Kenya: Most Nairobi Women Prefer Implants – Report
This post originally appeared on AllAfrica here. Reposted with permission.
By John Muchangi
Nairobi residents are quickly warming up to long-term family planning methods, data collected from city health facilities reveals. Contraceptive implants are the fastest growing option in the city followed by injections.
The demand for implants rose 54 per cent last year, compared to 2011, according to the data released by county reproductive health co-ordinator Angela Njiru. The rise is important because in 2008 implants were among the most unpopular family planning methods in Kenya, used by only one per cent of married women countrywide.
Njiru said the curve clearly shows demand for options that last longer. “These services are offered free and the implants last an average five years,” she said.
The data was released ahead of this week’s international family planning conference in Addis Ababa. Nairobi has Kenya’s lowest fertility rate – the average number of children per woman in her lifetime – at 2.8 , according to the 2008 demographic and health survey (DHS).
The county’s booming population is driven by rural to urban migration. The data was taken from public facilities managed by the county government. “There are few private facilities reporting despite the fact that many offer family planning services in Nairobi,” Njiru said.
The analysis revealed that generally more people are seeking contraceptions. For instance, last year 238,645 city residents sought family planning services from the county health facilities, up from 191,523 in 2011.
Most clients opted for condoms, which they combine with other methods. Injections are still popular, with more than 50,000 people receiving them last year. However the number of new and old clients going for implants is rising fast. Last year, about 30,000 received implants compared to 10,000 in 2011.
“Many women may not have time to go for injections every three months, but one implant can keep them for five years. It’s also easier for a women to revert back to fertility quickly if they want children,” Njiru said.
An implant is a small rod the size of a matchstick, which is inserted just under the skin in a woman’s upper arm. Within 24 hours, it begins to release hormones that stop the ovaries from releasing eggs. Pregnancy cannot happen without these eggs.
The hormones also change the lining of the uterus and thicken the mucus in the cervix, making it difficult for sperm to reach the egg. The implant is over 99 per cent effective.
According to Dr Moses Owino, the medical officer of health in the Kasarani sub-county, these procedures are entirely free in public health facilities.
The popularity of implants is also driven by their increased availability after Bayer, the German manufacturer of the popular implant Jadelle, cut the price by 50 per cent in January this year.
“This means the government can procure more implants, which are then administered for free,” Dr Owino says.
The programme will be supported for six years by the Bill and Melinda Gates Foundation, the Clinton Health Access Initiative, and the United Nations Population Fund among other bodies.
The Jadelle implant now retails at Sh800 ($8.50) down from Sh1,500 (US$18) in Kenya and more than 50 other countries globally.
Dr Owino says access to family planning services can save nine of the 21 women in Kenya who die daily during childbirth.
Gates foundation, on the other hand, estimates the Jadelle programme will avert more than 28 million unintended pregnancies by 2018 in the participating countries and prevent about 280,000 infant and 30,000 maternal deaths.
Access to contraception in Kenya still remains a dream to 24 per cent of fertile women who want but cannot access these services, according to the 2008 KDHS. Governments in developing countries use DHS surveys to analyse national data on health and population.
The 2008 Kenyan survey showed that while nearly all married women (98 per cent) and men (99 per cent) could cite at least one modern method of contraception, only 39 percent of married women are using any method.
The most widely used methods are contraceptive injections, the pill, female sterilisation and periodic abstinence respectively. Three per cent of married women are using the IUD, and one per cent use contraceptive implants countrywide.
Central Kenya has the highest contraception use, followed by Nairobi.
The survey further showed that most Kenyans (58 per cent) receive family planning services from government facilities while 33 per cent are supplied by private medical sources, five per cent through other private sources, and three per cent through community-based distribution agents.
Dr Njiru said these figures should be higher. But the majority of family planning departments in public facilities lack skills to offer services like implants and insertion of intra-uterine contraceptive devices.