Kenya

Kenya is home to over 39 million people from more than 40 ethnic groups with a relatively low 32% of the population living in urban areas. In 1999, only seven urban centers had populations of over 100,000: Eldoret, Kisumu, Nairobi, Nakuru, Machakos, Meru and Mombasa. In spite of Kenya being one of the first countries to adopt a policy to slow population growth, high fertility combined with declining mortality resulted in Kenya having one of the world's highest population growth rates in the 1970s and 1980s.

The idea of limiting births was slow to catch on in a society that valued large families, but Kenya's total fertility rate (TFR), or average number of births per woman, declined from an estimated 8.1 children per woman in the late 1970s to 4.7 in the late 1990s, according to Kenya national survey estimates. Kenya's remarkable success in lowering its fertility rate was linked to a growing acceptance of family planning (FP) and increased contraceptive availability. However, Kenya's fertility decline has stagnated since then with the 2008 TFR estimated at 4.6 children per woman. The percentage of women using modern contraception, after showing little change in the early 2000s, has increased to 39% in 2008.

Kenya has also had to grapple with the AIDS epidemic, which eroded hard-won progress in health and mortality, and led to an estimated decline in the average life expectancy from 59 years in the 1980s to 53 years in 2007. Despite the fertility decline and AIDS mortality however, Kenya's population has continued to grow at a rapid pace: estimated at 2.6% annually in the early 2000s. The total population has more than doubled since 1978 and it is projected to reach 83.8 million by 2050.

The country-level program of the Urban Reproductive Health Initiative in Kenya (TUPANGE) is led by Jhpiego, an international health organization affiliated with The Johns Hopkins University in Baltimore. TUPANGE is a 5-year (2010-2015) integrated FP project designed to assist the Government of Kenya revitalize its family planning program in urban areas. TUPANGE will take place in the five urban centers of Kakamega, Kisumu, Machakos, Mombasa and Nairobi.

TUPANGE will promote both spacing and limiting methods of FP, focusing on increasing access to FP methods among the lowest three wealth quintiles. The project aims to significantly increase the contraceptive prevalence rate (CPR) in these selected urban centers of Kenya by 2015.

This will be accomplished by:

• developing cost-effective interventions for integrating quality FP services into existing maternal and child health and HIV services;
• improving the quality of FP services for the urban poor with emphasis on high volume clinical settings;
• testing innovative private-sector approaches to increase access to and use of FP by the urban poor;
• developing interventions that create demand for and sustain the use of contraceptives; and
• increasing funding and financial mechanisms and a supportive policy environment for ensuring success to FP supplies and services for the urban poor.