Mainstreaming Emergency Contraception in Kenya

The Council expanded access to emergency contraception (EC) in public- and private-sector facilities by training providers and creating awareness about its availability and correct use.

The Issue

Emergency contraception (EC) is a highly effective option for women who wish to prevent pregnancy after unprotected sexual intercourse. However, availability of EC has been highly limited in Kenya, resulting in poor knowledge and limited use among women and providers.

The Progress

In late 2006, Kenya’s Ministry of Health (MOH), the Population Council, and Population Services International (PSI) launched an initiative to increase the availability of EC pills and to mainstream provision of EC in both the private and public sectors. Specific objectives were to increase knowledge, awareness, and use of EC among Kenyan women aged 18–30 years; increase knowledge and awareness of EC among providers and pharmacists; and strengthen EC provision in both the private and public sectors.

Project activities included:

  • A national awareness-raising campaign that included mass-media activities, development of printed materials to answer women’s questions and concerns regarding EC, an EC telephone “hotline,” and discussion groups that provided women aged 18–30 with information on EC and other family planning methods.
  • Training of public-sector providers on EC provision, strengthened training on EC for student nurses, and improved supply sustainability through better record-keeping and enabling facilities to re-order EC.
  • Training private-sector pharmacists on EC provision; a “facts at a glance” leaflet containing five simple messages on EC to display on pharmacy counters; and education on helping current EC users choose effective contraceptive methods.

In 2010, a follow-on project focused on assisting the MOH in institutionalizing and sustaining the achievements of the initiative; providing continued support to the private sector to address concerns in the mass media over possible misuse of EC; locating additional support for EC services in Kenya; and sharing the Kenyan experience with other countries.

The Impact

The initiative has increased access to EC in the public and private sectors and resulted in the development of innovative strategies to provide basic information on EC to women. An endline survey conducted by PSI in 2009 of women living in sites that had been surveyed in 2007 found significant increases in the proportions of women who had heard of EC (from 24% to 56%) and who had ever used it (from 5% to 10%). Sales of EC in the private sector more than tripled over the course of the project—from 45,840 units in 2007 to more than 138,000 in 2009—and use of EC in the public sector also increased, though not as significantly. Knowledge of EC among providers increased, and providers demonstrated more favorable attitudes toward EC.

The Nursing Council and the Clinical Officers’ Council in Kenya updated their training curriculums to integrate training on EC, and the Kenya Ministry of Health revised the National Family Planning Guidelines to include updated guidance on EC. The results of the project were disseminated to the national press guild, policymakers, and donors at a national dissemination meeting in June 2010.

Kenya’s experience serves as a model for other countries in the region that are interested in mainstreaming EC services. The Council organized site visits for teams from Malawi, Rwanda, Uganda, and Zambia to demonstrate how EC is procured, dispensed, and reported.

Principal Investigator