Why Kenya’s family planning crisis is far from over after the latest US decision

Paul is widely known for campaign and accountability reporting on health, the environment, and public finance, including his Follow the Money investigations. Before joining Defrontera, he served as Lead Editor at... Learn more

The US government, Kenya’s biggest financier for family planning, has reduced global health funding in its next year’s budget by another $4.3 billion, and in the document, Kenya has been singled out as not receiving any contraceptives from the US.

The Fiscal Year 2027 budget request states that “The United States should not pay for the world’s birth control and therapy” and lists “promoting health equity and providing condoms and contraception in Kenya” as one of the examples of eliminated activities.

This announcement cuts all hopes of Kenya receiving family planning funding. The country had depleted its stock of all commodities due to funding cuts from the United States and other countries that fund nearly 90 per cent of the world’s family planning. Earlier this year, Kenya’s largest family planning provider, the United Nations Population Fund (UNFPA), lost its financial support from the United States.

Defrontera’s inquiries to the Ministry of Health were directed to the Treasury. A source from the Ministry of Health, who had not obtained authorisation to speak to the media by the time this story went to press, told Defrontera: “We present the needs of the country and wait for allocation.”

Treasury Cabinet Secretary John Mbadi told Defrontera that the government has stepped up funding for key health programmes to cushion the impact of reduced donor support. He said that the government allocated KES 7.55 billion to the Ministry of Health in this financial year, a slight increase from KES 7.10 billion in the previous year.

Mr Mbadi told Defrontera: “One of the biggest beneficiaries of the increment was the budget for procurement of TB drugs, which more than tripled from Sh70 million to Sh300 million. The budget for procurement of family planning and reproductive health commodities remained flat at Sh500 million, which means that the stock-outs will persist.”

According to the Department of Family Health, the unit in the Ministry of Health that coordinates reproductive health, Kenya needs KES 5.8 billion for family planning in 2026. What the government has provided, KES 0.5 billion, is only 9% of the requirement. Despite family planning being a national programme—alongside HIV, malaria, and tuberculosis—the Treasury boss directed the burden to the counties:

“Health is the number one devolved function. If you add to the money that counties should be allocating, all the 47 counties should be allocating to health programmes, we should almost be there in terms of providing universal health care.”

In its policy intent to the global partnership focused on family planning (FP2030), Kenya had stated that the country would “increase domestic financing for family planning commodities to cover 100% of the requirements by 2026.” The country has not met this commitment.

Family planning stock-outs will continue to persist because of how the government has structured its procurement and distribution. According to a 2024 analysis by UK-based health consultants Options, Kenya included family planning in its development blueprint, Kenya Vision 2030, targeting to increase the use of modern contraceptives to 70% by 2030.

However, the report notes that the short-term planning documents that guide allocation of funds do not include family planning as a priority.

The report reads: “Family planning commodities are missing in the Medium-Term Plan (MTP) and in the Medium-Term Expenditure Framework (MTEF). FP commodities budget is bundled together under the Project Code & Project Title - 1081105300 Procurement of FP & Reproductive Health Commodities; this obscures proper budget allocation and complicates advocacy efforts.”

The government has perennially not allocated adequate funds to family planning. Between 2020/21 and 2024/25, the family planning commodities budget was forecast at US$149.5 million, but the government allocated just 40% (US$36.8 million) of its required contribution. There was no government funding at all in the years 2022 and 2024.

Even when money is allocated, sometimes as little as just 20% is used.

“The main reason why there is low prioritisation is because of overreliance on donor financing of FP commodities — GOK expectations that donors will fund FP commodities as they always have, and the FP programme not being anchored in the MTP, leaving it at the mercy of MoH officers to choose whether to prioritise it in the MTEF.”