Family Planning Services in Kenya during a Transition: Utilization Trends across Counties

Author(s): Ndiritu M, Anyango R, Ombech E, Mwita C, Gwer S

Year: 2017

Abstract:

Kenya reports one of the highest maternal and child mortality rates in the world. Family planning (FP), which is used both for limiting and spacing pregnancies, is a crucial element in increasing child survival and reducing maternal mortality. Recently, Kenya has been undergoing changes in its health system, transitioning from a centralized to a devolved system of health governance. Thus, county governments are facilitating health services, such as FP provision. We sought to understand the trends in FP utilization within the counties over this period of transition.

The objectives of this study were to estimate the general prevalence of FP use among women of childbearing age and the prevalence of FP use by county; analyze the trends in FP utilization over the period of transition, from 2012 to 2015; and estimate the extent to which counties had integrated reporting of FP services in Kenya’s national district health information system, known by the name of the software that runs it: DHIS 2.

During the four-year period of transition, we observed little change in FP utilization in most counties. We also observed significant disparity in FP utilization between counties in the Central and Western regions and those in the North Eastern and Coast regions. There was significant discrepancy between FP utilizations analyzed from DHIS 2 data and that reported in the KDHS 2014 report.

Data systems are still broken, and existing data are grossly inaccurate. Facility-level health management information systems (HMIS) that interact directly with the DHIS 2 would enhance data accuracy. Overall FP utilization is dismal, and great intercounty disparities exist that call for an affirmative action in counties that are least-served.