District health facilities/stores continue to bear the brunt of insufficient Family Planning (FP) supplies as compared to private and NGO facilities, which, are buffered by other sources. Key findings from the Kenya Urban Reproductive Health Supply Chain study indicate that contraceptive supply at national level is effective, unlike district stores occasioned by frequent stock outs and low fulfillment rates.

The study further demonstrated the lack of sufficient funding to support the supply chain, inadequate flow of information, distribution challenges and lack of skills among health workers to execute commodity management. However, four key options on how to improve the supply chain emanated from the study:

• Maintain the current system but increase support to the district stores.
• Kenya Medical Supplies Agency (KEMSA) to supply all facilities (both public and private) directly, hence bypassing the district stores, which would then serve as buffer sources.
• KEMSA to supply all public facilities (both Ministry of Health and municipality facilities) and the district stores to act as a buffer for public facilities as well as supply private facilities.
• KEMSA to supply all public facilities (both Ministry of Health and municipality facilities) with the district acting as a buffer whilst private facilities source for their own supplies independently.

The third option was perceived as the best option and discussions are underway with the National Reproductive Health Commodity Security Committee on how to utilize the findings of this study to inform improvement of reproductive health commodity supply chain in the country.

These findings made up part of the discussions at the Family Planning quarterly stakeholders’ Technical Working Group (TWG) meeting held on May 8, 2012. The meeting served as a platform to discuss how best to meet set targets, share ideas and experiences on how to improve the quality and efficiency of FP service delivery. The GIZ Health Sector Programme participated in this meeting as a key stakeholder in improving access to and utilization of modern methods of family planning.

The meeting also tackled a report on the Family Planning Commodities Stock levels at central level as at end of March 2012. Injectable contraceptives, in particular DMPA (Depo-Provera), and condoms (male and female) were both noted to be under stocked, however, 1.5M vials of DMPA and 8.64 million male condoms were undergoing clearance at the port. The apparent under stock of female condoms was due to the transfer of 1.67M units transferred from KEMSA stores to Kenya National Aids and STI Control Programme (NASCOP). Some of the planned and on-going activities to improve FP commodity security include:

• Review of the FP Commodity Pipeline
• On-going orientation of pharmacists on reproductive health commodity management
• Provision of manual and electronic Logistics Management Information Systems (LMIS) tools for FP data collection and reporting
• On-going distribution of FP commodities to lower levels

FHI360 also presented results of their Mobile for Reproductive Health (m4RH) pilot study, which showed that the system had a broad reach, is easy to use, increased FP knowledge and increased uptake on FP particularly among young people. The study conducted in Kenya further shows that the system can be easily adapted to disseminate other health messages e.g. maternal health, HIV, etc., and can be utilized in sending clinic visit reminders.

Key challenges that would need to be addressed if the system is to be rolled out to a larger scale include issues of sustainability including costs of engaging a technological partner, coordination and management.

M4RH is a reproductive health promotion platform that utilizes the short message service (SMS) system to disseminate messages on family planning methods that users can access via their mobile phones. The messages are centred on evidence-based information, including the World Health Organization family planning handbook for providers, and crafted specifically for short message service (SMS) or text message use. The m4RH system also provides service delivery information so users can locate clinics to provide more information and the family planning method of their choice.

Family planning is a life-saving phenomenon, it saves the lives of women and children, prevents mother to child transmission of HIV, while helping men and women choose the number, healthy spacing and timing of their children. Despite this, the unmet family planning need among married women remains high. Furthermore, it is anticipated that the number of couples of reproductive age, together with sexually active unmarried individuals in need of Family Planning information and services will grow by 200,00 per year in the period 2005-2015.