How do we ensure that family planning remains on top of the agenda in Kenya?

This article was originally published in The Star (Kenya) on 11 November 2022.

As it has been the norm since President Ruto announced his cabinet nominees, the county government heads followed suit and presented the names of individuals who will be part of their executive committee for the next 5 years. What follows is their approval by parliament and county assemblies respectively. As they start setting new priorities to inform service delivery we ask, what becomes of initiatives started or achieved by previous administrations?

Democratic societies elect their leaders with the expectation that they will help solve the challenges they face and bring about positive changes in their lives. Governments who are in power do this through policies that outline how they will go about addressing the needs and concerns of its citizenry.

But challenges persist beyond a governments’ legislative period, making policies transitional in nature – meaning they exist or persist until the issue is either solved or they are changed or adapted to new circumstances.

The government in Kenya has put several health policies that guarantee the highest attainable standard of health, including reproductive health, implemented through both the national government responsible for policy and county governments which implement these policies and deliver health services.

The Ministry of Health, through the Kenya Health Policy 2014-2030, aims to achieve a level of health that is commensurate with that of a middle-income country by 2030. Based on this, other domain specific policies have been developed, including the National Reproductive health policy 2022-2033 which was launched days before Kenya’s general election in August 2022, it reflects the commitment of the Government of Kenya to all persons in need and requiring reproductive services of the highest standard. This policy is operationalised through various strategy documents and guidelines.

Experience shows that the delivery of successful health programmes requires commitment and political support by leaders and decision-makers, especially in resource-constrained settings. Government policies and budgets can either support or hinder the delivery of health services. Supportive policies and strategies help place delivery of health services high on the national and county development agenda and play a critical role in the resource bidding process. They also ensure that adequate resources are allocated to actualise the plans.

The government demonstrated its political will and commitment to maternal health and wellbeing when it recently developed national development strategies that prioritise family planning services.

Following the classification of Kenya as a low middle income country by World Bank in 2015, we have witnessed a reduction in donor support towards health with the expectation that the country should be able to cover the costs through domestic financing. It is therefore imperative that health, and especially reproductive health, is prioritised both at national and county levels as part of this aid transition.

As the Kenya Kwanza government settles in and budget review and prioritisation is underway, it is important that the gains made so far in improving reproductive, maternal, newborn, child and adolescent health, and especially family planning, are secured through maintaining or increasing the allocations in the budget. This commitment is well articulated in the current government’s manifesto and the Kenyan citizens will be expecting that the new government will honour its campaign pledges.

Also, county governments are in the process of developing county integrated development plans (CIDP) which provide a framework for planning, budgeting, funding, monitoring, and evaluating programmes and projects in five-year terms. This provides an opportunity to ensure that implementing the government’s reproductive health policy, guidelines and strategies are well catered for and resources availed to safeguard the gains and accelerate progress towards universal health coverage.

Through the CIDP the county governments ensure existing policies and programmes in get implementation support. Secondly, it provides an opportunity to highlight county health needs and linkage to the wider government agenda to achieve health for all and thirdly through public participation and present issues of priority in reproductive maternal, neonatal, child, adolescent health and family planning.

As Kenyans, we have a constitutional duty anchored in the doctrine of public participation to ensure that our right to highest attainable reproductive health is upheld and prioritised. Therefore, let’s scrutinise national and county budgets and demand that they ring fence funds for reproductive health, let’s examine whether CIDPs have strong articulation of reproductive health as one of the key priorities and let us raise our voices in advocating for policies and investments that secure both our future and that of the next generation.

It is important to highlight that within the provisions of the Public Finance Management Act, counties can develop laws which permit them to confer upon health facilities some level of financial autonomy. Due to the many benefits that such autonomy would yield to the facilities, it is important to support efforts which ensure revenues generated by health facilities are protected and ring-fenced for use in line with the immediate priorities and barriers they face in progressing toward achieving Universal Health Coverage.

To our newly elected leaders, our reproductive health is important to us and so it is important to you too. We  therefore call on you to facilitate the implementation of the reproductive health policy by ensuring the right resources are available at the right time and look forward to a healthy and prosperous Kenya.

By Timon Ayieko, Technical Officer, Options Consultancy Services