Nairobi: APHRC, 2014. 136 p.
Mumah, Joyce
Kabiru, Caroline W.
Mukiira, Carol
Brinton, Jessica
Mutua, Michael
Izugbara, Chimaraoke O.
Birungi, Harriet
Askew, Ian
African Population and Health Research Center
STEP UP Research Report
The report draws on data from four Kenya Demographic and Health Surveys (KDHS) (1993, 1998, 2003 and 2008/09), the Kenya AIDS Indicator Survey (KAIS) (2007), the Kenya Service Provision Assessment (KSPA) (2004 and 2010) and the Kenya National Survey for Persons with Disabilities (KNSPWD) (2008). Levels of key family planning and reproductive health indicators are set out, as well as fertility-and abortion indicators in Kenya. An equity lens was used, which differentiates these indicators by age, marital status, region, education and wealth. The report also looks at differential access to and quality of family planning and abortion/post-abortion services to assess their current situation, as well the various financing and delivery mechanisms for these crucial services. Chapter 2 provides an overview of reproductive health from a human-rights perspective. It presents information on sexual and reproductive health (SRH) rights in Kenya from a legal-, policy- and socio-cultural standpoint. This chapter gives a brief history of, and describes the current status of reproductive health, family planning and abortion laws and policies, the legal system and mechanism for protecting relevant human rights. It further provides an overview of vulnerable groups and the socio-cultural norms and trends concerning family formation and childbearing. Chapter 3 focuses on family planning and reproductive health, specifically on measures of family planning, contraceptive use, fertility levels, trends and differentials, fertility preferences, family planning use among vulnerable populations and the magnitude of abortion. This chapter also covers SRH indicators such as age at first birth/marriage, teenage pregnancy, and the ideal number of children desired and the levels of unwanted fertility. Differential analysis is performed in the chapter to provide a better understanding of the trends and patterns affecting different subsets of the population Chapter 4 covers indicators for access to and quality of family planning and abortion and post-abortion services. Specifically, it examines access to information and services, availability of services and access to abortion and post abortion care. Chapter 5 examines the various financing and delivery mechanisms for reproductive health in Kenya. This chapter assesses the current situation of various delivery mechanisms such as the clinic-based approach, community-based delivery, and social marketing of family planning services. Financing of reproductive health is assessed by examining different funding mechanisms including government, donors, cost sharing, output-based financing and health insurance schemes. Finally, Chapter 6 summarizes the report and discusses the key challenges facing reproductive health with a special focus on unintended pregnancy in Kenya. The chapter ends with policy and programmatic implications.
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