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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis

Authors: Joseph K. Wulifan, Albrecht Jahn, Hervé Hien, Patrick Christian Ilboudo, Nicolas Meda, Paul Jacob Robyn, T. Saidou Hamadou, Ousmane Haidara, Manuela De Allegri

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

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Abstract

Background

Unmet need for family planning has implications for women and their families, such as unsafe abortion, physical abuse, and poor maternal health. Contraceptive knowledge has increased across low-income settings, yet unmet need remains high with little information on the factors explaining it. This study assessed factors associated with unmet need among pregnant women in rural Burkina Faso.

Method

We collected data on pregnant women through a population-based survey conducted in 24 rural districts between October 2013 and March 2014. Multivariate multilevel logistic regression was used to assess the association between unmet need for family planning and a selection of relevant demand- and supply-side factors.

Results

Of the 1309 pregnant women covered in the survey, 239 (18.26%) reported experiencing unmet need for family planning. Pregnant women with more than three living children [OR = 1.80; 95% CI (1.11–2.91)], those with a child younger than 1 year [OR = 1.75; 95% CI (1.04–2.97)], pregnant women whose partners disapproves contraceptive use [OR = 1.51; 95% CI (1.03–2.21)] and women who desired fewer children compared to their partners preferred number of children [OR = 1.907; 95% CI (1.361–2.672)] were significantly more likely to experience unmet need for family planning, while health staff training in family planning logistics management (OR = 0.46; 95% CI (0.24–0.73)] was associated with a lower probability of experiencing unmet need for family planning.

