In the last one week, there has been a lively conversation about unsafe abortions and their impact on the lives of women and girls in Kenya.
This conversation was sparked by a recent story published in a local daily, rekindling the debate about the state of sexual and reproductive health, especially of adolescent girls and young women up to age of 24 years.
Listening to the conversations springing from the story, especially on broadcast media, the sense of despair among many contributors was palpable. Many of them were wondering what needs to be done to change the situation.
Even though the subject of unsafe abortions is a complex and multifaceted one, one of the strategies public health officials have proposed to combat unsafe abortions is ensuring that every sexually active woman of reproductive age has access to family planning information, services and contraceptives.
The Ministry of Health identifies family planning information, services as one of the strategies towards averting over half a million unsafe abortions. As the article pointed out, women and girls seek to terminate a pregnancy because it is unintended.
Scores of sexually active women in Kenya who want to stop or delay childbearing are not using any method of contraception. They are referred to as women with unmet need for family planning.
The two women whose story is told in the article were of reproductive age, sexually active but wanted to delay childbearing, but were not using any method of contraception. Reducing the number of women with unmet need for family planning is key to any efforts to stem the need for unsafe abortions.
Interventions to ensure sexually active women of reproductive age have access to family planning information and services they need comes down to sufficient funding for family planning programmes.
Over the years, the family planning programme in Kenya has mostly depended on donor funding. A source that is unsustainable and fast dwindling.
The reproductive and maternal health services unit at the Ministry of Health recently provided figures showing just how dire the reduction has been. Donor funding has fallen from Sh700 million to Sh100 million over the last five years.
With the advent of devolution in 2013, the responsibility of planning and executing family planning programmes in Kenya fell at the feet of county governments.
The Fourth Schedule of the Constitution provides that county governments are responsible for the majority of health service provision functions, including family planning services.
Along with the responsibility to provide family planning services, county governments also bear the duty to invest in the necessary enablers to provide family planning services.
Many county governments are currently developing multi-year actionable roadmaps called family planning costed implementation plans designed to help them achieve their family planning goals.
The family planning costed implementation plans address and budget for all aspects of family planning programme.
Nandi county for example recently launched the Nandi County family planning costed implementation plan 2017 – 2021. The plan estimates that the county needs one billion shillings over the next five years for the county’s family planning programme. The funds are earmarked for things such as medical supplies, awareness campaigns and to pay for salaries for healthcare workers, among other costs.
Other counties that have launched family planning costed implementation plans include Kilifi, Mombasa and Nakuru while others are working on their plans.
Hopefully, these family planning costed implementation plans will result in sufficient budgetary allocation for the public health sector, enabling it to lead efforts in bringing down the high number deaths and injuries that thousands of women and girls suffer due to unsafe abortions.
— The writer is Kenya country director at Deutsche Stiftung Weltbevoelkerung (DSW)— [email protected]