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Family Planning (FP) is an important intervention that can help curb rapid population growth and spur economic development. In recognition of these links, the Government of Kenya (GoK) has put in place various strategies and policies that are aimed at accelerating achievement of the Family Planning and Sexual and Reproductive Health (SRH) outcomes. Family planning is a central pillar of Kenya’s SRH programme and the wider national health priorities as outlined in the Kenya Health Sector Strategic and Investment Plan (KHSSP) 2018-2023, Kenya Vision 2030 and Kenya Health Sector Policy 2014-2030.
The central role of FP is also emphasized in Sessional Paper No. 3 of 2012 on Population Policy for National Development (The Republic of Kenya, 2012). The Policy identifies rapid population growth and a youthful population structure as key issues that if poorly managed pose challenges to the realization of Vision 2030 and Sustainable Development Goals (SDG) 3 and 5. Family planning is a key aspect of the targets relating to universal access to sexual and reproductive health found in SDG 3.7 and 5.6.
The Government of Kenya has also fully committed to fulfilling Sexual and Reproductive Health and Rights (SRHR) as per the Constitution of Kenya (2010). Article 43 section 1 states that Every person has the right to the highest attainable standard of health, which includes the right to health care services, including reproductive health care. In addition to the implementation of the Constitution, Kenya has also committed to achieving some Sustainable Development Goals (SDGs) directly relating to SRHR. These are:
Other SDGs have an indirect effect on SRHR. These include:
Family planning has been defined as according to World Health Organization, as “the ability of individuals and couples to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through the use of contraceptive methods and the treatment of involuntary infertility” (Institute of Medicine (US) Committee, 2009). In health, FP has a three-pronged significance as it helps couples avoid unintended pregnancies; reduces the spread of sexually transmitted diseases (STDs); and by extension, it helps reduce rates of infertility. In the face of Universal Health Coverage and health for all, RH provides for the right of men and women to not only be able to access the health services but as well, be informed on acceptable methods of family planning of their choice.
The objective of developing a national FP policy would be:
According to Kenya Population and Housing Census of 2019, a total of 47,564,296 persons were enumerated, comprising 23,548,056 males, 24,014,716 females and 1,524 intersexes. This represented an intercensal growth rate of 2.2 percent compared to a growth of 2.9 percent in the 2009 census. Despite the gradual increase in population size, the country’s Total Fertility Rate (TFR) has been reducing since the year 2003. Kenya has made incredible progress in improving its contraceptive prevalence rate (CPR) which has led to the reduction in the TFR. Despite this great progress, the country is still struggling with addressing contributary factors- including social-cultural factors that contribute to the high unmet need for FP which has stagnated between 17-18% between the years 2016 and 2019. Generally, the number of unintended pregnancies averted due to the use of modern methods of contraception has increased from 2,203,000 (2016) to 2,356,000 (2019); the number of unsafe abortions averted due to the use of modern methods of contraception increased from 485,000 (2016) to 519,000 (2019); the number of maternal deaths averted due to use of modern methods of contraception increased from 8,200 (2016) to 8,800 (2019). The number of additional users of modern methods of contraception increased significantly from 1,358,000 (2016) to 1,967,000 (2019). This is an increase of 44.8 percent between the two periods. The contraceptive prevalence rate for modern methods for all women also plateaued at 45 percent whereas the percentage of women with unmet needs reduced slightly from 18 percent to 17 percent in the period under review. In addition, the aggregated results are impressive but further interrogation reveals uneven progress in mCPR across counties in Kenya. The Kenya FP-CIP 2017 to 2020 had projected that the injectable method would continue to dominate other contraceptive methods but would decline in the percentage of WRA using it. It also projected that the use of IUDs and implants would continue to increase over the period of the plan. Current data reveal implants are the most popular method (36%-All WRA), followed by injectable (32.5%-All WRA) and condoms (7.3%). The most popular among adolescents are condoms (31.9%), implants (28.5%) and injectables (21.8%). The popularity of condoms is good news for HIV programming because it offers dual protection for HIV/STI infections and pregnancy. Adolescent pregnancy is a major problem in Kenya, with a teenage pregnancy rate of 18 percent, and an unmet need for family planning as measured by the contraceptive prevalence rate among sexually active, unmarried girls aged 15-19 years of 49 percent (Ministry of Health, 2016). Adolescent pregnancy also increases the risk of maternal and newborn deaths and disability, including complications from unsafe abortion, prolonged labour, childbirth, and the postnatal period.
