Hormonal Intrauterine Devices (IUDs), a contraceptive method often prescribed to women with heavy menstrual bleeding, were previously only available in private health facilities at a cost ranging from Sh20,000 to Sh35,000. The government has now introduced this method to women in public health facilities in Kenya at no cost, the Ministry of Health announced.
Data from the Ministry of Health, Division of Family Planning, show that healthcare providers have dispensed a total of 6,816 devices to women in Kenya. Nairobi (1,285), Homa Bay (1,051), Kakamega (593), Nyeri (403), and Migori (372) Counties provided the most, accounting for nearly half of the total number. The government had procured 62,000 hormonal IUD units through the Kenya Medical Supplies Agency, (KEMSA).
Kenya’s Head of Family Planning, Dr Albert Ndwiga, said the government made the contraceptive method available in public health facilities to offer more choices to women who may not access them due to cost or medical challenges associated with traditional methods.
“There’s a population of women who would benefit more from using hormonal-based family planning, such as the HIUD,” said Dr Ndwiga.
Besides preventing pregnancy, hormonal IUDs prevent menorrhagia — a condition characterised by painful or heavy periods that can last up to ten days — and thereby help prevent iron-deficiency anaemia. A family planning method being incompatible with a woman’s body is one of the reasons why 14 percent of women do not use any modern contraceptive method despite yearning to delay pregnancy, according to the 2022 Kenya Demographic Health Survey.
It took the country 9 years to offer the service in public health facilities, ensuring both its safety and that the government could afford to continuously provide it, according to Dr Ndwiga. In 2015, the World Health Organisation (WHO) added the hormonal IUD to the WHO Essential Medicines List. Four years later, Kenya added it to the country’s list in 2019, authorising its use in health facilities. However, the method has only been available in private hospitals, where it costs as much as Ksh 20,000 to access it, a price that was out of reach for many women.
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Nurse-midwife and family planning specialist Alinda Ndenga, who was part of the team incorporating the service into public health facilities, said that the health system needed to be prepared with healthcare providers who could determine which women qualified for the hormonal IUD based on a set of medical criteria.
Alinda, along with 29 other healthcare workers experienced in counselling and inserting and removing another type of IUD — the copper IUD — was part of the first group trained by Jhpiego, an international NGO working to advance access to health for women and families, on the insertion and removal of hormonal IUDs in 2016.
“Healthcare providers needed to be trained to counsel the women appropriately, and when the women accepted, the healthcare provider inserted the hormonal IUD safely and removed it at any time upon the woman’s request,” said Ms Ndenga.
During this training, the Ministry of Health also developed a curriculum to train other healthcare workers to offer the service in Kenya. Using the developed curriculum, the first group of 30 trained healthcare providers trained another 65 healthcare providers from Kisumu and Migori counties. These two counties were used as pilot areas to gather the community’s attitudes and perceptions towards hormonal IUDs.
“To qualify to provide services, the tutors trained in the first group supervised the healthcare providers in Kisumu and Migori counties as they inserted ten hormonal IUDs and assessed them; 48 of the 65 trained healthcare providers qualified,” said Alinda.
Dr Ndwiga added that the Ministry of Health continues to train healthcare workers to ensure the quality of services provided. The Ministry of Health trained 5,342 healthcare workers in 1,788 public health facilities in the first phase of readying the country to offer the services.
