Family planning and female sanitary products
Business Model Description
Manufacture and distribute family planning products, such as condoms, and affordable female disposable and reusable sanitary products.
Expected Impact
Positively contribute to female health and wellbeing and reproductive choices.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- Kenya: Rift Valley
- Kenya: North Eastern
- Ghana: Eastern
- Kenya: Western
Sector Classification
Health Care
Development need
The Sustainable Development Report 2020 indicates Kenya's performance against SDG 3 - Good Health and Wellbeing is moderately improving, yet it is considered a major challenge.(1) COVID-19 has reversed some of the progress made on this goal by overwhelming health systems, and reducing access to health services for the population, especially vulnerable groups.
Policy priority
The Government of Kenya prepared a project called Transforming Health Systems for Universal Healthcare (THS-UC) with the World Bank to improve primary healthcare, focusing on reproductive, maternal, newborn, child, and adolescent health services.(2) Among the 'Big Four' policy agenda of the Third Medium Term Plan is reaching 100% universal healthcare coverage by 2022.(3)
Gender inequalities and marginalization issues
Around 25% of Kenya's population lack regular access to healthcare, which is exacerbated by poverty and gender. Studies estimate that each year, approximately 2.6 million people fall into poverty traps due to ill health.(36)
Investment opportunities introduction
Kenya is currently undergoing a transformation in its healthcare system to increase the affordability of services and medicine. Healthcare exhibits high policy momentum, and as such, presents attractive opportunities for investors. COVID-19 has also brought attention to new healthcare technologies / medicine / treatment methods that present a potential for innovation.
Key bottlenecks introduction
The main bottlenecks include regional disparities in services coverage, the low numbers of medical staff, low qualifications of medical personnel, limited healthcare infrastructure, lack of medical equipment and spare parts, high cost of medical equipment (mostly imported), limited access to drugs and medicine, difficulty in accessing medical universities and the lack of medical waste disposal.
Biotechnology and Pharmaceuticals
Development need
Kenya's development needs include investment in conscious family planning and maternal health, and increasing access to affordable family planning products and female reusable and disposable menstrual products.
Policy priority
The Kenyan Government prepared a project called Transforming Health Systems for Universal Healthcare (THS-UC) with the World Bank, to improve primary healthcare focusing on reproductive, maternal, newborn, child, and adolescent health services.(2) Among the 'Big Four' policy agenda of the Third Medium Term Plan is reaching 100% universal healthcare coverage by 2022.(3)
Gender inequalities and marginalization issues
The healthcare sector is strictly connected with the wellbeing of females. Improved access and promoted solutions for birth planning and feminine hygiene products may positively impact the number of women in the job market, reducing unemployment and improving the situation of families in the country.(4),(5)
Investment opportunities introduction
Investments in this sector will support one of the most important goals of the Third Medium Term Plan 2018 – 2022: providing improved access to contraceptives and decreasing the number of HIV (Human Immune Virus) cases and unplanned pregnancies.(3) This is also emphasized by the Kenyan Health Policy of 2014-2030.
Key bottlenecks introduction
The high cost of imported biotechnology products and pharmaceuticals cause affordability issues among the local population. The lack of public awareness about family planning and the inaccessibility of physicians may present other challenges.
Biotechnology and Pharmaceuticals
Pipeline Opportunity
Family planning and female sanitary products
Manufacture and distribute family planning products, such as condoms, and affordable female disposable and reusable sanitary products.
Business Case
Market Size and Environment
Kenya imports USD 5.9 million worth of contraceptives, and 4 million girls in schools need sanitary products.
In 2019, Kenya imported almost USD 5.9 million worth of rubber sheath contraceptives (8), indicating a large demand which could not be satisfied through domestic production. According to a report by McKinsey, the price of pharmaceutical products produced locally can be up to 12% lower than the cost of imported pharmaceuticals.(9)
According to the Kenyan Menstrual Hygiene Management Policy, there are more than 4 million adolescent females in Kenyan schools who are likely to need sanitary products.(10)
According to studies, approximately 15% of pharmacies in Kenya do not stock contraceptive implants.(11)
Indicative Return
15% - 20%
The estimated return rate for investors is 17.5% - 21.5%. This rate is a benchmark calculated as the cost of equity with a country risk premium, reflecting an average return required by investors active in the pharmaceutical drugs subsector.(12)
Investment Timeframe
Medium Term (5–10 years)
Due to capital expenditure requirements, the construction period and the time needed for obtaining permits to manufacture pharmaceuticals and female disposables in Kenya is expected to be medium term.
