The number of women in Kenya using contraceptives has risen considerably over the past five years, according to the 2014 Kenya Demographic and Health Survey, released recently.

The survey reports that 58 per cent of married women in Kenya are using birth control compared with 46 per cent when the survey was last conducted five years ago.

The report says this has had important health benefits for women, children and infants. Significantly, there has been a decline in the number of children who die before their fifth birthday.

“As contraceptive use increased, infant mortality dropped from 52 deaths per 1,000 live births in 2009 to 39 deaths per 1,000 live births today. The under-five mortality rate has seen an even steeper decline, from 74 deaths per 1,000 births to 52 deaths per 1,000 births,” says the report.

According to Josephine Kibaru-Mbae, director-general of the National Council for Population and Development (NCPD), the increase in contraceptive use in Kenya is a result of guidelines the government issued recently that allow community health workers to provide injectable contraceptives and scale up advocacy and awareness activities at the county level, thereby building support and creating demand for family planning.

At the 2012 London Summit on Family Planning, Kenya made a strong commitment to ensure more women have access to contraceptives.

According to the FP2020 progress report released in November last year, Kenya has made significant gains as a whole in increasing contraceptive use.

However, some areas are lagging far behind. For example, only 2 per cent of women in Mandera and Wajir counties in the northeast use contraceptives compared with 81 per cent of women in Kirinyaga in central Kenya.

“With devolution making family planning more of a county responsibility, it’s now more critical than ever before for counties to make family planning a priority so that the health of all women, children and infants in Kenya improves,” said Dr Kibaru.

Similar surveys are being conducted in the other East African countries.

Rwanda is expected to release new DHS data this year, and Tanzania will start data collection for a new survey this year.

According to the report, slightly more than half of married women (58 per cent) are using some method of contraception; 65 per cent of sexually active unmarried women currently use some method of contraception.

Among married women, modern methods of contraception are more commonly used (53 per cent) than are traditional methods (5 per cent). Of the modern methods, injectables are the most widely used (26 per cent), followed by implants (10 per cent) and the pill (8 per cent).

The report, however, shows that a higher proportion of urban women (62 per cent) uses some method of contraception, compared with their rural counterparts (56 per cent). Contraceptive prevalence increases dramatically with education.

Only 18 per cent of currently married women with no education use contraception, while more than half of women with at least some primary school level of education use contraception. Women with 3-4 children are the most likely to be using contraception (66 per cent).

The unmet need among Kenyan women has declined slightly from the plateau experienced in the past decade and a half. Eighteen per cent of married women reported an unmet need for contraception in the 2014 KDHS compared with roughly one-quarter reported in surveys since 1998.

Women with an unmet need are those who are fecund and sexually active but are not using any method of contraception, but report not wanting any more children or wanting to delay the next child.

The level of unmet need varies by background characteristics. The unmet need is higher in rural areas (20 per cent) than in urban areas (13 per cent).

Married women with no education have the highest unmet need for family planning (28 per cent) compared with 12 per cent among women with secondary or higher education. The unmet need declines steadily as wealth increases, from 29 per cent in the lowest wealth quintile to 11 per cent in the highest quintile.

Total demand for family planning also varies by background characteristics. Total demand increases with age, peaking at 35-39 years, after which it declines. Demand for family planning is lowest among women with no education and women in the lowest wealth quintile.

The three regions with the highest total demand for family planning services are Eastern (83 per cent), Central (82 per cent) and Western (80 per cent). The percentage of demand satisfied with modern methods peaks at age 25-29 (77 per cent), and it increases with education and wealth.

Although the total demand is similar in urban and rural areas, the proportion of demand satisfied is higher in urban areas. Northeastern region has the lowest total demand (33 per cent); however, it also has the lowest percentage of demand satisfied.

Sexually active unmarried women reported a higher demand for family planning and a higher unmet need than currently married women. The total demand is 92 per cent, while the level of unmet need is 27 per cent.