Data Hub

Poor women top in use of birth control implants

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The use of birth control implants is highest among poor and uneducated women in Kenya who are taking advantage of free facilities in public health centres, a new survey showed.

An estimated 53.3 per cent of women using implants in Kenya are uneducated while 41 per cent fall within the lowest wealth quantile, research by the Performance Monitoring and Accountability (PMA 2020) reveals.

“A higher proportion of implant users compared to all modern contraceptive users are married, live in rural areas, are less educated, are poorer, obtain their services from public health facilities and receive their method for free,” the research said.

Although implants are the fastest growing contraceptive method in Kenya, supplanting injectable, their uptake remains low among educated working-class women who mainly visited private hospitals where the cost of such services remained prohibitive and are not covered by health insurance packages. The report states that among all the modern methods of contraception, implants account for 33.4 per cent.

It costs an average of Sh7,000- 15,000 to obtain implant services in private hospitals in Kenya—a possible indication of why the uptake remains low among the category of women who frequent such private facilities.

More women in the lower segment of the social pyramid prefer the use of implants, with the study saying 41 per cent of implant users are from the lowest wealth quintile, 23 per cent in the middle quintile while 36 per cent in the highest wealth bracket.

Rural residents contribute to the highest proportion of birth control with the research indicating that 72.3 per cent use them compared to the urbanites who only contribute to 27.7 per cent.

The survey which interviewed women in reproductive age bracket, 15-49 years, shows majority of implant users are between the ages of 20 to 34 years.

Most of the implant users, 82 per cent, received their contraceptives from public health facilities and only 54.7 per cent of them paid for the service.

The report, however, says most of the implant users receive their method for free.

About 94.90 per cent of public facilities said they do stock and offer the implant service, while only 25.40 per cent of private facilities stock and offer the service.

“Implant services are much more likely to be offered from public health centre than a private one,” states the PMA2020 report.

Women have greatly benefitted from public health facilities that offer free contraceptives while others receive the same at a subsidized rate from reproductive health care services who ran on donor funding.

That however could soon change since the United States ,which is the most generous global aid donor in absolute terms, is seeking to completely eliminate funding for reproductive health and family planning.

The US administration has proposed that the budget for 2019 will cut international family planning and reproductive health from its 2017 level by 50 per cent. Their national budget year ends on September 30, but in the recent past, as the drawn-out work on the 2018 budget demonstrated, the government has been forced to operate on a series of temporary measures known as continuing resolutions.

Already, Marie Stopes International which promotes reproductive health care services in countries with a low contraceptive prevalence rate no longer gets money from the US because of the global gag rule.

The three month injectable that were offered in Marie Stopes for next to free are now not available and women spend close to Sh500 for the same services. Prescription contraceptives like the pills and intrauterine device (IUD)are still the most expensive of the reversible methods because they require medical supervision.

They are, however, not covered by insurance companies and women pay out of pocket for the essential services.

The services can cost up to about Sh7,000 for the non-hormonal type and will still require the woman to pay for doctor’s consultation.

Dr Nelly Bosire, an obstetric/gynecologist, says that pharmaceutical commodities are imported and are subject to the dollar rate and whenever the shilling goes down the costs is borne by the end user.

“Any hike in prices felt by suppliers will be passed to the user because the extra cost in doing business always affects the consumer,” she said