When women can't afford it, contraception is no longer a choice, it's a luxury

Access to contraception has continued to be a thorn in women's lives because of all the challenges they face when trying to get these crucial services. Services that allow them to have children by choice and not by chance. You would wonder why such a great thing would be fought so much.

From the inaccessibility of a variety of contraceptive methods to the need for women to seek consent from their partners and or families before getting contraception to the high cost of the methods themselves. All these things make the dream of women enjoying their bodily autonomy remain just that, a dream.

The theme of this year's World Contraception Day, 'The Power of Choice' wouldn't have come at a more crucial time. A time when we are still debating choice, the power it possesses, and why it is important for women to experience it fully when accessing contraception.

I have heard people argue that contraception is just contraception that women need to be okay with what is available and that the issue of choice is taking things too far. Separating access to contraception and the right to healthcare which is a human right is what has landed us here.

Seeing it as more of a luxury than a crucial building block that allows women to fully enjoy their right to the highest attainable standard of healthcare as our 2010 Kenyan Constitution accurately puts it is a huge error.

It doesn't end there, some have even argued that access to contraception is a Western agenda that seeks to reduce Africa's population. The root cause of all these myths and assumptions is what we need to shine a spotlight on if we are ever to place the power of choice back in the hands of women.

Over the years we have seen different efforts to improve women's access to contraception including creating awareness about the different methods that exist. These efforts, unfortunately, have been heavily countered by different aspects such as the unavailability of different methods at healthcare facilities and the unaffordability of these methods makes them out of reach for women.

It is an unfortunate reality especially when you imagine how frustrating it must be for women to walk into a healthcare facility and not get the services they want either because they are unaffordable or the method they want is out of stock, which just means that they are forced to get what is available.

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Then one would wonder whether women having information about choice and how they are entitled to access the contraceptive method that they want is beneficial since that dream is cut short at the healthcare facility. The truth is that this information is very crucial as it allows women to know what they deserve and compare it to what is currently being offered which is quite key if we are to call for change.

One such effort that is set to take back the progress so far when it comes to access to contraception is the Nairobi County Finance Bill 2023 which has proposed an introduction of charges for Contraception services at its Level Four hospitals.

Services that are currently being offered for free will soon cost as follows, Sh500 to insert or remove an implant, Sh350 to insert an IUCD, and Sh500 to remove it, a Depo-Provera injection will cost Sh150, while contraceptive pills will be free of charge at Level Four hospitals within Nairobi.

While contraceptive pills remaining free is a win, it is important to recognise that Injectable contraceptives and implants are the most commonly used contraception methods among women of reproductive age in Kenya, as shown in recently released data from the 2022 Kenya Demographic and Health Survey key indicator report.

Instead of trying to figure out why women were not able to access contraception in the first place even when they were free, our Nairobi County government saw it best to increase barriers to access.

When leaders don't listen to people, the strategies that they propose will always lack the human-centered aspect that makes all the difference by centering the person whose needs are supposed to be met by the said strategies.

In a world where women's autonomy over their bodies remains a dream, the significance of World Contraception Day and its theme, 'The Power of Choice,' cannot be overstated. It is a timely reminder that choice is not an extravagance but a fundamental human right.

Access to contraception should not be seen as a luxury or a Western agenda but as an essential pillar of comprehensive healthcare.

Even as debates surrounding choice and access continue to rage on, it is crucial for us, especially policymakers to recognize that access to contraception is not a matter of convenience but is at the core of women's well-being and autonomy.

We need to be intentional about freeing women from the frustration they experience when they walk into healthcare facilities and encounter barriers to accessing contraception. We can achieve this by starting by doing two things, one is ensuring women have knowledge about choice and entitlement which is vital, as it empowers women to demand the healthcare they deserve and helps drive the transformation of outdated systems.

The second thing is making contraception free and easily accessible to women everywhere and being intentional about further examining and addressing other underlying factors that prevent women from accessing contraception.

As we navigate the complexities of addressing these issues, it is essential for leaders to listen to the voices of those they represent, ensuring that policies prioritize the well-being of their constituents over short-term gains. Only then can we truly return the power of choice to the hands of women, where it belongs, and make the dream of accessible and affordable contraception a reality for all.

-- The author is a sexual and reproductive health advocate