Family Planning in a new era: Improving access to the poor in Kenya

Purpose of work: To improve access to family planning services by the poor

Data used: Kenya data indicates that the country has not made progress in reducing inequalities in family planning use between the poorest and wealthiest groups over time. With a contraceptive prevalence rate of 39 percent, unmet need for family planning among the poorest groups (33 percent) was almost twice as high as those in the wealthiest group (17 percent) KDHS (2003).

Methods used: The team used semi-structured interview guides in a group discussion format with poor women both below the age of 30 and above that age, users and non users of family planning, and men. Key informant interviews were conducted with service providers in the maternal and child health and family planning clinics in both government and non government health facilities.

Major results: Despite the large family sizes, the poor do not attribute their poverty to the number of children they have. With very limited finances and competing needs, family planning has not been a priority for the poor. Other results show family planning information getting out to the community had largely involved women and totally leaving out men who are major decision makers. For family planning users; insufficient attention by service providers at health facilities, misconceptions and side effects are not addressed.

Recommendations and policy implications: To develop strategies that ensure improved family planning access by the poor, there is a need to involve both men and women in family planning, re-energize the Community Based Distributors programme to inform the community about the importance of family planning and avail the services at community level, ensure free access for family planning services, no user fee to be charged and conduct community outreach programmes specifically targeting the poor