The United Nations Population Fund (UNFPA) says although universal access to reproductive health by 2015 is one of the targets of the Millennium Development Goals, (MDGs) most developing nations still have a long way to go.
UNFPA says some 222 million women worldwide who would like to avoid or delay pregnancy lack access to effective family planning facilities some of which over the years have either collapsed or been exposed to bad management.
Locally, a recent report shows that women are still making uninformed decisions based on myths and misconceptions not to mention the serious problem of the birth control pharmaceutical products market being flooded with fake drugs..
The study by Tupange-Kenya Urban Reproductive Health Initiative conducted in Nairobi, Mombasa, Kisumu, Machakos and Kakamega paints a grim picture: That in this day and age women are still operating under a spell of myths and misconceptions about contraceptives, which has watered down efforts to promote its use.
Most of these myths and misconceptions are exacerbated by persistent archaic traditional ethnic beliefs and traditions that are still heavily entrenched among some communities across the country – with the situation being worsened with lack of access to proper accurate inforamtaion.
Margaret Kilonzo, a Nairobi-based programme manager at Tupange, says 95 per cent of the women interviewed have knowledge mixed with misconceptions on the use of contraception – this revelations emerged during the World Population day that was marked Worldwide in June this year.
An interesting example emerged about Nairobi that despite being the country’s capital with a more educated and informed population, myths and misconceptions about family planning are widespread, with close to 80 per cent of women surveyed believing that users of family planning end up with serious health problems.
A number of the misconceptions include rumours that contraceptives reduce a woman’s libido, make her add weight or harm her health - while it is not contested that all drugs, including contraceptives have side effects, medics agree that this notion has been blown out of proportion.
A senior official with Tupange Jyoti Dhiman had this to say: “In the pharmaceutical world, no drug is minus side effects, even painkillers. Women need to make intelligent decisions when choosing a family planning method and to tolerate the minor side effects that come with it.”
The country’s leading health services provider, the Kenyatta National Hospital (KNH) head of Obstetrics and Gyneacology Dr John Ongech, agrees that there is a lot of misinformation on the side effects of contraceptives.
“The truth is that contraceptives are safe because they are tailor-made for each woman, depending on her health conditions. All medicines have side effects and women must realise that a contraceptive that worked for one woman won’t work for another,” says Dr Ong’ech.
The Tupange-Kenya Urban Reproductive Health Initiative study findings clearly indicates that needs that were or are not met is also part of some of the biggest challenges that are hampering the rolling out of reproductive health services across the country.
Indeed a technical officer with Tupange, Paul Nyachae stresses that this is the highest among the poorest populations in many parts of the country both in rural and urban areas, but declined on a very a steady course as wealth and prosperity increased.
Mr. Nyachae points out that this state of affairs suggests that our women populations are not accessing the necessary reproductive health services they may want or need, with the worst affected segment of the group being the poorest women.
The Minister for Medical Services, Prof Nyong’o on the part of government efforts in this area says the policy guidelines and a Cabinet memorandum had been passed and proposes to offer citizens free medical health care including reproductive health.
“The Bill of Rights requires that the Government provides medical services to all Kenyans. This is in strict accordance with the stipulations in the Constitution of the Republic of Kenya 2010 that we as a ministry are in the process of implementing to the letter, by crafting the relevant Bills to be enacted into law and enforced,” says Prof. Nyong’o.
The Minister who was speaking during celebrations to mark World Population Day at Embakasi, Nairobi in June, pointed out that an appalling number of about 8,000 women die every year because of pregnancy related complications.
According to the Democratic Health Survey covering the year 2008/2009 maternal death in the country remained at high levels with 488 deaths per 100, 000 – with the worst scenario being the fact that with every pregnancy, chances are increased of our women dying from complications arising from the pregnancy and child birth.
Indeed Prof. Nyong’o concedes that development in the reproductive health services provision has been slow over the years and gave the key examples as there being a lack of community involvement, family planning needs which have not been met, delays in seeking and getting appropriate medical care and poor access to skilled attendance.
However, he says that the government has already developed an all encompassing strategy that will enhance and improve the reproductive health status of every Kenyan by ensuring the increase of equitable access to reproductive health services in all corners of the country, especially under the devolved county government structures.
Back to the Tupange-Kenya report which focused on the poor populations in the selected urban areas/towns since the settlements of the poor in these areas have the highest population statistics with rapid growth – in Nairobi alone a paltry 30 per cent of women among the poor populations were found to be using contraceptives, while among the among the wealth a slightly higher than 40 per cent were using birth control methods.
The study established that in Kenya’s coastal city of Mombasa recorded the lowest figures with only 23 per cent of the poor population found to be using family planning methods and a mere 28 per cent of the wealthier population doing the same.
As already pointed out above, the main barriers cited in the lack of using birth control measures among the populations interviewed in the study were socio-cultural beliefs and of course religion where the Catholic Church is the most vocal and un-wavering in its stance against using contraceptives and other modern methods of birth control apart from abstinence and natural family planning methods.
It also emerged that the other challenge in the whole business the chain of supplies in the country’s health system which over the years has been heavily dependent on the donor community for contraceptive commodities that were not readily available.
This state of affairs was also compounded by the methods of family planning that were or are available to the populace, since those that were or are available in the country’s health system were found to be turning off most of the women who were interested.