Time flies with great content! Renew in to keep enjoying all our premium content.
Prime
Most women in Kenya spend own cash on ‘free’ family planning
Over the years, funding for family planning has come mainly from international development assistance, which has gradually declined as Kenya's economy has grown and achieved lower-middle-income status.
A majority of women in Kenya are still spending their own money to access birth control items such as pills, coils, and implants despite contraception being labelled a free service by the State with more funds allotted toward the cause over the years.
A new report by the International Centre for Reproductive Health shows that out-of-pocket spending on family planning contraceptives accounted for 44 percent of total health expenditure as at 2017 (latest available data), highlighting the need for the government to increase domestic funding and better use resources for family planning.
The report also shows that the government’s allocation for family planning commodities increased from Sh105 billion to Sh124 billion between 2018 and 2020.
However, the figures show that the country is still not on track to meet its 2025 target. The government aims to rely entirely on its own funding by next year, moving away from donor support.
“The impact of budget cuts on family planning services in Kenya is a significant concern that could have far-reaching consequences. Kenya has made remarkable progress in expanding access to reproductive health services and prioritising family planning as an integral part of primary health care. However, recent reductions in funding for family planning initiatives raise serious apprehensions about sustaining these achievements," the report said.
Over the years, funding for family planning has come mainly from international development assistance, which has gradually declined as Kenya's economy has grown and achieved lower-middle-income status.
According to the report, this marks a crucial turning point for raising investments to sustain the country's family planning programme.To prepare for the shift in domestic and donor funding, Kenya established a memorandum of understanding (MoU) between the Ministry of Health and key development partners in 2019, highlighting the need to increase domestic funding for family planning commodities.
The MoU outlined a plan for the ministry to fully fund commodities by the financial year 2025/26, with donor funding decreasing accordingly.
In the agreement, donors agreed to match the Ministry of Health's funding contributions at a ratio of 1:0.5 in 2023, 1:0.25 in 2024 and finally 1:0 in 2025, implying that the government will begin to fully fund family planning commodities.
Kenya, like many other developing countries, faces unique challenges in ensuring equitable access to family planning services, particularly for women from marginalised and vulnerable groups.
According to the United States Agency for International Development, budget cuts in this vital area widen existing inequalities.
“Vulnerable groups, including low-income individuals, rural communities, and adolescents, rely heavily on subsidised services and are disproportionately affected by the cuts,” it said.
However, Kenya has made significant progress in increasing access to family planning services in recent years, with the modern contraceptive prevalence rate increasing from 39 percent in 2014 to 58 percent in 2021. This achievement is a result of the country's ambitious plan among development partners to move away from external funding.
“The government of Kenya has demonstrated its commitment to FP2030 through a number of initiatives, such as increasing the budget allocation for family planning services, developing policies and guidelines to improve the quality of services, and strengthening partnerships with both the public and private sector,” the report says.
In Kenya, a large proportion of health financing has historically come from out-of-pocket payments, usually in the form of official user fees. In 2020, out-of-pocket spending on health increased to 26.6 percent from 24.3 percent in 2019, falling short of the World Health Organization (WHO) recommendation of 10 percent.
The WHO suggests that more than 50 percent of health spending should go to primary care, particularly human resources, infrastructure, and equipment, to achieve universal health coverage in low- and middle-income countries by 2030.
In the fiscal year 2024/2025, Kenya's National Treasury allocated Sh127 billion less to the health sector than in the previous fiscal year, with only Sh20 billion allocated, painting a worrying picture of the country's progress towards achieving universal health coverage.
