Family Planning a key health and development issue

Lucy Ndirangu marking her register as she prepares to make her next round in Mwiki,Kasarani.Picture:Joyce Chimbi
Lucy Ndirangu marking her register as she prepares to make her next round in Mwiki,Kasarani.Picture:Joyce Chimbi

A certified Community Health Worker, Lucy Ndirangu is often seen around her neighbourhood in Mwiki, Kasarani in Nairobi County distributing condoms.

She has taken the initiative to respond to the needs for dual protection against sexually transmitted infections as well as unplanned pregnancies.

“Though there are various health facilities in this area, many people do not like to seek for contraceptive products here,” says Ndirangu who has taken her initiative further. “I also distribute pills but to people who are already in hospital records but who may not be able to collect the commodities due to work and or child care.”

She expounds: “I go where they are based on their calendar.”

Though this passionate family planning champion is responding to a real need and gap in the community, experts are increasingly reinstating the fact that family planning is a health and development agenda that is much more than just popping a pill or using a condom.

More than birth control

Nairobi based reproductive health advocate Grace Gakii says family planning is not just about controlling birth. “It is also about policies and attitudes that hinder access to contraceptives, information gaps, services at health facilities as well as availability of commodities just to name a few. All these factors must come together to help a woman avoid an unintended pregnancy,” Gakii observes.

It has long been documented that when women and men are unable to control their fertility they end up being caught in a vicious cycle.

“They have no room to do much else other than to carry a pregnancy, deliver and nurse the child. This locks women out of equally important productive work that can contribute to the betterment of their families,” Gakii explains.

Dr Wilfred Subbo, a gender and development expert and lecturer at the Institute of Anthropology, Gender and African Studies at the University of Nairobi explains that it is important for women not to be coerced into family planning just because it is a health and development issue.

“Women and their partners should be educated and provided with all the relevant information since an informed decision is bound to have a positive change and transformative benefits,” Subbo advices. He adds: “More importantly, decisions made in this manner are more sustainable.”

Gakii speaks of the strong link between family planning and gender equality further saying that when the “spacing is right and the children are not born in the heels of each other, both the health of the mother and children is not compromised”.

Research has shown that spacing pregnancies at least 24 months apart (the equivalent of three years between births) is linked to reduction of stunting among children under five. It can also have an impact in reducing the under-five child mortality.

Children born after a two-year interval or less, compared with a four-year interval are 27 percent more likely to be stunted and 23 percent more likely to be underweight.

Embrace best practices

Kenya is currently reaping the benefits of a reduction in the unmet need for contraceptives.

In the 2008-2009 Kenya Demographic and Health Survey, an estimated 24 percent of women in their reproductive health age either married or in unions who wished to delay or stop child bearing could not access any method of contraceptive.

In the 2014 survey, the most recent, the percentage had fallen to 18 percent. Within the same period, some notable direct benefits were also recorded.

The infant mortality rate decreased to 39 deaths per 1,000 live births from 52. Similarly, the under-five mortality rate decreased to 52 deaths per 1,000 live births in 2014 from 74 in 2008-2009.

“For women, partners and community to embrace these best practices in family planning, they need to be informed of the many benefits of family planning to their household income and how this also impacts on the economy in general,” Gakii expounds.

Subbo speaks to the transformational benefits of family planning to the Sustainable Development Goals which is the new global development agenda, after the end of the Millennium Development Goals era in 2015.

“Family planning is key in population growth control, very important in poverty reduction and in a general sense, human development,” Subbo expounds.

He emphasizes that proper family planning practices and supportive culture at the community level can hasten transformative progress in all the five thematic areas under the Sustainable Development Goals which are People, Planet, Prosperity, Peace and Partnerships.

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