Family planning link to development agenda

History reminds us that Kenya and the Asian tigers were peers. At some point, Kenya gave Malaysia a development loan. That sounds almost impossible given the huge chasm between the two nations today.

One is a nation on the upsurge, revelling in good health and vibrant economy, while the other is still wallowing at the lower end of the development matrix.

This begs the question; what did the Asian tigers do that our beloved Kenya did not? The obvious answer to that according to demographers and scientists would be demographic dividend.

In simpler terms, this is the situation where a nation reaps from investing in the health and education of its children and young people who in turn take over and drive key pillars of a nation. The key ingredient in this being family planning.

The central role of family planning towards realising county, national, regional and global development dreams can never be overstated. It is one of the most evidence-based interventions not just for realising better health outcomes but also for contributing to holistic development.

A study by the National Council for Population and Development (NCPD) and Population Reference Bureau (2012) estimated that by investing Sh5.3 billion in contraception, the Government would have been able to save Sh8.6 billion on education, Sh5.6 billion on maternal health, Sh2.8 billion on immunisation, Sh2.7 billion on water and sanitation and Sh600 million on malaria. This would have translated to a saving of Sh20.3 billion by the end of 2015, much more than the initial investment!

Devolution of health care services firmly handed county governments the mandate of taking care of the complete emotional, physical and mental well-being of the people.

The Constitution of Kenya envisaged that devolution would accelerate realisation of better health outcomes and bridge the enormous gaps in health indicators between different regions.

Whereas the national government has developed policies and strategies including Sessional Paper No. 3 of 2012 on Population Policy for National Development, which aims at increasing contraceptive prevalence to 70 per cent in 2030, county governments too have an immense role to play to realise sustainable increase in uptake of family planning with sufficient will and resources.

This increase, however, should not just take into consideration married women; it must take into consideration sexually active, unmarried young people, married adolescents and persons living with disability.

Young people are hesitant about consuming sexual and reproductive health services such as family planning in health facilities that do not recognise and respect their right to affordability, privacy, confidentiality and style. Provision of these key services in a youth-friendly manner that gains their confidence will thus greatly increase uptake in this special group.

It is disheartening that a decade after the National Guidelines of Provision of Youth Friendly Services, only one out of ten of healthcare facilities provide comprehensive youth-friendly services that include access to information on reproductive health and required services.

This has to be accompanied by increased budgetary allocation to health including youth-friendly services. In line with programme-based budgeting, there should also be a deliberate allocation to family planning to address all demand and supply oriented barriers to access and use of family planning.

Access to family planning by all will not only reduce the high rates of unintended pregnancies, high incidence of unsafe abortion, birth related complications and the ensuing maternal mortality that remains among the highest in the world, but it will also improve general standards of living of women and men.

But investing in family planning is not only a health issue, it is also smart economics for the nation as reduced population growth will free monumental resources to provide for economic and social rights as stipulated in the Constitution and other local and international human rights instruments.

According to the policy brief 'Family Planning in Kenya; Saving lives, Saving Money', currently every shilling spent on family planning saves Sh4.50 in direct healthcare costs. With accelerated investment, one shilling could save Sh5.50!

Overall, we need to domesticate our international commitments including the global Sustainable Development Goals and the United Nations Commission for Population and Development process, and implement our national dreams embodied in the Population Policy and the three pillars of Vision 2030 among others.