Family Planning fronted as a key health and development issue

Lucy Ndirangu marking her register as she prepares to make her next round in Mwiki, Kasarani. Photo Joyce Chimbi
Lucy Ndirangu marking her register as she prepares to make her next round in Mwiki, Kasarani. Photo Joyce Chimbi

Lucy Ndirangu is often seen around her neighborhood in Mwiki, Kasarani in Nairobi County distributing condoms.

She is a certified Community Health Worker taking initiative to respond to the needs for dual protection, against sexually transmitted infections as well as an unplanned pregnancy.

“Though there are various health facilities in this area, many people do not like to seek for contraceptive products here,” she says.

Ndirangu has taken her initiative further, “I also distribute pills but to people who are already in hospital records but who may not be able to go to the hospital because they have to work and feed their children.”

“I go to where they are based on their calendar,” Ndirangu expounds.

Though this passionate family planning champion is responding to a real need and gap in her community, experts are increasingly reinstating the fact that family planning as a health and development agenda is much more than popping a pill or using a condom.

Family planning more than “Birth Control”

Nairobi based reproductive health activist Grace Gakii says that family planning is not just about controlling birth “it is also about policies, attitudes that hinder access to contraceptives, information gaps, services at health facilities, availability of commodities just to name a few.”

“All these factors must come together to help a person to avoid an unintended pregnancy,” she observes.

It has long been documented that when women and their male partners are unable to control their fertility, they end up caught up in a vicious cycle.

“They have no room to do much else than to carry a pregnancy, deliver and nurse the child. This locks women out of equally important productive work that can contribute to the betterment of their families,” Gakii explains.

Dr Wilfred Subbo, a gender and development expert and lecturer at the University of Nairobi explains that it is important that women are not coerced into family planning just because it is a health and development issue.

“Women and their partners should be educated and provided with all the relevant information. Information is key since an informed decision is bound to have a positive change and transformative benefits,” he urges.

“More importantly, decisions made in this manner are more sustainable,” he adds.

Gakii speaks of the strong link between family planning and gender equality further saying that when the “spacing is right and the children are not born in the heels of each other, both the health of the mother and children involved is not compromised.”

Research has shown that spacing pregnancies at least 24 months apart (the equivalent of 3 years between births) is linked to reduction of stunting among children under 5, and can also have an impact in reducing under 5 mortality.

Children born after a 2-year interval or less, compared with a 4-year interval, are 27 percent more likely to be stunted and 23 percent more likely to be underweight.

Embrace best practices

Kenya is currently reaping the benefits of a reduction in the unmet need for contraceptives.

In the 2008/09 Kenya Demographic and Health Survey, an estimated 24 percent of women in their reproductive health age either married or in unions who wished to delay or stop child bearing could not access any method of contraceptive.

In the 2014 survey, the most recent, the percentage had fallen to 18 percent. Within the same period, some notable direct benefits were also recorded.

The infant mortality rate decreased to 39 deaths per 1,000 live births from 52. Similarly, the under-five mortality rate decreased to 52 deaths per 1,000 live births in 2014 from 74 in 2008-09.

“For women, partners and community to embrace these best practices in family planning, they need to be informed of the many benefits of family planning to their household income and that also impacts on the economy in general,” she expounds.

Dr Subbo speaks about the transformational benefits of family planning to the Sustainable Development Goals which is the new global development agenda, after the end of the Millennium Development Goals era ended in 2015.

“Family planning is key in population growth control, very important in poverty reduction and in a general sense, human development,” he expounds.

He emphasizes that proper family planning practices and supportive culture at the community level, can hasten transformative progress in all the five thematic areas under the Sustainable Development Goals which are People, Planet, Prosperity, Peace and Partnerships.