Investing in Garissa County’s birth spacing programme
Background Social statistics Male 458,975 Garissa County is one of three north eastern Female 382,344 counties in Kenya and covers an area of 44,174.1 Population (2019)6 square kilometers. It lies 366 kilometres north east Intersex 34 of Nairobi by road. Garissa County is principally semi-arid and borders the Republic of Somalia Total 841,353 to the East, Lamu County to the south, Tana River County to the West, Isiolo County to the north west Total fertility rate (number of children 5 6.1 and Wajir County to the north. It has seven sub- per woman) (2015-2020) counties: Fafi, Garissa, Ijara, Lagdera, Balambala, 8 Hulugho (Administrative Unit) and Dadaab. It is Poverty index (2014) 59% mostly inhabited by ethnic Somalis and is also Male 53.6% home to the Dadaab refugee complex which has a % Distribution of population population 217,108, as of the end of October 2019. aged 15 years and above with Female 30.3% ability to read and write (2014)7 The county has a total of 198 health facilities3a, Total 41.7% with a density of 2.3 health facilities per 10,000 population just under the World Health 3b. In terms of service provision, 65% of the facilities in the Organisation‘s (WHO) recommendation of 2.0 It county offer family planning services with only 72% has a core health workforce density of 10.0 core having all the family planning tracer commodities which health personnel per 10,000 population against include pills, injectables and condoms3b. WHO’s recommended 23 health workers3b.
Number of maternal deaths per year Number of adolescent pregnancies per year
4 4 4 0
1 2 24 29 23 28 29 31 38 0 0 24 2 4 1 1 2 1 411 1 1 0 14 1 21 2014 201 201 201 201 201 2020 2014 201 201 201 201 201 2020
regnancies among non adolescents over Adolescent pregnancies aged
pregnant women were 16 2/10 adolescents in 2020* maternal deaths could have been prevented through birth spacing in 20201
To tackle both maternal deaths and teenage pregnancies, more investments in birth spacing are required. Benefits of investing in The status of birth spacing birth spacing2 access and funding in Garissa county 1. Health benefits Modern contraceptive prevalence rate (mCPR 2014) • Lower number of unintended pregnancies • Decline in unplanned births • Reduction in unsafe abortions m R of currentl married women • Decrease in maternal deaths 4 using an famil 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 • Improvement in children’s health, education and wellbeing 2 4 4 • More savings as well as a higher household 1 1 1 0 income and gross domestic product per 1 4 1 14 2 capita as a result of women’s economic 14 1 participation
• Attainment of the demographic dividend 2014 201 201 201 201 201 2020
To reap these benefits in Garissa 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 birth 1 21 spacing services 2 2 2
Counselling on and 2 2 sensitisation to long actingbirth spacing 2014 201 201 201 201 201 2020 methods must be provided to increase the Comparison of funding needs and 4 uptake of long acting disbursements, by financial year 1 1 4 1 1 methods 1 4 1 1 1 2 1 1 1 1 1
More domestic financing for birth S billion
spacing is required 201 1 201 1 201 1 201 20 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, Nanyuki. 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).