Conclusion

Findings suggest the need to strengthen family planning interventions in Burkina Faso to ensure greater uptake of contraceptive use and thus reduce unmet need for family planning.
Literature
1.
Bongaarts J, Bruce J. The causes of unmet need for contraception and the social content of services. Stud Fam Plan. 1995;26:57–75.CrossRef
2.
Westoff CF. Measuring the unmet need for contraception. Comment on Bongaarts. Popul Dev Rev. 1992;18:123–5.CrossRef
3.
Bankole A, Hussain R, Sedgh G, Rossier C, Kaboré I, Guiella G. Unintended pregnancy and induced abortion. In: Burkina Faso: causes and consequences; 2014.
4.
Nortman DL. Measuring the unmet need for contraception to space and limit births. Int Fam Plan Perspect. 1982;8:125–34.CrossRef
5.
Westoff CF, Pebley AR. Alternative measures of unmet need for family planning in developing countries. 1981.
6.
Okonofua FE, Odimegwu C, Ajabor H, Daru PH, Johnson A. Assessing the prevalence and determinants of unwanted pregnancy and induced abortion in Nigeria. Stud Fam Plan. 1999;30:67–77.CrossRef
7.
USAID. Family planning and the MDGs. Saving lives, saving Ressources. Task Order. 2009;1:8.
8.
Sengh G, Bankole A, Singh S. Women with an unmet need for contraception in developing countries and their reasons for not using a method. 2007 p. 80. Report No.: 37.
9.
Kabagenyi A, Jennings L, Reid A, Nalwadda G, Ntozi J, Atuyambe L. Barriers to male involvement in contraceptive uptake and reproductive health services. A Qualitative Study of Men and Women’s Perceptions in Two Rural Districts in Uganda. Reprod Health. 2014;11:21.CrossRefPubMedPubMedCentral
10.
11.
Mosha I, Ruben R, Kakoko D. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania. A Qualitative Study. BMC Pub Health. 2013;13:523.CrossRef
12.
Cates WJ. Family planning. The essential link to achieving all eight millennium development goals. Contraception. 2010;81:460–1.CrossRefPubMed
13.
Hill K, Choi Y. Maternal mortality in 2000. Estimates developed by WHO, UNICEF and UNFPA. Geneva: World Health Organization; 2004.
14.
WHO. HRP - UNDP/UNFPA/World Bank special Programme of research, development and research training in human reproduction. Kenyan men interested in family planning, but can the available services address their needs? Soc Sci Res Policy Briefs. 1999;1:1–2.
15.
16.
Blanc AK, Way AA. Sexual behavior and contraceptive knowledge and use among adolescents in developing countries. Stud Fam Plan. 1998;29:106–16.CrossRef
17.
Casterline JB, Sinding SW. Unmet need for family planning in developing countries and implications for population policy. Popul Dev Rev. 2000;26:691–723.CrossRef
18.
Central Intelligence Agency, USA. The world Factbook. Africa, Burkina Faso; 2014.
19.
Population Reference Bureau. Population and economic development 2014 data sheet. Washington, DC: PRB, 2014 - Google Search; 2014.
20.
Sedgh G, Rossier C, Kaboré I, Bankole A, Mikulich M. Estimating abortion incidence in Burkina Faso using two methodologies. Stud Fam Plan. 2011;42:147–54.CrossRef
21.
Bankole A, Singh S, Hass T. Reasons why women have induced abortions: evidence from 27 countries. Int Fam Plan Perspect. 1998;24(3):117–27. 1998CrossRef
22.
Adanu RM, Seffah J, Anarfi JK, Lince N, Blanchard K. Sexual and reproductive health in Accra, Ghana. Ghana Med J. 2012;46:58–65.PubMedPubMedCentral
23.
Okech TC, Wawire NW, Mburu TK. Contraceptive use among women of reproductive age in Kenya’s City slums. Int J Bus Soc Sci. 2011;2:22–43.
24.
Palamuleni ME. Socio-economic and demographic factors affecting contraceptive use in Malawi. Afr J Reprod Health. 2013;17:91–104.PubMed
25.
Babalola S, Vonrasek C. Communication, ideation and contraceptive use in Burkina Faso: an application of the propensity score matching method. J Fam Plann Reprod Health Care. 2005;31:207–12.CrossRefPubMed
26.
Sando B, Sya D, Pare R, Kouanda S, Savadogo L. The use of contraceptive methods by the Mossi in a rural health district of Kaya. Burkina Faso: Montrouge; 2001.
27.
Ayah R, Joshi MD, Wanjiru R, Njau EK, Otieno CF, Njeru EK, et al. A population-based survey of prevalence of diabetes and correlates in an urban slum community in Nairobi, Kenya. BMC Public Health. 2013;13:371.CrossRefPubMedPubMedCentral
28.
Korra A. Attitudes toward family planning and reasons for nonuse among women with unmet need for family planning in Ethiopia. Calverton: ORC Macro Calverton; 2002.
29.
Westoff CF. New estimates for unmet need and demand for family planning. 2006.
30.
Imasiku ENS, Odimegwu CO, Adedini SA, Ononokpono DN. Variations in unmet need for contraception in Zambia. Does ethnicity play a role? J Biosoc Sci. 2014;46:294–315.CrossRefPubMed
31.
Omane-Adjepong M, Oduro FT, Annin K. A multinomial regression analysis of unplanned pregnancies in Ahafo Ano South District, Ghana. Am Int J Contemp Res. 2012;2:12.
32.
Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21:459–68.CrossRefPubMed
33.
Westoff CF, Bankole A. Trends in the demand for family limitation in developing countries. Int Fam Plan Perspect. 2000;26:56–97.CrossRef
34.
Woldemicael G, Beaujot R. Currently married women with an unmet need for contraception in Eritrea. Profile and determinants. Can Stud Popul. 2011;38:61–81.CrossRef
35.
Adebowale SA, Palamuleni ME. Determinants of unmet need for modern contraception and reasons for non-use among married women in rural areas of Burkina Faso. Afr Popul Stud. 2014;28:499–514.CrossRef
