When Wamboi Wamboi walks into her local dispensary in Mukuru every three months, she knows exactly what she needs: the contraceptive injection that has kept her life on track for the past 29 months.
At just 20 years old, she says the shot has been her shield against unwanted pregnancies that have derailed the lives of many of her friends.
“I can’t even imagine what missing that injection would look like. I don’t even want to imagine it,” she tells Eastleigh Voice. But Wamboi has heard the whispers of a looming shortage. Her prayer is simple: that the shelves never run dry.
Six months ago, donor funding that sustained Kenya’s family planning program was suspended. United States Agency for International Development (USAID), once a major supplier of contraceptives, froze support early last year.
Globally, donor funding for contraception had already fallen to its lowest point in nearly a decade, and Kenya was left to rely on stored commodities and strong support from the United Nations Population Fund (UNFPA).
That cushion is now wearing thin. Public hospitals across the country report stockouts, leaving women like Wamboi anxious about their next dose. According to the Ministry of Health, nearly half of Kenyan women aged 15 to 49 either do not want more children or would prefer sterilisation. Yet their ability to exercise that choice is becoming more uncertain by the day
Mary Mueni, a community health promoter (CHP) and family planning advocate in Mukuru’s Lunga Lunga village, has guided women toward safe, reliable contraceptives for more than a decade.
Mueni says she has already received complaints from women, most of them users of short-term methods like pills, about being turned away at clinics.
“This is a setback in a community that has long faced unwanted pregnancies, teenage pregnancies, maternal deaths, and malnutrition,” she explains.
Speaking to The Eastleigh Voice about whether selling commodities through certified private clinics and chemists could help ease shortages, she said she believes it might, noting that women in her community already purchase contraceptives due to the distance from the only government health centre in the area.
“The only worry would be if the Total Market Approach made products more expensive, thus exploiting women. That would be a sad state,” she says.
She, however, fears that price hikes will push family planning out of reach. “Imagine women having to choose between buying food and paying for contraceptive services. That will be a crisis and might negatively affect the strides made in the sector.”
Collins Muchoki of Population Services Kenya believes the solution lies in a Total Market Approach. The model categorises clients by socioeconomic status and ensures tiered access to family planning services.
Poor women would continue to receive free commodities at government dispensaries, those who can afford small payments would access subsidised products at county hospitals, while middle and high-income clients could buy contraceptives at retail prices, easing the government’s burden.
Muchoki argues that including the private sector will not only fill the gap left by donor cuts but also introduce new products such as self-injectable contraceptives and self-care options.
On fears of exploitation, he points to Kenya’s strict regulatory framework. “The country has stronger laws to curb that. The government must ensure that those who cannot pay still get products at subsidised rates, as it is now,” he says.
Kenya’s government currently provides over 80 per cent of family planning commodities. This dominance has historically made the market unattractive to commercial retailers. But with shortages biting, the private sector’s role is becoming critical.
The 2022 Kenya Demographic and Health Survey revealed stark inequalities: arid and semi-arid counties such as Marsabit, where 38 per cent of women have an unmet need for family planning, Tana River at 34 per cent, and West Pokot at 30 per cent, bear the highest burden.
These regions also record the highest fertility rates, deepening cycles of poverty. Reviving the commercial market could expand choices and ensure sustainability. Yet the challenge remains: how to balance affordability with availability.
For Wamboi, Mueni, and thousands of women across Kenya, family planning is not a luxury – it is survival. The looming shortage threatens to undo years of progress in reducing maternal deaths, teenage pregnancies, and malnutrition.
Whether the Total Market Approach can deliver equity and access will determine if every woman, regardless of income, retains the power to choose.