The Kenyan government talks a good game when it comes to providing family planning. Year in and year out, our government ministries including the Ministry of Health (MOH) present their budget proposals, supposedly based on the priorities and needs of the Kenyan population. In fact, the government developed a National Family Planning Costed Implementation Plan 2010-2015 to reposition family planning within the national development agenda.
While this plan is meant to guide the budgeting process for contraceptives, it seems unrealistic. Looking at the recent trends in budget allocation and expenditures towards family planning and contraceptives in Kenya, the funds allocated are meager and nowhere near the proposed plans. Moreover, the funds for 2010/11, 2011/12 and 2012/13 financial years have been constant at Kshs 575,025,000 (approximately $6.5 million), with Kshs 522,750,000 ($5.9 million) allocated towards procurement of contraceptives and Kshs 52,275,000 ($589,000) allocated towards distribution of family planning. This flat funding begs the question of whether the government is serious about providing family planning services to all women and men.
Research conducted by Health Rights Advocacy Forum (HERAF) on the government investment toward contraceptives found that the contraceptive budgeting process by the Ministry of Health, Department of Reproductive Health (DRH), and development partners tend to be dictated by bureaucratic processes. This results in budgets based on inadequate revenue and budget ceilings—not on DRH key priorities.
According to the Kenya Demographic Health Survey 2008-2009 (KDHS), about 25 percent of married women want to prevent pregnancy but need contraception. Add this to the 46 percent who currently use family planning, and more than 70 percent of married women in Kenya want to limit or space their pregnancies. As the trend toward smaller families continues and the number of women of reproductive age increases, the number of women using or desiring family planning will rise.
Looking at these figures, I am baffled by the fact that the Kenya government allocated the same amount of funding for the 2010/11, 2011/12 and 2012/13 financial years. The lack of funding increases for family planning is out of touch with the increase in demand for these services due to population increases. Our research found that this has led to inadequate access to family planning services at the community and facility level, and stock outs of contraceptives at health clinics.
We need more commitment from the government—not only for increased financial support, but also for development partners to craft budgets that are in line with priorities and that respond to actual contraceptive needs. Family planning needs must be taken seriously in the budgeting process in order to overcome the problem of insufficient provision and distribution of contraceptives. This is the only way of ensuring improved availability of contraceptives and better access for all Kenyan women.
Josphine Kinyanjui is the Research, Monitoring and Evaluation Officer at the Health Rights Advocacy Forum (HERAF), a partner of PAI.