Rift Valley and Coastal regions. Central and North Eastern region, which has strict religious norms, have the lowest number of teenage pregnancies.
Health secretary James Macharia said the survey would inform the ministry’s 2015/16 spending plan.
“We are going to use it not only to convince the Cabinet to support our 2014-2030 national health policy but also to push for more funding beginning with the budget for the next fiscal year,” Mr Macharia said.
Aside from birth control, the KDHS report shows that the push for free education that former President Mwai Kibaki launched 12 years ago has had a knock-on effect on the number of births per woman.
By end of last year —when the first beneficiaries of Kibaki’s free primary education campaign sat their Kenya Certificate of Secondary Education exam — women with at least secondary education had three children on average. By comparison, the survey shows, those without formal education had seven (birth rate of 6.5) children.
Slightly more than 30 per cent of girls aged between 15 and 19 without education have started bearing children compared to only 12 per cent among the educated lot.
The survey uncovered lowest use of contraceptives in counties where cultural practices still hold sway like Mandera (1.9 per cent), Wajir (2.3 per cent) and Garissa (5.5 per cent) and highest use of birth control measures in Kirinyaga (81 per cent), Makueni (80.3 per cent), Meru (78.2 per cent), Machakos (75 per cent), Kiambu and Tharaka-Nithi (74 per cent) and Nyeri (73.1 per cent).
The rural-urban divide also widens when it comes to delivery as only half of births in rural areas benefit from skilled care compared to 82 per cent in towns.
On average, at least 85 per cent of births in counties in central Kenya takes places in health facilities, an indicator that drops to 53 per cent for Nyanza counties and less than one third for Tana River, Wajir, Marsabit, Turkana, West Pokot and Samburu.