Ticket Size
USD 500,000 - USD 1 million
Market Risks & Scale Obstacles
Business - Supply Chain Constraints
Problems related to demand and public awareness
Problems related to demand and public awareness
Impact Case
Sustainable Development Need
In 2012, only 45% of women of reproductive age received family planning (16) and in 2019, unplanned pregnancies reached 44%.(17) The use of contraceptive products declined between 2017 and 2019, from 62% to 56% among married women.(17)
Kenya's score for new HIV (Human Immune Virus) infections per 1,000 population is 1.2, signalling a significant challenge and need for further investments in products that can prevent sexually transmitted diseases.(7)
According to recent research, two in three girls in Kenya cannot regularly access menstrual products (18), leading to the use of unsafe substitutes or no usage at all, directly impacting women’s attendance at school, work or related activities.(18)
Gender & Marginalisation
This investment opportunity area is designed with a gender lens. Further statistics are provided below.
Research from Huru International shows 65% of women and girls in Kenya cannot afford menstrual products. Because of this, the average girl reports missing at least 3 days of school per month.(19)
During the last 50 years, almost all countries recorded a drop in the total fertility ratios, moving towards 2-3 births per woman and advancing in gross domestic product (GDP) per capita. Facilitating family planning requires better access to family planning products.(20)
Expected Development Outcome
Increased access to family planning products
Reduced number of unplanned pregnancies, stabilized population growth
Reduced spread of HIV (Human Immune Virus) and venereal diseases
Gender & Marginalisation
Increased access to family planning and reproductive health services for women
Primary SDGs addressed
3.3.1 Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations
3.7.1 Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods
3.7.2 Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age group
166 per 1,000 population at risk (37)
77.6% of married woman (37)
81.79 births per 1,000 women aged 15-19 (37)
N/A
100%
N/A
4.6.1 Proportion of population in a given age group achieving at least a fixed level of proficiency in functional (a) literacy and (b) numeracy skills, by sex
85.2% youth literacy, 74.97% adult literacy (37)
100%
5.6.1 Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care
56% in 2017 (37)
100%
Secondary SDGs addressed
Directly impacted stakeholders
People
Gender inequality and/or marginalization
Public sector
Indirectly impacted stakeholders
People
Outcome Risks
Single-use contraceptive methods used repeatedly (condoms) generate waste that may be harmful if not handled properly.(21)
Unusable contraceptives (damaged, expired etc.) further contribute to this problem.(21)
The Menstrual Hygiene Management Policy highlights a potential problem of poor disposal of menstrual products. It argues that it may lead to infections and diseases if not handled properly.(22)
Gender inequality and/or marginalization risk: There is a risk that contraceptives and menstrual products remain inaccessible to Kenyan women if their prices do not fall.
Impact Risks
Execution Risk: The probability that the activities are not delivered as planned or do not result in the desired outcomes. That is, imported products are preferred to the domestically manufactured options, or contraceptive use does not increase due to low public awareness. These factors mean impact is not achieved.
Gender inequality and/or marginalization risk: The lack of public awareness about how to or whether to use contraceptives may reflect risks on female reproductive choices and health.
Impact Classification
What
Providing access to affordable contraceptives and menstrual products will positively contribute to female health and wellbeing and reproductive choices/family planning.
Who
This investment opportunity area will increase access to family planning for the entire population and support the reproductive rights of women.
Risk
Poor disposal and waste management may pose environmental risks.
Impact Thesis
Positively contribute to female health and wellbeing and reproductive choices.
Enabling Environment
Policy Environment
Kenya Health Policy 2014-2030: This policy recognizes the need for investments in contraceptives as one of the critical factors relating to maternal health and family planning.(23)
Kenya Youth Development Policy 2019: This policy highlights early and unintended pregnancies as one of the key issues prohibiting female empowerment.(24)
Third Medium Term Plan 2018 – 2022: This plan recognizes insufficient access to contraceptives as an obstacle against reducing the number of HIV (Human Immune Virus) cases and unplanned pregnancies.(3)
As a part of global partnership in Family Planning 2020, Kenya committed to increasing the availability of contraceptives to 58% for married women.(25)
Kenya Reproductive, Maternal, Newborn, Child and Adolescent Health Investment Framework: This framework sets 5 ambitious goals for female empowerment to be achieved by 2020, such as increasing female skills training, antenatal care visits, the use of contraceptives, HIV (Human Immune Virus) testing and counselling.(26)
Financial Environment
Fiscal incentives: Newly listed companies receive preferential corporate tax rates, depending on the percentage of listed shares. (The normal rate is 30% for resident corporations and 37.5% for non-resident corporations.)(33)
Other incentives: A 2.5% capital deduction is offered for industrial buildings for the first 40 years of operation.(33) There is a 100% investment deduction for capital expenditures on manufacturing buildings/machinery; this is increased to 150% for investment over USD 2 million outside of Nairobi. (33),(34) There are wear and tear deductions of 37.5% for heavy machinery, tractors etc.
