By Evelyn Samba

More domestic investment needed for reproductive health services in Kenya to beat dwindling external funding

Recently, it was reported that in Nakuru county, four out of ten women could not access contraceptives, with women in far flung corners of that county being worse off.

This news hit home just as the right of Kenyan women and their partners to access sexual and reproductive health services is coming under threat not seen for years.

Already hit by dwindling external funding, sexual and reproductive healthcare suffered a fresh blow as U.S President Donald Trump re-instated the “global gag rule,” or Mexico City Policy in January 2017.

The ‘global gag rule’ (known as the Mexico City Policy) means that any organization involved in providing sexual and reproductive health services that uses its own money to provide, or even discuss, abortion services, will lose any US development funding it receives.  Even if the activities for which it receives US funding have nothing to do with pregnancy, family planning or abortions.

The world has been here before. President Ronald Reagan first sanctioned the ‘global gag rule’ in 1984. It was later withdrawn by President Bill Clinton, restored by President George W. Bush in 2001, and withdrawn again by President Barack Obama in 2009.

From 2001 to 2009, 20 developing countries in Africa, Asia, and the Middle East lost U.S. government funded contraceptives because of President Bush’s reinstatement of the ‘global gag rule’. Many organizations and clinics offering sexual and reproductive health services were forced to scale down services, lay off staff, or shut down entirely.

This adversely affected family planning, HIV services, maternal and child health, and even malaria services.

In 2006, Engender Health published a study documenting the impact of the 2001 – 2009 ‘global gag rule’ in Kenya. Family planning, HIV services, maternal and child health, and even malaria services were all affected.

The consequences were more severe for underserved and low income communities. This is because the clinics that were forced to shut down or scale down their operations, were often, the only source of healthcare for those communities. By 2005, the study estimated that 9,000 Kenyans had lost access to crucial health services due to the closure of reproductive health eight clinics operated by a non-profit health service provider.

The findings of that report by Engender Health show that the ‘global gag rule’ will disproportionately affect for low income and underserved communities.  Like those in Kuresoi North in Nakuru County in the media report mentioned above.

In the light of dwindling external resources, county governments need to up their investment in sexual and reproductive health service provision, and especially family planning services.

Investments for sexual and reproductive health services including family planning, go towards building/fabricating consultation rooms at health facilities, hiring and paying health workers, purchasing commodities as well as funding outreach activities.

Studies have shown that access to sexual and reproductive health services, including family planning, helps in cutting maternal and child deaths, eases the burden of post abortion care as well as new HIV and STI infections.

For the sake of all Kenyans, but especially underserved, remote and low income communities all over Kenya, it is vital that we direct more investment to sexual and reproductive health services.

This will ensure continued access to sexual and reproductive health services including family planning, voluntary counseling and testing (VCT) for HIV/AIDS, management of sexually transmitted infections, pharmaceutical services, laboratory services, post-abortion care, maternal and child health services for millions of Kenyan women, their partners and children.

In turn, continued access to sexual and reproductive health services will likely translate into a healthier, more economically productive population to power Kenya’s development aspirations.

The writer is the Kenya Country Director, at Deutsche Stiftung Weltbevoelkerung (DSW)