by Mia Foreman, policy analyst, International Programs
Kenya’s population is growing rapidly, more than tripling from 10.9 million people in 1969 to 38.6 million in 2009. According to the United Nations, the annual population growth rate between 2010 and 2015 is 2.7 percent with 22.5 percent of the population residing in urban areas in 2011.
One area that has seen tremendous growth is Nairobi’s largest slum, Kibera. While experts have given estimates ranging from 270,000 to 2 million residents, Kibera is a large area of informal settlements plagued by challenges such as the lack of electricity, job opportunities, and high levels of violence.
While it may be easier to focus on what is lacking in Kibera, there are also many services being provided in the community including affordable and quality reproductive health care by organizations such as Marie Stopes Kenya.
Marie Stopes Kenya was established in Kenya in 1985 as a locally registered nongovernmental organization. It is Kenya’s largest and most specialized sexual reproductive health and family planning organization and is known for providing a wide range of high-quality, affordable, and client-centered services to men, women, and youth throughout Kenya. In 1997, Marie Stopes Kenya opened its first clinic in Kibera and began offering reproductive health services at an affordable rate for residents.
During a visit to the clinic, I had the honor of interviewing the Kibera Clinic Manager, Pamela Warinda. Pamela is a nurse and midwife by training and has been working with Marie Stopes since 1995. She began managing the clinic in Kibera in September, 2010.
When I asked her why Marie Stopes decided to open a clinic in the heart of Kibera, she replied, “The clinic is an absolute necessity. We take care of the women and men living in the slums and provide them [with] a place to go for quality healthcare that is non-judgmental. While there are other places to receive reproductive health services in Kibera, Marie Stopes offers methods that may not be available elsewhere such as implants, IUDs, and tubal ligation. People in Kibera can access contraceptives through government facilities but they may not have a provider available who can provide methods such as implants or IUDs so they can come to us for a small fee and receive these services. The fees we charge are lowered a bit to accommodate the economic reality of the residents.”
Pamela stated the clinic sees about 3,000 clients a year, most of whom are women between the ages of 14 and 40. The majority request the Depo Provera injection due to its privacy and ease of use. There are also, on average, 10 to 15 cases of post-abortion care each month. Pamela confirmed that many women in the community know that Marie Stopes Kenya offers post-abortion care services but they think they won’t be able to afford the care and end up dying of injury or infection.
To address these challenges, Marie Stopes Kenya advertises the services they offer throughout the community via signposts and in newspapers. They also partner with government facilities and other NGOs working in the community, such as Medecins Sans Frontieres, so patients can be referred to the Marie Stopes clinic for specialized services such as tubal ligation or post-abortion care.
While Pamela is seeing more women take ownership over their health, she still recognizes the need to combat rumors and share information about reproductive health in the community.
“Many women in Kibera don’t know about their reproductive rights and in general, about their own reproductive health. They think contraceptives have a lot of side effects and are scared to use the methods. I always tell them that using family planning to prevent an unwanted pregnancy is better than delivering a baby you didn’t want in the first place or going to great risk to abort the pregnancy. While we have accomplished so much, we continue to see the need to educate people in the community about the benefits of family planning so they can see us as a resource for their health and livelihood here in Kibera.”