Regulatory Environment
Reproductive Health Care Bill (2014): This Bill imposes an obligation on the national and county governments to make available contraception and family planning services, including contraceptive options, counselling, information and education.(27)
Guidelines for the Conduct of Clinical Trials in Kenya: These guidelines set the current minimum requirements to obtain authorization for conducting clinical studies for investigational drugs, medical devices or herbal drugs.(28)
Guidelines for the Transportation of Pharmaceuticals in Kenya: These guidelines outline the requirements for transporting pharmaceutical products to maintain product quality within the distribution channel from manufacturing to consumption and disposal.(29)
Compendium of Good Manufacturing Practices: This document provides conditions and requirements for carrying out GMP (good manufacturing practice) inspections,(30)
Pharmacy and poisons Act 2012, Chapter 244: This Act regulates the procedures for obtaining permission to produce pharmaceuticals in Kenya. (31) Food, Drugs and Chemical Substances Act 1978, Chapter 254: This Act prevents the adulteration of food, drugs and chemical substances.(32)
Marketplace Participants
Private Sector
Reckitt-Benckiser, DKT International, Marie Stopes Kenya, Pfizer Inc., Innolatex (Thailand) Ltd, Hartwood Enterprises, Merck Co. Inc, AFRIpads
Government
Ministry of Health
Multilaterals
World Bank, World Health Organization (WHO), US Agency for International Development (USAIDP), Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, One Acre Fund
Non-Profit
International Center for Reproductive Health (Kenya), National Council for Population and Development, ZanaAfrica Foundation
Target Locations
Kenya: Rift Valley
Kenya: North Eastern
Ghana: Eastern
Kenya: Western
References
- (1) Sachs, J., Schmidt-Traub, G., Kroll, C., Lafortune, G., Fuller, G., Woelm, F. (2020). The Sustainable Development Goals and COVID-19. Sustainable Development Report 2020. Cambridge: Cambridge University Press.
- (2) World Bank (2021). Transforming Health Systems for Universal Care. https://projects.worldbank.org/en/projects-operations/project-detail/P152394?lang=en&tab=procurement
- (3) Republic of Kenya (2018). Third Medium Term Plan 2018 – 2022 Transforming Lives: Advancing Socio-economic Development Through The 'Big Four', 2018.
- (4) Gapminder (2018). Falling birth rates and powerful leaders. https://www.gapminder.org/topics/birth-rates-leaders/
- (5) Belvedere, M.J. (2019). Melinda Gates to religious and political leaders: ‘The Pill’ can help lift families out of poverty. CNBC. https://www.cnbc.com/2019/04/24/melinda-gates-the-pill-can-help-lift-families-out-of-poverty.html
- (6) Frost and Sullivan (2018). Digital Market Overview: Kenya. https://ww2.frost.com/files/5915/2878/3560/Digital_Market_Overview_FCO_Kenya_25May18.pdf
- (7) UNKenya (2020). Articulating the Pathways of the Socio-Economic Impact of the Coronavirus (COVID-19) Pandemic on the Kenyan Economy.
- (8) Comtrade database.
- (9) Conway, M., Holt, T., Sabow, A. and Yuan Sun, I. (2019). Should Sub-Saharan Africa make its own drugs? McKinsey. https://www.mckinsey.com/industries/public-and-social-sector/our-insights/should-sub-saharan-africa-make-its-own-drugs
- (10) Ministry of Health (2020). Menstrual Hygiene Management Policy 2019-2030. Republic of Kenya. https://www.health.go.ke/wp-content/uploads/2020/05/MHM-Policy-11-May-2020.pdf
- (11) Kenya National Bureau of Statistics (2014). Kenya 2014 Demographic and Health Survey Atlas of County-level Health Indicators. https://www.dhsprogram.com/pubs/pdf/ATR16/ATR16.pdf
- (12) PwC analysis based on Prof. A. Damodaran data, 2020.
