Family Planning Is a Crucial Investment for Kenya's Health and Development
February 6, 2012
The Kenya Population Data Sheet 2011 provides population, health, and environment data compared over time, and among regions, wealth quintiles, and education levels. It was prepared by the Population Reference Bureau’s Informing DEcisionmakers to Act (IDEA) project and the National Coordinating Agency for Population and Development (NCAPD).
(February 2012) In just over four decades, Kenya’s population has nearly quadrupled in size, from 10.9 million in 1969 to an estimated 40 million people today. The Kenya Population Data Sheet 2011 illustrates this dramatic growth since the mid-20th century, as mortality declined and births rates remained high.
Given this rapid growth, it is no surprise there are substantially more people in the younger age groups than the older age groups. A majority of the population is under age 20, and more than two out of five people are under age 15 (see figure).1
Kenya’s Age and Sex Structure
Source: Population Reference Bureau and National Coordinating Agency for Population and Development, Kenya Population Data Sheet 2011 (Washington, DC: PRB, 2011).
The large size of Kenya’s young population and its rapid population growth are influenced by several factors that have serious consequences for the health and well-being of women and children, and the development of Kenya:
- Early Marriage and Childbearing. Among women ages 20 to 24, one out of four is married by age 18, and one out of four gave birth by age 18. In this same age group, women in rural areas are twice as likely to be married by age 18 as women in urban areas, increasing the likelihood of childbearing at a young age. Women who are poor, have less education, and are living in rural areas have the youngest median age at first birth.
- Unmet Need for Family Planning. One out of four married women ages 15 to 49 has an unmet need for family planning, meaning they wish to delay their next pregnancy by two years or more, but are not using any method of contraception. The poorest women report the highest unmet need. Almost half of women report that their most recent birth was an unplanned pregnancy.
- High Total Fertility Rate (TFR). Kenya’s TFR is 4.6; women have an average of four to five children during their lifetime. Even if the average number of births declines to 3.7 children per woman by 2030 (as projected by the United Nations medium variant), the population will still grow to 65.9 million people.2
These factors increase the likelihood of unintended and unwanted pregnancy, unsafely performed abortion, high-risk births, and disease and death from pregnancy-related complications. Maternal mortality continues to be high. The 2008-09 Kenya Demographic and Health Survey estimates 488 maternal deaths per 100,000 live births.
In addition to health concerns, rapid population growth has implications for development due to the increasing demands on the economy, social services, and natural resources. According to the Kenya government, there are not enough employment opportunities for the growing number of young people.3
As the population expands and becomes increasingly dense, the amount of arable land per capita available to rural farmers and their children is shrinking. Almost 70 percent of the population lives in rural areas, but two out of three farmers do not believe their land is sufficient for their children to stay and live.
Benefits of Family Planning
Ensuring access to voluntary family planning helps manage rapid population growth by preventing unintended pregnancies while reducing maternal and child mortality, and improving the health and economic well-being of families and communities. Research demonstrates that family planning is an essential component of achieving development goals for health, poverty reduction, gender equality, and environmental sustainability, including Kenya’s Vision 2030, a national framework for development.
The United Nations estimates that every dollar spent on family planning saves between $2 to $6 in interventions aimed at achieving other development goals.4 When combined with progressive development policies, family planning reduces poverty and stimulates economic growth because:
- Fertility decline after a period of rapid growth produces a temporary window of opportunity for a nation’s economy as the size of the dependent population is reduced in relation to the size of the working population. The large base of workers with fewer dependents means there are more resources available for health, education, infrastructure, and job creation.
- Helping women and families prevent unintended pregnancies and unwanted births makes it easier for communities to pace development with population growth. This enables a community to expand health care, build schools, and develop infrastructure and employment opportunities as the population grows. The nation can invest more in the quality of care instead of struggling to keep pace with the quantity of services.
- Planned childbearing makes it easier for parents, especially women, to achieve education and career goals, which raise family income. When countries develop and fertility declines, the proportion of women earning wages rises sharply.
- Family planning programs reduce inequality between women in different socioeconomic groups. Unintended childbearing is most common among poor, rural, and uneducated women. Countries that effectively reach people in these communities with family planning have fewer socioeconomic differences in unplanned reproductive health outcomes.5
Kenya’s Family Planning Comeback
Although Kenya faces challenges due to rapid population growth, it has also experienced the benefits of family planning. In 1967 Kenya emerged as a leader in development after launching the first official nationwide family planning program in sub-Saharan Africa. Throughout the 1980s and early 1990s, the program was comprehensive with strong political will. As contraceptive use increased, the TFR declined from an average of 8.1 children per woman in 1978 to 4.7 in 1998. The family planning program struggled in the late 1990s as the HIV epidemic diverted donor funding and political leadership waned. As a result, the decline in the fertility rate has stalled over the last decade.
However, family planning is making a comeback in Kenya. The new constitution, passed in August 2010, 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.” Recent high-level meetings have demonstrated support for family planning at the national and community levels, such as the National Leaders Conference for Population and Development in November 2010, and the Effective Community Approaches to Family Planning Meeting in July 2011. A new national population policy is currently being developed with family planning at its core. And for the first time, beginning in 2011-2012, the government will cover the full cost of contraceptive commodities.
As the government makes greater commitments to family planning, the reproductive health of the large young generation must not be overlooked. Among youth ages 15 to 24, more than 10 percent of girls and 20 percent of boys had sex before age 15. Married youth in this age group report the highest unmet need for family planning.
During adolescence, young people develop many of the behaviors and relationships they will carry into their adult lives. Providing youth-friendly family planning information and services will drastically improve the health of this generation while contributing to higher educational attainment and greater opportunities for employment in the years ahead.
Family planning is a “win-win” for both health and wealth. Although the government has made some exciting advancements, more needs to be done to prevent unintended pregnancies. Empowering people, including youth, with knowledge about family planning and access to services will improve health and well-being and pave the way for a more prosperous Kenya.
Maura Graff is a policy analyst, International Programs, at the Population Reference Bureau.
- Population Reference Bureau and National Coordinating Agency for Population and Development, Kenya Population Data Sheet 2011 (Washington, DC: PRB, 2011).
- United Nations, World Population Prospects: The 2010 Revision (New York: UN Population Division, 2011).
- Government of Kenya, “Coordinating and Accelerating MDGs in Kenya’s Development Process. Transition Period for the Completion of the Project: Mainstreaming MDGs in Kenya’s Development Process 2005-2008” (2009).
- UN Population Division, “What Would it Take to Accelerate Fertility Decline in the Least Developed Countries?”Policy Brief (New York: UN Population Division, 2009).
- John Bongaarts and Steven Sinding, “Family Planning as an Economic Investment,” SAIS Review 31, no. 2 (2011): 35-44.