Nowadays, more than ever, the improvement of access to family planning (FP) has become an international goal. What constitutes access to FP? Current human rights-based contraceptive guidelines indicate that access beg...Nowadays, more than ever, the improvement of access to family planning (FP) has become an international goal. What constitutes access to FP? Current human rights-based contraceptive guidelines indicate that access begins as soon as women or couples express a desire to avoid pregnancy and their risk of unintended pregnancy is established. However, few studies have sought to define and measure cognitive and psychosocial access to contraception. To propose a comprehensive framework for the cognitive and psychosocial accessibility of contraception, we critically analyzed the literature on attitudes toward FP. The main dimensions that emerged were knowledge about FP, fear of side effects, approval of contraception, and contraceptive agency. We then identified and adjusted some questions that can capture these dimensions more comprehensively. As a result, we developed a questionnaire module comprising 15 questions, which was integrated into the 6th round of the PMA2020 survey in Burkina Faso in 2019. This research highlighted that previous studies have collected separate dimensions of contraceptive access, and the psychosocial dimension tended to be neglected. Our results demonstrate that it is possible to collect comprehensive data on cognitive and psychosocial dimensions of access to family planning.展开更多
Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern co...Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.展开更多
While studies have examined physical access to services, cognitive and psychosocial barriers to contraceptive use have received less attention, despite their impact on access. Research shows that fours main dimensions...While studies have examined physical access to services, cognitive and psychosocial barriers to contraceptive use have received less attention, despite their impact on access. Research shows that fours main dimensions exist under the broad concept of cognitive and psychosocial access. This study aims to validate the construction of these dimensions and measure the relation between them and their links with modern contraceptive use. We utilized a questionnaire module to collect 15 questions measuring these dimensions through the 6<sup>th</sup> round of the Performance monitoring and accountability 2020 (PMA2020) survey in Burkina in 2019. We employed the scale validation technique to choose appropriate measures (observable indicators or items) for constructing each latent dimension (unobservable) in our study. The items consisted of questions that utilized a 5-point Likert scale or dichotomous responses to capture various psychosocial aspects. To assess the validity, reliability, convergence, and divergence of the latent dimensions and items, we utilized the validscale command in Stata. The validation process confirmed the reliability of all the dimensions. Contraceptive approval is more aligned with birth spacing rather than birth limiting, reflecting prevailing social perceptions. Women’s contraceptive agency was found to be more associated with their ability to discuss and negotiate with their partners rather than independent decision-making. Correlations between dimensions were generally weak, but the levels of knowledge, agency, and approval of contraception are positively correlated with contraceptive use and intention to use. Giving women more decision-making power and providing information to address side-effect concerns can enhance contraceptive approval.展开更多
Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender ...Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.展开更多
Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. A...Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.展开更多
文摘Nowadays, more than ever, the improvement of access to family planning (FP) has become an international goal. What constitutes access to FP? Current human rights-based contraceptive guidelines indicate that access begins as soon as women or couples express a desire to avoid pregnancy and their risk of unintended pregnancy is established. However, few studies have sought to define and measure cognitive and psychosocial access to contraception. To propose a comprehensive framework for the cognitive and psychosocial accessibility of contraception, we critically analyzed the literature on attitudes toward FP. The main dimensions that emerged were knowledge about FP, fear of side effects, approval of contraception, and contraceptive agency. We then identified and adjusted some questions that can capture these dimensions more comprehensively. As a result, we developed a questionnaire module comprising 15 questions, which was integrated into the 6th round of the PMA2020 survey in Burkina Faso in 2019. This research highlighted that previous studies have collected separate dimensions of contraceptive access, and the psychosocial dimension tended to be neglected. Our results demonstrate that it is possible to collect comprehensive data on cognitive and psychosocial dimensions of access to family planning.
文摘Background: Efforts have been made in Burkina Faso, a French-speaking country, since 2010 to improve healthcare access and provide affordable contraceptive methods to women. With the increasing prevalence of modern contraceptives in Burkina Faso, it is important to examine the socio-demographic factors that contribute to this new pattern of contraceptive use. This study aims to analyze the changes in socio-demographic factors associated with long-term contraceptive use and provide scientific evidence to guide policy development and action planning in family planning. Data and Methods: We utilized data from the 2010 Demographic and Health Survey, which included 17,087 women aged 15 - 49 years, and the 2015 Demographic and Health Module, which included 11,504 women in the same age group. For the analysis of contraceptive use, we focused on women who were in need of contraception (either met or unmet), of reproductive age, non-pregnant, and either married or sexually active but not married. We included users of modern reversible methods and excluded non-users, as well as users of traditional or permanent methods. Results: Our findings revealed a high prevalence of long-term contraceptive use across all categories;however, certain challenges were identified, such as lower levels of information about contraceptive methods among users and the persistence of inequalities. Family planning discussions and partner approval did not influence long-term contraceptive choice. Additionally, some providers selectively offered specific methods based on women’s life course characteristics, such as parity and marital status, despite evidence suggesting that young and nulliparous women can effectively use long-term methods. Conclusion: Given the high effectiveness of long-term contraceptive methods, it is crucial to address barriers that hinder their utilization among young and nulliparous women, as well as those who desire to delay pregnancy. Efforts should focus on improving knowledge and dispelling misconceptions surrounding long-term methods. Providers play a pivotal role in this process by adopting counseling strategies that enhance users’ understanding and facilitate informed decision-making regarding contraceptive options.