The significance of Family Planning in Kenya has led to the need to develop a Family Planning Policy that will be done in consultation with all key stakeholders. It will take cognizance of the devolved governance structures. The Family Planning Policy will articulate what will be done to make Family Planning programme robust and respond to the need of FP clients. It will serve to align the National priorities for FP and serve as a framework that will inform counties in FP programming. It will also serve as a reference document for county governments, development and implementing partners in gaining a deeper understanding of the FP programme in the country while providing an opportunity to harmonize efforts and in identifying resources required for advancing FP programme implementation in Kenya. Kenya has committed to develop a National FP Policy as part of its commitment under the FP2030 framework. The anticipated FP policy is expected to catalyze achievements made under the FP2030 commitments by ensuring an enabling environment.
A nationally adopted public policy is, ideally, the requisite foundational framework to achieving a national ambition or solution to a persistent national issue or problem. The Ministry of Health, as part of its constitutional mandate, is spearheading and guiding the process for development and adoption of a national FP policy through an elaborate consultative policy development process and evidence based so as to acquire broad national acceptability. The process of developing this policy is informed by the procedures outlined in the Ministry of Health’s Common Technical Procedure Manual. This process has started and subsequent work will build on progress made so far. The Ministry of Health has constituted a task force to steer the stakeholder engagement and public participation exercise and the subsequent review of the zero draft by incorporating the views of the stakeholders and the members of public.
The summary of the remaining process procedure is as follows:
The vision of the Family Planning Programme as espoused in the Kenya National FP-CIP 2021-2024 is to have a country where citizens enjoy and make informed choices on their use of sexual and reproductive health (SRH) services. The mission is to ensure that citizens have access to quality, affordable, comprehensive, and equitable family planning services. The goal of the FP-CIP is to reduce the unmet need for family planning among women of reproductive age from 18% in 2020 to 9% by 2024.
The seven priority action areas for Family Planning Policy shall include:
The purpose of this consultancy is to provide technical assistance during the development of the national family planning policy. The consultant will provide technical expertise to the DRMH and guide the process to optimize consultations, quality and contents of the policy to be proposed.
Supervision and Support:
The day to day management of this consultancy will be done by the FP Program manager from MOH, in close consultation with USAID MCGL. The FP TWG under MOH will provide oversight and technical support during the review of the draft policy, validation and finalization of the FP policy. Other key Government of Kenya agencies and supporting partners will also provide technical inputs during the policy development process in line with the policy development manual procedures before finalization.
Timelines
The assignment will be carried over timelines tentatively outlined below:
Task | Output | Timeline | |
1 | Develop communication materials, such as fact sheets, guides, and presentations, to provide information about the policy development process help collect views | Stakeholder engagement and public participation package | Week 1 |
2 | Facilitate stakeholder meetings and public participation forums | Report | Week 2 |
3 | Analyze and and synthesize the feedback received from stakeholders and the public | Report | Week 3 |
4 | Drafting of first draft policy | Draft 1 | Week 4 |
5 | Facilitate Validation workshop of draft policy | Validated policy | Week 5 |
# | Deliverable | Number of Days | Date |
1 | Detailed report and feedback on the stakeholder and public participation exercise | 10 days | TBD |
2 | Consolidate feedback received from stakeholders during the public participation process into the zero-draft policy | 5 days | TBD |
3 | Report from validation workshop detailing inputs and validated draft policy | 5 days | TBD |
4 | Final Draft Family Planning Policy | 10 days | TBD |
Total Days | 30 days |
The scope is scheduled for 30 days period between July 20th 2024 to December 15th 2024. It is expected that the assignment will be concluded within these calendar months from the commencement date.
The Ministry of Health through its FP partners including MCGL Project will bear all the travelling costs associated with this engagement. The consultant will be paid in 3 installments upon certification of satisfactory work as per work plan and endorsed by both the Division of Reproductive and Maternal Health and MCGL.
The consultant will perform the following specific tasks:
Important:
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