Audit of USAID/Kenya"s population activities

USAID/K has made significant progress toward achieving its strategic objective for population. Kenya"s total fertility rate, once the highest in the world, but now the lowest in sub-Saharan Africa, dropped from 7.7 children per woman in 1984 to an estimated 4.9 in 1995. Over the same period, the contraceptive prevalence rate has increased. USAID/K contributed to this reduction by funding, inter alia: (1) development of a contraceptive distribution system with a central Nairobi warehouse supplying a network of regional and district warehouses, which in turn distribute contraceptives to local hospitals and clinics; (2) establishment of voluntary surgical contraception sites; (3) dissemination of FP information through radio and print media; and (4) training of community-based contraceptive distributors. USAID/K has made excellent progress towards output targets for the three project; in some cases it has exceeded targets. However, the Mission did not always establish interim targets or benchmarks to measure progress. Also, improvements are needed in the contraceptive supply system and inventory control. It is recommended that USAID/K: (1) establish interim targets for the Private Sector FP II project; (2) work with the Government of Kenya and with other donors to resolve transportation problems impeding the delivery of contraceptives to clinics; (3) assess operational needs for improving regional warehouses and district store management, inventory control practices, and record keeping; (4) ensure that regional warehouses are fully incorporated into the Logistics Management System; and (5) bring to the attention of the Kenyan Health/Population Donors Forum the complaints that have been received concerning pre-packaged medical kits and the physical examination equipment at clinics (even though these commodities are not supplied by USAID/K).