- (13) Finlay, J. and James, E. (2017). 'Barriers to Contraceptive Use: Examination of Contraceptive Laws and Contraceptive Use in Sub-Saharan Africa', Journal of Reproductive Health and Contraception, 2. https://contraceptivestudies.imedpub.com/barriers-to-contraceptive-use-examination-ofcontraceptive-laws-and-contraceptive-use-insubsaharan-africa.php?aid=20342
- (14) Ministry of Health (2020). Menstrual Hygiene Management Policy 2019-2030. Republic of Kenya. https://www.health.go.ke/wp-content/uploads/2020/05/MHM-Policy-11-May-2020.pdf
- (15) Haider, T. and Sharma, M. (2012). 'Barriers to Family Planning and Contraception Uptake in Sub-Saharan Africa: a Systematic Review', International Quarterly of Community Health Education 33(4). https://www.researchgate.net/publication/256704309_Barriers_to_Family_Planning_and_Contraception_Uptake_in_Sub-Saharan_Africa_A_Systematic_Review
- (16) Government of Kenya. Kenya Health Sector Strategic And Investment Plan (KHSSPI) July 2013 – June 2017
- (17) Global Citizen (2020). Unplanned Pregnancies Are Increasing in Kenya as Family Planning Services Decline. https://www.globalcitizen.org/en/content/unplanned-pregnancies-are-increasing-in-kenya/
- (18) Begley Bloom, L (2018). How One Woman Is Starting A Menstrual Revolution In Kenya. Forbes Women. https://www.forbes.com/sites/laurabegleybloom/2018/08/31/woman-starting-menstrual-revolution-kenya/?sh=db5cf2920444
- (19) Kite Oxford Nairobi (2019). Going With The Flow. https://www.kiteoxfordnairobi.org/blog/2019/9/6/going-with-the-flow
- (20) Gapminder (2018). Falling birth rates and powerful leaders. https://www.gapminder.org/topics/birth-rates-leaders/
- (21) United Nations Population Fund (2013). Safe Disposal and Management of Unused Unwanted Contraceptives. https://www.unfpa.org/sites/default/files/resource-pdf/Safe%20Disposal%20and%20Management%20of%20Unused%20Unwanted%20Contraceptives_2.pdf
- (22) Ministry of Health (2020). Menstrual Hygiene Management Policy 2019-2030. Republic of Kenya. https://www.health.go.ke/wp-content/uploads/2020/05/MHM-Policy-11-May-2020.pdf
- (23) Ministry of Health. Kenya Health Policy 2014-2030. http://publications.universalhealth2030.org/uploads/kenya_health_policy_2014_to_2030.pdf
- (24) Republic of Kenya. Kenya Youth Development Policy 2019.
- (25) KOIS Partners (2019). KOIS Impact Report 2019. https://koisinvest.com/wp-content/uploads/2020/05/KOIS-impact-report-2019.pdf
- (26) Ministry of Health (2016). Kenya Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) Investment Framework. https://www.globalfinancingfacility.org/sites/gff_new/files/Kenya-Investment-Case.pdf
- (27) Republic of Kenya. Reproductive Health Care Bill (2014). http://kenyalaw.org/kl/fileadmin/pdfdownloads/bills/2014/ReproductiveHealthCareBill2014__1_.pdf
- (28) Republic of Kenya. Guidelines for the Conduct of Clinical Trials in Kenya. https://pharmacyboardkenya.org/downloads
- (29) Ministry of Health. Guidelines for Transportation of Pharmaceuticals in Kenya. https://pharmacyboardkenya.org/downloads
- (30) National Drug Authority. Compendium of Good Manufacturing Practices (GMP). https://pharmacyboardkenya.org/downloads
- (31) Pharmacy and Poisons Act, Chapter 244, Rev. 2012. http://kenyalaw.org/kl/fileadmin/pdfdownloads/Acts/PharmacyandPoisonsAct_Cap.244.pdf
- (32) Food, Drugs and Chemical Substances, L.N. 105/1978, L.N. 228/1978, L.N. 190/1988, 1978 Kenya. http://kenyalaw.org:8181/exist/kenyalex/sublegview.xql?subleg=CAP.%20254
- (33) KENIvest. Investment Incentives. http://www.invest.go.ke/starting-a-business-in-kenya/investment-incentives/
- (34) Kenya Revenue Authority. https://www.kra.go.ke/en/ngos/incentives-investors-certificate/investing-in-kenya/incentives-investors
- (35) DKT International (2016). Kenya. https://www.dktinternational.org/country-programs/kenya/
- (36) Oxfam. Kenya: extreme inequality in numbers. https://www.oxfam.org/en/kenya-extreme-inequality-numbers
- (37) SDG Tracker (2021). End poverty in all its forms everywhere. https://sdg-tracker.org/no-poverty