Kenya: Condoms Shortage at the Center of HIV Prevention Crisis

(file photo).
30 November 2021

Nairobi — The Ministry of Health has warned of an acute shortage of condoms attributed to dwindling donor resources.

This was highlighted in the Kenya National Condom Strategy 2018-2023 (KNCS) report, where it emerged that the country needs 455 million condoms annually against the 1.6 million provided by the government monthly.

Experts have blamed the shortage on heavy taxation of the commodity in a country where free condom programs are mainly donor-funded.

"There was a time that we had to reroute some commodities to neighboring countries since they do not levy taxes on donations. The lengthy procurement processes are also another battle for the donors," program analyst for HIV and disability at United Nations Population Fund, Lilian Langat said.

The ministry has however, advised Kenyans to visit the various health facilities and be informed on other available family planning methods, saying female condoms are in surplus.

"Together with our partners we have secured resources and we should be able to give further information when to expect these deliveries into the country," Health Cabinet Administrative Secretary Dr. Mercy Mwangangi said.

Last year, about 20 million condoms were distributed to Kenyans for free under a programme funded by the Global Fund and the United Nations Population Fund (UNFPA).

Despite Kenya's strong economic growth and lower-middle-income status, presence of a vibrant commercial market for consumer goods, commercial brands represent below 2% market share of the total condom market.

"The social marketers and for-profit private sector players distribute their condoms through various channels including supermarkets in urban centers, small corner shops and retail pharmacies among other outlets (Condom landscaping Report, 2017)," the KNCS report showed.

Investment by the Government in the condom program has been limited and particularly in the commitment of resources to finance procurement of the commodities.

About 600,000 female condoms are procured and distributed, with donor support, every year against an estimated annual demand of about 1.8 million (Data on file, UNFPA, 2009) in Kenya.

The resultant limited access to female condoms has discouraged their broader use by women to reduce the risk of HIV infection and unintended pregnancies.

The female condom is also commonly used by men having sex with men (MSMs) in Kenya. This is particularly because of their durability, better lubrication and low risk of breakage.

"Male condoms are widely available compared to female condoms in the country. Female condoms are often out of stock for extended periods. This limited and irregular supply of the female condoms is, in large part, due to the high unit cost and, therefore, low volumes are procured and distributed to users in the country."

National AIDS and STIs Control Program (NASCOP) head Catherine Ngugi said that the country needs USD4.6 million (Sh460 million) to procure 1.3 million male condoms and 884, 210 female condoms, funding which mainly comes from donors.

The cost of producing one male condom is around USD 4.3 (Sh430) while that of producing a female condom USD0.38 (Sh38).

"Even with donations from donors, we are nowhere near our target. We have not been able to meet our needs as a country. We are thinking of bringing other donors on board," Dr Ngugi said.

Ngugi underscored the need to address condom shortage amid rising cases of teenage pregnancy, HIV/Aids among the youth and the resurgence of sexually transmitted illnesses, including syphilis whose prevalence has risen to 28% among teenagers.

On condom promotion, an assessment they conducted revealed only 39.5 per cent women reported using condoms while the percentage of men stood at 70 percent.

This means out of 10 women, only four were using condoms while seven out of 10 men were using the family planning commodity, explained the National Aids Control Council CEO Ruth Masha.

The average global usage is 40 condoms per man while in Kenya, the figure stands at 14 condoms per man per year.

The distribution of public sector condoms from health facilities into the community remains a great challenge due to lack of a clear strategy. The KNCS report highlighted a lack of clarity on organizations tasked with the responsibility of ensuring this is done.

Some civil society organizations distribute public sector condoms from the health facilities to end-users through various channels and approaches including during awareness campaigns and events as well as in social places like bars and lodgings.

Another challenge is posed by limited storage at the lower level health facilities. This has impacted negatively on effective storage and timely distribution of adequate quality condoms to meet demand.

Kenya has made tremendous progress on the national and global targets to combat the HIV epidemic.

According to the Kenya HIV estimates 2017, the national HIV prevalence, among the adult population is 4.9% with approximately 1.5 million people were living with HIV.

Adult new HIV infections stand at 44, 800 as of 2018.

Adolescents and Young people age 15-24 and key populations account for 40% and 33% of new HIV infections respectively.

The high new HIV infections among adolescents and young people can be attributed to lower risk perception of HIV and changing attitudes: casual sex with multiple partners (or more partners in a shorter period of time), and cross-generational sex.

This has also led to high adolescent and teenage pregnancies, which this condom strategy will address.

The report further unveiled a 10 point action plan for a sustainable Kenya condom program that includes:

Implementation of a policy and legislative framework to scale up access to condoms in 'areas of most need'.

Establishment of routine condom forecasting and quantification within national systems.

Establishment of a supply and logistics management system for condoms within the broader supply chain management for health products.

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