REPUBLIC OF KENYA KENYA POPULATION SITUATION ANALYSIS Kenya Population Situation Analysis Published by the Government of Kenya supported by United Nations Population Fund (UNFPA) Kenya Country Oce National Council for Population and Development (NCPD) P.O. Box 48994 – 00100, Nairobi, Kenya Tel: +254-20-271-1600/01 Fax: +254-20-271-6058 Email: [email protected] Website: www.ncpd-ke.org United Nations Population Fund (UNFPA) Kenya Country Oce P.O. Box 30218 – 00100, Nairobi, Kenya Tel: +254-20-76244023/01/04 Fax: +254-20-7624422 Website: http://kenya.unfpa.org © NCPD July 2013 The views and opinions expressed in this report are those of the contributors. Any part of this document may be freely reviewed, quoted, reproduced or translated in full or in part, provided the source is acknowledged. It may not be sold or used inconjunction with commercial purposes or for prot. KENYA POPULATION SITUATION ANALYSIS JULY 2013 KENYA POPULATION SITUATION ANALYSIS i ii KENYA POPULATION SITUATION ANALYSIS TABLE OF CONTENTS LIST OF ACRONYMS AND ABBREVIATIONS ........................................................................................iv FOREWORD ..........................................................................................................................................ix ACKNOWLEDGEMENT ..........................................................................................................................x EXECUTIVE SUMMARY ........................................................................................................................xi PART 1 ....................................................................................................................................................1 CHAPTER 1: INTRODUCTION ...................................................................................................................................1 PART 2 ....................................................................................................................................................5 CHAPTER 2: OVERVIEW OF POPULATION DYNAMICS AND DEVELOPMENT ..........................................5 PART 3 ..................................................................................................................................................25 CHAPTER 3: POPULATION SIZE, GROWTH AND STRUCTURE .................................................................. 25 CHAPTER 4: FERTILITY AND FAMILY PLANNING........................................................................................... 39 CHAPTER 5: HEALTH SYSTEMS AND SERVICE DELIVERY FOR SEXUAL AND REPRODUCTIVE HEALTH ............................................................................................................................................... 61 CHAPTER 6: OVERALL, INFANT, CHILD AND MATERNAL MORTALITY ................................................... 85 CHAPTER 7: HIV, SEXUALLY TRANSMITTED INFECTIONS, MALARIA AND TUBERCULOSIS ..........107 CHAPTER 8: THE YOUTH: STATUS AND PROSPECTS ..................................................................................123 CHAPTER 9: MARRIAGE AND FAMILY ..............................................................................................................155 CHAPTER 10: EMERGENCY SITUATIONS AND HUMANITARIAN RESPONSE ......................................171 CHAPTER 11: URBANIZATION AND INTERNAL MIGRATION ....................................................................187 CHAPTER 12: INTERNATIONAL MIGRATION AND DEVELOPMENT ......................................................215 PART 4 ............................................................................................................................................... 243 CHAPTER 13: INEQUALITIES AND THE EXERCISE OF RIGHTS ..................................................................243 CHAPTER 14: RELATIONSHIPS AND THEIR RELEVANCE TO PUBLIC POLICIES ....................................279 CHAPTER 15: CHALLENGES AND OPPORTUNITIES .....................................................................................293 ANNEX 1: LIST OF CONTRIBUTORS ................................................................................................................................309 KENYA POPULATION SITUATION ANALYSIS iii LIST OF ACRONYMS AND ABBREVIATIONS AASF African-American Students Foundation ACP Africa, Caribbean and Pacific AEZ Agro-Ecological Zones AHR Adult Household Ratio AIDS Acquired Immune Deficiency Syndrome AMADPOC African Migration and Development Policy Centre ANC Antenatal Care ARH&D Adolescent Reproductive Health and Development Policy ART Antiretroviral Treatment ARV Antiretroviral Vaccine ASAL Arid and Semi-Arid Lands ASFR Age-Specific Fertility Rate ASRH Adolescent Sexual and