Investing in County’s family planning programme

Background Social statistics Narok County covers an area of 17,933 square kilometers and lies 142.4 kilometres west of ’s Male 579,042 capital city . It is situated along the Great Rift Female 578,805 Valley in the southern part of the country where it Population (2019)6 boarders the Republic of Tanzania. The county is Intersex 38 administratively divided into 6 sub-counties namely Total 1,157,873 Transmara West, Transmara East, Narok North, Narok South, Narok East and Narok West. Narok Total fertility rate (number of children 6 is a cosmopolitan county with Maasai and Kalenjin per woman) (2015-2020)5 being the dominant ethnic groups and is also home to marginalized communities such as the Ogiek Poverty index (2014)8 41% and Oromo ethnic groups. The county’s capital city Narok town is approximately 30 minutes by air and Male 76% two hours by road from Nairobi. % Distribution of population aged 15 years and above with Female 62% The county has a total of 207 health facilities3a with a ability to read and write (2014)7 density of 1.5 health facilities per 10,000 citizens, Total 69% which is lower than the World Health Organisations‘ (WHO) recommended 2.03b. It has a core health In terms of service provision, 95% of the facilities in the workforce density of 6.1 core health personnel county offer family planning services. Only 42% have all per 10,000 citizens, compared to the WHO‘s the family planning tracer commodities which include recommended 23 health workers. pills, injectables and condoms3b.

Number of maternal deaths per year Number of adolescent pregnancies per year

40000

35000

30000

25000

20000 14962 15255 15000 15287 10861 10000 8359

5000 0 19 36807 32777 35799 32104 33219 28825 11 10 27 16 8 12 22 0 26322 2014 2015 2016 2017 2018 2019 2020 2014 2015 2016 2017 2018 2019 2020 Pregnancies among non-adolescents (over 20) Adolescent pregnancies (aged 10-19)

pregnant women were 9 4/10 adolescents in 2020* maternal deaths could have been prevented through family planning in 20201

To tackle both maternal deaths and teenage pregnancies, more investments in family planning are required. Benefits of investing in The status of family planning family planning2 access and funding in Narok county 1. Health benefits Modern contraceptive prevalence rate (mCPR 2014) • Lower number of unintended pregnancies • Decline in unplanned births • Reduction in unsafe abortions 38.1% mCPR (% of currently married women • Decrease in maternal deaths using any family planning method)

2. Social and economic benefits of healthier birth timing and spacing Number of new family planning clients per year* • Increase infant survival rates 100000 • Improvement in children’s health, education and wellbeing 80000 • More savings as well as a higher household 60000

income and gross domestic product per 40000 88653 49441 49528

capita as a result of women’s economic 44823 43562

20000 37209 participation 30801 0 • Attainment of the demographic dividend 2014 2015 2016 2017 2018 2019 2020

To reap these benefits in Narok county: Method mix by short and long acting methods among women of reproductive age*

% of Clients receiving long acting family planning commodities** More women need to % of Clients receiving short acting family planning commodities** be reached with family 16% 18% planning services 36% 37% 41% 37% 34%

84 64% 63% 59% 63% 66% 82% Counselling on and

sensitisation to long 2014 2015 2016 2017 2018 2019 2020 acting family planning methods must be provided to increase the Comparison of funding needs and disbursements, by financial year4 uptake of long acting 2.99 2.83 2.83 2.52 2.48 methods 2.26 2.15 2.08 2.08 1.87 1.58 1.55 More domestic KSH, billion financing for family 2016/17 2017/18 2018/19 2019/20 planning is required Health sector budget request (within ceilings provided) Amount disbursed by Exchequre (from approved and supplementary budget) Expenditure (Amount utilised by Health department)

References * Data from Kenya Health Information System as of March 2021 1 Ahmed, Saifuddin et al, Maternal deaths averted by contraceptive use: an analysis of 172 countries, The Lancet, Volume 380, Issue 9837, 111 – 125 2 Starrs A, Ezeh A, et al, Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission, The Lancet, vol. 391, issue 10140, (2018), pp: 2642-2692, Published by Elsevier 3a Kenya Master Health Facility List (KMHFL). 3b Kenya harmonized health facility assessment 2018/19 (KHFA) 4 County program based budgets 2016/17, 2017/18, 2018/19 & 2019/20 and County Government budget implementation review report 2016/17, 2017/18, 2018/19 & 2019/20. 5 United Nations, Department of Economic and Social Affairs, Population Division (2019). World population prospects 2019, Online edition. Rev. 1. 6 2019 Kenya population and housing census. 7 The 2015/16 Kenya integrated household budget survey (KIHBS) reports 8 Wiesmann, U., Kiteme, B., Mwangi, Z. (2016). Socio-economic atlas of Kenya: Depicting the national population census by county and sub-location. Second, revised edition. KNBS, Nairobi. CETRAD, . CDE, Bern. ISBN (e-print): 978-9966-767-55-4 DOI: http://dx.doi.org/10.7892/boris.83693 9 Kenya demographic health survey 2014 ** Long acting family planning methods - intra uterine device (IUD) and implants ** Short acting family planning methods – combined oral contraceptive pills, progestogen-only contraceptive pills, injectable and condoms

2021

Delivering Sustainable and Equitable Increases in Family Planning in Kenya (DESIP) is funded with UK aid from the British people and implemented in a consortium led by Population Services Kenya (PS Kenya), in partnership with AMREF Kenya, Options Consultancy Services Limited, Faith To Action Network (F2A) Health Rights International (HRI), Voluntary Service Overseas Kenya (VSO) and Population Services International (PSI).