文摘While studies have examined physical access to services, cognitive and psychosocial barriers to contraceptive use have received less attention, despite their impact on access. Research shows that fours main dimensions exist under the broad concept of cognitive and psychosocial access. This study aims to validate the construction of these dimensions and measure the relation between them and their links with modern contraceptive use. We utilized a questionnaire module to collect 15 questions measuring these dimensions through the 6<sup>th</sup> round of the Performance monitoring and accountability 2020 (PMA2020) survey in Burkina in 2019. We employed the scale validation technique to choose appropriate measures (observable indicators or items) for constructing each latent dimension (unobservable) in our study. The items consisted of questions that utilized a 5-point Likert scale or dichotomous responses to capture various psychosocial aspects. To assess the validity, reliability, convergence, and divergence of the latent dimensions and items, we utilized the validscale command in Stata. The validation process confirmed the reliability of all the dimensions. Contraceptive approval is more aligned with birth spacing rather than birth limiting, reflecting prevailing social perceptions. Women’s contraceptive agency was found to be more associated with their ability to discuss and negotiate with their partners rather than independent decision-making. Correlations between dimensions were generally weak, but the levels of knowledge, agency, and approval of contraception are positively correlated with contraceptive use and intention to use. Giving women more decision-making power and providing information to address side-effect concerns can enhance contraceptive approval.
文摘Background: In Burkina Faso, efforts have been made between 2010 and 2015 to address the low levels of contraceptive utilization. However, the socio-cultural context in the country still reinforces traditional gender roles, low status for women, and a strong desire for larger families. The objectives of this study are twofold: 1) to analyze the trends in reversible modern contraceptive prevalence, and 2) to identify the factors influencing the use of reversible modern contraceptives, comparing the urban and rural areas. Data and Methods: We conducted an analysis using data from Burkina Faso sourced from the 2010 Demographic and Health Survey (DHS) and the 2015 Demographic and Health Module (DHM). The 2010 DHS received responses from 17,087 women aged 15 - 49 years, achieving a response rate of 98.4%. Similarly, the 2015 DHM garnered responses from 11,504 women aged 15 - 49 years, with a response rate of 96.6%. Results: Our findings revealed that while advancements were observed in urban areas, the majority of underprivileged women still faced limited access to modern contraception. Moreover, we did not observe any significant interaction effects between age and parity with the year of the survey. However, there was a slight decrease in the impact of marital status, although the difference between married and non-married women remained significant in 2015. It is noteworthy that family planning discussions and approval continued to play crucial roles. Conclusion: The initiatives to subsidize contraceptive costs and establish mobile clinics have proven inadequate in facilitating rural, impoverished, and young women’s access to modern contraception. Additional endeavors are required to enhance geographical accessibility to modern contraceptives by expanding the availability of supply sources, particularly in rural areas. Furthermore, providing psychosocial support has the potential to empower women in making informed contraceptive decisions and exercising greater control over their reproductive choices.
文摘Background: Long-acting and reversible contraceptive methods hold great potential as solutions to address the unmet need for contraception and the significant discontinuation rates, especially in sub-Saharan Africa. Among these methods, the Implant has gained popularity in sub-Saharan Africa, whereas the utilization of Intrauterine Devices (IUDs) has remained comparatively low, particularly in Burkina Faso. This study aims to evaluate the shifts in IUD and Implant usage from 2010 to 2020 and to pinpoint the factors influencing the choice of IUDs among LARCs users in Burkina Faso. Data and Methods: We conducted an analysis using data from Burkina Faso, drawn from the 2010 Demographic and Health Survey (DHS) and the 2020 PMA Phase 1 data. The 2010 DHS garnered responses from 17,087 women aged 15 - 49, achieving a response rate of 98.4%. The 2020 PMA data collected responses from 6590 women aged 15 - 49, with a response rate of 95.8%. The final sample of Long-Acting Reversible Contraceptives (LARCs) users consisted of 1502 women, including 576 women from the 2010 survey and 926 women from the 2020 survey. Results: The study demonstrates an expansion of IUD usage to include socioeconomically disadvantaged segments among LARC users. However, higher levels of education, older age, and decisions influenced by healthcare providers are correlated with the preference for IUDs over Implants. The choice of IUDs is also connected to a comprehensive understanding of contraceptive methods, suggesting potential biases in the counseling process. Conclusion: Facilitating the broader adoption of IUDs among disadvantaged groups could be achieved by improving the accessibility of IUD products and services in rural areas. Nevertheless, there should be focused initiatives to enhance access to removal services, as this factor could dissuade specific users. Further efforts are required to train healthcare providers, aiming to mitigate biases in delivering Long-Acting Reversible Contraceptives (LARCs). Providers should provide impartial counseling, irrespective of the selected type of LARC.
