1. Kenya RHCS Program & Commodities Status June 21, 2016

2. Introduction Kenya has seen great improvement in utilization of family planning services in the last few years  Rise in CPR from 46% to 58 % for any method and 39% to 53% for modern methods  A decline in fertility rates from 4.6 to 3.9 children per woman  A decline in the unmet need for family planning from 26% to 18%

3. Improvements in Method Mix In 2008/9 high reliance on short acting methods at 78% and long acting methods at only 9% By 2014 latter methods accounted for 25% of the method mix and Long Acting method 69% Erosion of the permanent methods.

4. Method Mix Changes for Modern Methods Between 2008/9 and 2014

6. GOK created a budget line for FP commodities in 2012 and gradually increased budget allocation from 5million to over USD 7 million in 2013/2014 financial year. GOK allocation on FP commodities stopped following devolved system of governance Funds for procurement of commodities were transferred to the county governments (47 in total). Country is faced with dwindling availability of FP commodities. Reduced allocations to commodities by major players while others have stopped procurement altogether (KfW). The funding gap for 2016/17 financial year is about USD 13 million. 2016 Government’s commitment is yet to be quantified Commodity Security

7. FUNDING, REQUIREMENTS AND COMMITMENTS

8. Investment in FP Investment in FP commodities has been increasing from about US$ 6 million in FY 2010/11 to over US$23 million in FY 2013/14. Ensured constant supply of comprehensive range of contraceptives.

10. Funding Trends 2010-2016

11. Commodity Requirements Vs Commitments for FY 2015/16 The supply plan requirements for FY 2015/16 are estimated at USD 10,108,207 against which commitments worth USD 8,305,976 have been made This represents a 82% commitment against the forecasted requirements

12. Commodity Requirements Vs Commitments for FY 2016/17 Supply requirements for the year estimated at USD 13,000,855 Only USD 620,000 has been secured.

13. Summary 2015-2016

14. Gaps in FP Service Deliveru Shortage of FP commodities (IUD and implants) Reaching young people: Accessing community in the arid and semi-arid regions Religious and cultural practices Inadequate skills of the health workers especially in provision of long acting and permanent methods. Opposition to Comprehensive Sexuality Education from religious groupings FP commodity stock-out due to transition to devolved system of governance low capacity in proper quantification and forecasting by the county health teams

15. Challenges in Supply Chain Weak forecasting and quantification of commodities at the county level. Poor data management resulting in poor quality of data Lack of harmonized reporting and ordering system. This hampers monitoring or tracking of commodities

16. UNFPA support to address challenges/ accelerate access to FP services. Supporting formulation and development of policies and guideline documents that create enabling environment for FP high level advocacy meetings with Parliamentarians, County Governors and other leaders on increase funding for FP and prioritize FP as a health and development agenda Procurement of FP commodities –in 2015 UNFPA procured commodities worth over USD 5 million Working with religious and community leaders to promote acceptability of child spacing concept Supporting Sexual Reproductive Health (SRH) information programs for adolescents and youth out of school through the line Ministries of Health and Youth Affairs

17. Summary The GOK developed a budget line for contraceptives in 2005 which increased gradually to USD 7 million in 2012/13 financial year prior to devolution. This was re-instated during the 2015/16 but at only USD 500,000 Kenya committed to fund its FP commodities to meet its FP2020 goal