Reproductive Health AU African Union AWP Annual Work Plan AYSRH Adolescent and Youth Sexual and Reproductive Health BPO Business Process Outsourcing CBD Community-Based Distribution CBD Community Based Delivery CB-DOTS Community-Based Dots CBK Central Bank of Kenya CBO Community Based Organization CBS Central Bureau of Statistics CDE Centre for Demography and Ecology CDF Constituency Development Fund CDR Case Detection Rate CEN-SAD Community of Sahel-Saharan States CNR Case Notification Rate COMESA Common Market for Eastern and Southern Africa CP Country Programme CPAP Country Programme Action Plan CPD Country Programme Document CPR Contraceptive Prevalence Rate CRED Centre for Research on the Epidemiology of Disasters DALY Disability-Adjusted Life Years DFID Department for International Development DHMB District Health Management Boards DHS Demographic and Health Survey DLTLD Division of Leprosy, Tuberculosis and Lung Disease DMC Drought Monitoring Centre DOTS Directly Observed Therapy Short Course DRF Development Results Framework DRH Division of Reproductive Health DRR Disaster Risk Reduction DRTB Drug Resistant TB DSS Demographic Surveillance System iv KENYA POPULATION SITUATION ANALYSIS EAC East African Community EDBI Ease of Doing Business Index EDRR Early Detection and Rapid Response EM-DAT Emergency Events Database EmOC Emergency Obstetric Care ERS Economic Recovery Strategy ESR Economic Support Ratio FAO Food and Agriculture Organization of the United Nations FGC Female Genital Cutting FGM Female Genital Mutilation FGM/C Female Genital Mutilation/Cutting FP Family Planning FPE Free Primary Education FSE Free Secondary Education FY Financial Year GBV Gender-Based Violence GCI Global Competitiveness Index GDP Gross Domestic Product GDS Geneva Declaration Secretariat GER Gross Enrolment Ratio GER Gross Enrolment Rate GFDRR Global Facility for Disaster Reduction and Recovery GGGI Global Gender Gap Index GIS Geographic Information Systems GoK Government of Kenya GPS Global Positioning System HACT Harmonized Approach to Cash Transfers HDI Human Development Index HDR Human Development Report HERAF Health Rights Advocacy Forum HFA Hyogo Framework of Action HIV Human Immunodeficiency Virus HIV-AIDS Human Immunodeficiency Virus- Acquired Immune Deficiency Syndrome HMIS Health Management Information System HQ Headquarter HTP Human Trafficking Protocol ICPD International Conference on Population and Development ICRC International Committee of the Red Cross ICT Information and Communications Technology IDMC Internal Displacement Monitoring Centre IDNDR International Decade for Natural Disaster Reduction IDPs Internally Displaced Persons IDUs Injecting Drug Users IEC Information, Education and Communication IGAD Inter-Governmental Authority on Development IHL International Humanitarian Law IHME Institute for Health Metrics and Evaluation ILO International Labour Organization IMF International Monetary Fund KENYA POPULATION SITUATION ANALYSIS v IMR Infant Mortality Rate IOM International Organization for Migration IPAS International Pregnancy Advisory Services IPs Implementing Partners IPTp Intermittent Preventive Treatment in Pregnancy IRD Institute for Resource Development IRH/FP Integrated Rural Health and Family Planning Program IRS Indoor Residual Spraying ITNs Insecticide Treated Nets IUD Intrauterine Device IUSSP International Union for the Scientific Study of Population IVM Included Integrated Vector Management JAMA Journal of American Medical Association KAIS Kenya AIDS Indicator Survey KANU Kenya National African Union KCO Kenya Country Office KDHS Kenya Demographic and Health Survey KEPH Kenya Essential Package For Health KESSA Kenya Scholars and Studies Association KFS Kenya Fertility Survey KFSSG Kenya Food Security Steering Group KfW Kreditanstalt Für Wiederaufbau KHPF Kenya Health Policy Framework KHSSP Kenya Health Sector Strategic Plan KIE Kenya Institute of Education KIPPRA Kenya Institute for Public Policy Research and Analysis KNBS Kenya National Bureau of Statistics KNCHR Kenya National Commission On Human Rights KNSPWD Kenya National Survey For Persons with Disabilities KPTJ Kenyans for Peace with Truth and Justice LASDAP Local Authority Service Development Plan LATF Local Authority Transfer Fund LLIN Longer Lasting Insecticide Nets M&E Monitoring and Evaluation MCH Mother and Child Health MDG Millennium Development Goal MDGs Millennium Development Goals MDR-TB Multi-Drug Resistant TB MHS Mean Household Size MICs Multi Cluster Indicator Surveys MIS Malaria Indicator Survey MISP Minimum Initial Services Package MMR Maternal Mortality Ratio MNCH Maternal, Newborn and Child Health MoE Ministry of Education MoH Ministry of Health MoMS Ministry of Medical Services MOPAN Multilateral Organization Performance