36.
Jones S, Wardlaw J, Crouch S, Carolan M. Modelling catchment areas for secondary care providers: a case study. Health Care Manag Sci. 2011;14:253–61.CrossRefPubMed
37.
Diesfeld HJ. The definition of the hospital catchment area and its population as a denominator for the evaluation of hospital returns in developing countries. Int J Epidemiol. 1973;2:47–53.CrossRefPubMed
38.
Acock AC. A gentle introduction to Stata. 4th ed. College Station, Texas: A Stata Press Publication, StataCorp LP; 2014.
39.
Long JS, Freese J. Regression models for categorical dependent variables using Stata. College Station, Tex: Stata Press; 2001.
40.
41.
World Bank. Contraceptive prevalence in Burkina Faso. World Bank- Ctry. Website-2015; 2010.
42.
Bradley SE, Croft TN, Fishel JD, Westoff CF. Revising unmet need for family planning- DHS analytical studies 25. USA: ICF Int. Calverton Md; 2012.
43.
Bongaarts J. The KAP-gap and the unmet need for contraception. Popul Dev Rev. 1991;17(2):293–313.
44.
Westoff CF. Is the KAP-gap real? Popul Dev Rev. 1988;14(2):225–32.
45.
Hamdela B, G/mariam A, Tilahun T. Unwanted pregnancy and associated factors among pregnant married women in hosanna town, southern Ethiopia. PLoS One. 2012;7:e39074.CrossRefPubMedCentral
46.
Ikamari L, Izugbara C, Ochako R. Prevalence and determinants of unintended pregnancy among women in Nairobi, Kenya. BMC Pregnancy Childbirth. 2013;13:69.CrossRefPubMedPubMedCentral
47.
Palamuleni ME, Adebowale A, et al. Prevalence and determinants of unintended pregnancies in Malawi. Afr Popul Stud. 2014;28:551–63.CrossRef
48.
49.
Hailemariam A, Haddis F. Factors affecting unmet need for family planning in southern nations, nationalities and peoples region, Ethiopia. Ethiop. J Health Sci. 2011;21:77–89.
50.
Cleland J, Harbison S, Shah IH. Unmet need for contraception: issues and challenges. Stud Fam Plan. 2014;45:105–22.CrossRef
51.
Lasee A, Becker S. Husband-wife communication about family planning and contraceptive use in Kenya. Int Fam Plan Perspect. 1997;23:15–33.CrossRef
52.
Mahmood N. Reproductive goals and family planning attitudes in Pakistan: a couple-level analysis. Pak Dev Rev. 1998;37:19–34.PubMed
53.
Bawah AA, Akweongo P, Simmons R, Phillips JF. Women’s fears and Men’s anxieties. The impact of family planning on gender relations in northern Ghana. Stud. Fam. Plann. 1999;30:54–66.
54.
Hall MAK, Stephenson RB, Juvekar S. Social and logistical barriers to the use of reversible contraception among women in a rural Indian Village. J Health Popul Nutr. 2008;26:241–50.PubMedPubMedCentral
55.
Kaida A, Kippi W, Hessel P, Konde-Lule J. Male participation in family planning. Results from a qualitative study in Mpigi District,Uganda. J Biosoc Sci. 2005;37:18.CrossRef
56.
Abeykoon A. Sex preference in south Asia: Sri Lanka an outlier. Asia Pac Popul J. 1995;10:5–16.PubMed
57.
Arnold F. Son preference in South Asia. In: Sathar ZA, Phillips JF, editors. Fertility transition in South Asia, vol. 2001. London: Oxford University Press; 1996. p. 281–99.
58.
Arnold F. Gender preferences for children. U. S. agency Int. dev. USAID- off. Popul. Reprod. Health bur. Glob. Health. 1997;
59.
Bairagi R. Effects of sex preference on contraceptive use, abortion and fertility in Matlab, Bangladesh. Int Fam Plan Perspect. 2001;27:137–43.CrossRef
60.
Clark S. Son preference and sex composition of children: evidence from India. Demography. 2000;37:95–108.CrossRefPubMed
61.
Edlund L. Son preference, sex ratios, and marriage patterns. J Polit Econ. 1999;107:1275–304.CrossRef
62.
Das Gupta M, Zhenghua J, Bohua L, Zhenming X, Chung W, Hwa-Ok B. Why is son preference so persistent in east and South Asia? A cross-country study of China, India and the Republic of Korea. J Dev Stud. 2003;40:153–87.CrossRef
63.
Winikoff B. The effects of birth spacing on child and maternal health. Stud Fam Plan. 1983;14:231.CrossRef
64.
Segal SJ. The effect of breastfeeding on the rate of conception. In: Tietze SL, Lincoln R, editors. Fertil. Regul. Public health. New York, NY: Springer New York; 1987. p. 3–4.CrossRef
65.
Labbok MH, Perez A, Valdes V, Sevilla F, Wade K, Laukaran VH, et al. The Lactational amenorrhea method (LAM): a postpartum introductory family planning method with policy and program implications. Adv Contracept. 1994;10:93–109.CrossRefPubMed
66.
WHO. Ensuring human rights in the provision of contraceptive information and services. Geneva: WHO; 2014.
67.
Ross JA, Winfrey WL. Contraceptive use, intention to use and unmet need during the extended postpartum period. Int Fam Plan Perspect. 2001;27:20.CrossRef
68.
Singh S, Sedgh G, Hussain R. Unintended pregnancy: worldwide levels, trends, and outcomes. Stud Fam Plan. 2010;41:241–50.CrossRef
69.
Kumpfer KL, Alvarado R, Smith P, Bellamy N. Cultural sensitivity and adaptation in family-based prevention interventions. Prev Sci. 2002;3:241–6.CrossRefPubMed
Metadata
Title
Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis
Authors
Joseph K. Wulifan
Albrecht Jahn
Hervé Hien
Patrick Christian Ilboudo
Nicolas Meda
Paul Jacob Robyn
T. Saidou Hamadou
Ousmane Haidara
Manuela De Allegri
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1614-z

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