- Currently, Kenya’s family planning budget faces a shortfall of Ksh2.4 billion, which could worsen if international support declines, potentially leading to increased unintended pregnancies and other maternal health issues.
- At the heart of this struggle are organisations like Marie Stopes Kenya (MSK), which supports the Embakasi clinic in delivering comprehensive reproductive health services.
- President Donald Trump’s re-entry into the White House on January 20, 2024 could signal the return of the global gag rule, which has the potential to disrupt healthcare delivery, increase unintended pregnancies, and lead to higher rates of unsafe abortions.
On the bustling streets of Tassia, in Nairobi’s Eastlands, a group of young activists march with purpose, chanting, “If you’re not prepared for a child, use a condom, save a life!” Their colourful t-shirts and impassioned slogans draw a mix of curious and disapproving stares from onlookers as they advocate for safe sex, contraception, and family planning on World Safe Abortion Day.
Just a few blocks away, a different scene unfolds at the Embakasi Health Centre. Its family planning clinic is filled with women, some accompanied by their partners, seeking a range of reproductive health services. This juxtaposition reflects the complex and often contentious landscape of reproductive healthcare in Kenya.
At the heart of this struggle are organisations like Marie Stopes Kenya (MSK), which supports the Embakasi clinic in delivering comprehensive reproductive health services. From family planning and STI screening to post-abortion care, MSK’s mission is to empower individuals to make informed choices about their sexual and reproductive health.
“We offer a variety of contraceptive methods, including hormonal and non-hormonal implants, IUDs, oral contraceptives, condoms, and permanent methods like tubal ligation and vasectomies,” explains Victor Mbogo, the chief medical officer’s representative at the Embakasi Health Centre. “We ensure that clients receive thorough counselling to help them select the most suitable method for their needs.”
Mbogo is however clear that the facility does not provide voluntary abortions, as the act is prohibited under Kenyan law. “We do not provide any kind of service that involves the voluntary termination of a pregnancy because the law does not allow it,” he states.
This legal restriction reflects the ongoing debate around reproductive rights in the country. In 2022, the Family Reproductive Healthcare Bill, introduced by Suba North Constituency Member of Parliament Millie Odhiambo, sought to address these challenges by allowing for the termination of pregnancy under specific circumstances, such as emergencies, risks to the mother’s life or health, and potential severe fetal deformities.
The Bill takes a comprehensive and balanced approach to addressing critical reproductive health challenges. It reaffirms constitutional provisions on abortion, allowing healthcare providers to conscientiously decline services while ensuring access to safe abortion through referrals.
It permits termination of pregnancy with the consent of the woman, and for pregnant minors, with the consent of parents or guardians while prioritising the minor’s best interests.
Furthermore, the Bill emphasises Menstrual Health Management and equitable reproductive healthcare for persons with disabilities, aiming to improve overall reproductive health outcomes in Kenya while respecting cultural and religious sensitivities.
However, pro-choice legislation has faced strong opposition in the past from groups like CitizenGo and other pro-life advocates who oppose abortion in any form, citing cultural and religious concerns. This opposition reflects the deep divisions that have long plagued the reproductive health discourse in Kenya.
Amid these legal and political hurdles, organisations like MSK have confronted an even more daunting challenge: funding.
The global gag rule is a US government policy that prohibits foreign Non-Governmental Organisations (NGOs) from receiving US global health assistance if they provide, advocate for, or refer to abortion services, even if those activities are funded by non-US sources.
Initially introduced by President Ronald Reagan in 1984, the policy has been reinstated and expanded by subsequent Republican administrations, most notably by President Donald Trump in 2017.
The implications of this policy are far-reaching. Organisations that choose to comply with the rule must forgo any involvement in abortion-related services or advocacy to maintain their eligibility for US funding.
This creates a significant barrier to comprehensive reproductive health care, as many organisations are forced to choose between essential funding and providing full reproductive health services.
About 40% of MSK’s work focuses on preventing unwanted pregnancies, highlighting the importance of family planning in reducing the need for abortion services.
Under the previous President Donald Trump’s administration, the reinstatement of the “global gag rule” – also known as the Mexico City Policy – has had a devastating impact on MSK’s operations.
The global gag rule cut $30 million or Ksh3.9 billion in annual US government funding that was to support MSK’s reproductive health services in Kenya. This setback severely hampered its ability to provide essential family planning and post-abortion care.
President Donald Trump’s re-entry into the White House on January 20, 2024 could signal the return of the global gag rule, which has the potential to disrupt healthcare delivery, increase unintended pregnancies, and lead to higher rates of unsafe abortions.
Despite this setback, MSK has continued to provide essential family planning and post-abortion care by securing emergency funding from European governments and other sources.
Meanwhile, the unmet need for contraceptives in the country persists. As of 2024, 14% of women in Kenya who wish to delay or avoid pregnancy still lack access to modern contraceptives, despite the contraceptive prevalence rate (CPR) among married women rising from 32% in 2003 to 57% in 2022.
The Kenyan government aims to increase the contraceptive prevalence rate (CPR) among married women from 57% in 2022 to 66% by 2030. But achieving this goal is fraught with challenges, including financial constraints and reliance on international funding.
Currently, Kenya’s family planning budget faces a shortfall of Ksh2.4 billion, which could worsen if international support declines, potentially leading to increased unintended pregnancies and other maternal health issues.
To address this gap, the United Nations Population Fund (UNFPA) has stepped in to advocate for increased access to family planning and contraceptives in Kenya.
The organisation emphasises the need for sustainable domestic financing for family planning and collaborates with the Ministry of Health and various partners to develop a roadmap aimed at increasing the national budget for contraceptives to 100% by 2026.
Adopting the perspective taken by MSK and other partners in the SRHR sub-sector, UNFPA continues to emphasize that improving access to family planning services is crucial for reducing unintended pregnancies, enhancing family welfare, and contributing to economic growth.
As the battle for reproductive rights and funding rages on, organisations like MSK remain steadfast in their mission to empower Kenyans with the knowledge and resources they need to make informed choices about their sexual and reproductive health.
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The stakes are high, as the possible reintroduction of the Helms Amendment and the Global Gag Rule under a Trump administration could severely impact the vital work these organisations are doing.
While the Global North’s political climate continues to shift, increased domestic funding for reproductive health programmes will become a key pillar to ensure their progress and protect the gains so far achieved.
Additionally, advocacy for sustained funding and support from international partners remains a priority for MSK and similar organisations working to improve reproductive health outcomes in the region.
