Investing in Elgeyo Marakwet County’s family planning programme

Background Social statistics Male 227,317 Elgeyo Marakwet County covers a total area of 2 Female 227,151 3029.6 Km on the upper rift valley. It borders West Population (2019)6 Pokot county to the north, Baringo County to the Intersex 12 east, Trans Nzoia County to the north west and to the West. The county is Total 454,480 wedged in between the Uasin Gishu Plateau to the west and the Kerio River to the east, and is divided Total fertility rate (number of children 5 4.1 into four sub-counties: Marakwet West, Marakwet per woman) (2015-2020) East, Keiyo South and Keiyo North. Poverty index (2014)8 53%

3a Male 87.3% The county has a total of 139 health facilities % Distribution of population with a density of 2.6 per 10,000 population, aged 15 years and above with Female 81.9% against the World Health Organisation‘s (WHO) ability to read and write (2014)7 recommendation of 2.03b. It has a core health Total 84.6% workforce density of 9.9 core personnel per 10,000 citizens, against WHO’s recommended 23 health In terms of service provision, 93% of the facilities in the workers. county offer family planning services. Only 41% have all the family planning tracer commodities, including pills, injectables and condoms.

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

15000

12000

9000

6000 4137 4019 4003 3002

3000 2545 0 0 13364 14112 13284 13250 13231 11811 2 2 12 6 2 6 0 9004 1 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 3 3/10 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 Elgeyo Marakwet county 1. Health benefits Modern contraceptive prevalence rate (mCPR 2014) • Lower number of unintended pregnancies • Decline in unplanned births • Reduction in unsafe abortions mCPR (% of currently married women • Decrease in maternal deaths 43.6% 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 25000 • Improvement in children’s health, education 20000 and wellbeing 23454 • More savings as well as a higher household 15000 18819 18770 income and gross domestic product per 10000 17874 16696 14925 capita as a result of women’s economic 14519 participation 5000

• Attainment of the demographic dividend 0 2014 2015 2016 2017 2018 2019 2020

To reap these benefits in Elgeyo Marakwet Method mix by short and long acting methods county: 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 18% 21% planning services 27% 27% 25% 35% 38%

Counselling on and 82% 73% 73% 75% 65% 62% 79% sensitisation to long acting family planning 2014 2015 2016 2017 2018 2019 2020 methods must be provided to increase the Comparison of funding needs and 4 uptake of long acting disbursements, by financial year 1.85 1.94 1.63 1.65 methods 1.49 1.55 1.57 1.52 1.51 1.37 1.39 1.39

More domestic financing for family KSH, billion

planning is required 2016/17 2017/18 2018/19 2019/20 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 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, . 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).