Wellness & Fitness

Tame birth rates by more focus on family planning

preg

Population growth rates correlate directly with access to family planning (FP) as well as other health services. FILE PHOTO | NMG

Last week a feature in the Daily Nation on national trends in population growth noted that Kajiado had one of the highest birth rates. This is not surprising given the challenges our geographic, economic and socio-cultural background imposes on our health system. The statistics strengthen the call for more support to players in reproductive health services in the county.

Population growth rates correlate directly with access to family planning (FP) as well as other health services. Kajiado’s vastness places huge constrains in terms of resources needed due to the dispersed dwelling patterns.

Over the last six years I have been privileged to work with the Maasai Wilderness Conservation Trust’s Health Programme (MWCT). It is a non-profit integrating a holistic approach towards addressing the needs of a remote Maasai community. In healthcare the focus is on reproductive and women’s health.

To get a rough idea, envision an area spanning 1,200 km2 with just four health facilities. Some villages are so far from a clinic that one takes a 25- kilometre roundtrip to get to one. Often this is on foot since no public transport exists. As a result some who desire FP services may struggle to obtain them.

One way to explain the high birth rate is a lower uptake of family planning services coupled with earlier ages at first pregnancy in the county. ‘Unmet need’ an indicator used to track FP uptake, shows the proportion of women desiring contraception but not receiving it. The Contraceptive Prevalence Rate or CPR assesses the number of married women on a contraception. It relates more to attitude and awareness as determinants to use of FP services.

The high birth rate can be due to cultural, infrastructure as well as economic causes. Traditional beliefs take long to change. Even harder is shifting male attitudes to accept contraceptives use as rights women should have. To address the low FP uptake, a multifaceted approach is needed.

MWCT’s model recognises education as crucial in this war. Efforts target enrolling more girls in schools, improving teacher: student ratios, building classes and scholarships. As proof of success, enrolment in schools in our catchment stands at 50:50 for boys and girls. Quite a commendable statistic!

All these tackles earlier sexual debuts, reduces teenage pregnancies, all contributing to increasing the age at first pregnancy that ultimately promotes sustainable family sizes.

In the health programme, our approach is to take services to the villages through mobile outreach clinics and supporting Community Health Volunteers as peer influencers on FP uptake. Employing extra health staff to augment public nurses also improves reliability of services.

Our experience shows, a collaborative cross-sectoral route works best.

Dr Omete is the Health Programme Director of the Maasai Wilderness Conservation Trust, a non-profit with reproductive health projects in the Amboseli-Tsavo ecosystem.