CLOSING THE GAP ON UNMET FAMILY PLANNING NEEDS OF THE URBAN POOR IN KENYA

Background. Women living in low-income urban areas in Kenya have a significant unmet need for family planning, according to a survey conducted by the Urban Reproductive Health Initiative in 5 urban cities. The poorest... [ view full abstract ]

Background.
Women living in low-income urban areas in Kenya have a significant unmet need for family planning, according to a survey conducted by the Urban Reproductive Health Initiative in 5 urban cities. The poorest quintile tended to have the largest proportion of women reporting an unmet need for family planning and this proportion declined as wealth increased. The unmet need among married women ranged from 16% in the richest quintile, 26% among the middle quintile to a high of 76% among the poorest quintile. This suggest poor women are at a greater disadvantage than richer women hence the need to focus on poor women to address this key gap.

Methodology
Implementation took place within a period of 3.5 years with primary focus on the urban poor. A household longitudinal survey of women of reproductive age was used to measure changes in unmet need. Women were categorized into 5 wealth quintiles (poorest, poor, middle, rich and richest) based on household characteristics. Community Health Volunteers living within the slums were identified and trained on family planning to enable them distribute pills, condoms and refer clients for long-term method within their communities. Family planning mobile outreaches were also conducted on a monthly basis targeting poor households. The services were offered free of charge.

Findings
The greatest change in family planning uptake by wealth quintile was among the urban. On average use of modern family planning increased from 23.2% to 42.5% and 29.5% to 44.4% within the urban poorest and poor respectively.

Conclusion
Strategies to reach the poor can help expand overall family planning service access and close the gap among the poor and the rich, ultimately leading to, less burden on strained social services, natural resources, and improved maternal and child health.
Reference
MLE Technical Working Paper 3-2015