Developing and Implementing Policies and Strategies to Remove Barriers to FP/RH Access among the Poor in Kenya

The project aims to enhance the development and implementation of strategies for improving access to family planning (FP)/reproductive health (RH) services among the poor by collaboratively identifying and addressing barriers to FP access; reviewing and revising existing policies/strategies; and designing appropriate indicators to monitor the impact of pro-poor interventions in Kenya. The USAID | Health Policy Initiative worked closely with Kenya's Health Financing Task Force and Division of Reproductive Health in the Ministry of Public Health and Sanitation.

To understand how to improve FP access among the rural and urban poor in Kenya, the project conducted market segmentation, system diagnosis, and operational barriers analyses, as well as key informant and focus group discussions with the poor and non-poor at national and sub-regional levels. Barriers impeding access to FP services among the poor included lack of male involvement, lack of culturally-appropriate FP information and services at the community level, limited access and use among the urban poor, regional disparities in FP access and use, high costs, long wait times, and transportation issues.

To address the complex issues of ensuring access to family planning and to implement sustainable solutions, the project identified appropriate policy interventions at national and provincial levels. The development and implementation of these interventions involved several interwoven processes: awareness-raising among a broad range of stakeholders at all levels, building partnerships and support, tapping into multisectoral planning groups, building local capacity, mobilizing information for decisionmaking, and updating pro-poor monitoring and evaluation indicators.

The following pro-poor strategies were selected and implemented to address the identified problems: (1) incorporating equity goals, pro-poor strategies, and equity-based monitoring and evaluation activities into the National Reproductive Health Strategy; (2) conducting high-level policy advocacy with Parliamentarians to gain commitment for improving access to FP among the poor and mobilize resources for FP; (3) designing a targeted approach to improve FP access in selected regions and urban poverty pockets; (4) informing the design of health sector financing strategy to ensure financing for services for the poor; and (5) promoting representation of poor in various planning and program committees.