Using Modern Contraception While Wanting a Child: What Does Contraceptive Over-Use Mean for the Human Rights-Based Approach in Burkina Faso? Insights from PMA2020 Data
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data
2.2. Variables
- Deliberate use: women who do not want another child or wish to postpone pregnancy for more than 12 months and are using modern contraception;
- Deliberate non-use: women who want another child within 12 months and are not using modern contraception;
- Overuse: women who want another child within 12 months but are using modern contraception;
- Unmet need: women who do not want another child or want to postpone childbearing for more than 12 months but are not using modern contraceptives.
2.3. Analyses
3. Results
3.1. Sample Distribution and Prevalence of Overuse by Women’s Characteristics
3.2. Factors Associated with the Overuse of a Modern Contraceptive
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Functioning | |
Contraceptive behaviors | Deliberate use, Deliberate non-use, Overuse, Unmet needs |
Capability set | |
The ability to: | - choose an ideal number of children |
- decide on another childbearing: “Once you have a first child, you can decide when to have another one?” Responses: 1 = strongly disagree, 2 = disagree, 3 = indifferent/doubtful, 4 = agree, 5 = strongly agree. | |
- decide on what to do with FP: “You are (would be) able to choose what to do about family planning without considering what your husband/partner tells you to do”. Responses: 1 = strongly disagree, 2 = disagree, 3 = indifferent/doubtful, 4 = agree, 5 = strongly agree. | |
Endowments/conversion factors | |
Individual level | Age; Education; Marital status; Number of children; Type of contraceptive (for users); Method decision maker (for users) |
Household level | - Household wealth tercile - Place of residence |
Contextual level | Level of family planning acceptance (five questions) - “Do you agree with couples who use a method to avoid a pregnancy?” - “Does your partner/husband agree with couples who use a method to avoid a pregnancy?” - “Do you agree with a man or a woman who use contraception to avoid a pregnancy?” - “Do you agree with a couple who use contraception to try to space the births of their children?” - “Do you agree with a couple who use contraception to try to limit the number of children they will have?” Responses: 1 = strongly disagree, 2 = disagree, 3 = indifferent/doubtful, 4 = agree, 5 = strongly agree. |
Level of fertility support (five questions) - “Do you agree if a woman still carries a child on her back, she should not get pregnant?” - “Do you agree if your older daughter is pregnant, you should not be pregnant yourself?” - “Do you agree that a woman who uses a method to avoid a pregnancy will not have the number of children God chose for her?” - “Do you agree that using a method to avoid a pregnancy encourages having sex before marriage?” - “Do you agree that using a method to avoid a pregnancy encourages having sex outside of marriage (adultery)?” Responses: 1 = strongly disagree, 2 = disagree, 3 = indifferent/doubtful, 4 = agree, 5 = strongly agree. |
Sample Distribution | Proportion of Overuse | ||||
---|---|---|---|---|---|
Variables | Categories | Frequencies (n) | Percentages (%) | ||
Functioning | Contraceptive behavior | Deliberate use | 784 | 37.5 | - |
Deliberate non-use | 541 | 28.5 | - | ||
Overuse | 140 | 5.3 | - | ||
Unmet need | 509 | 28.7 | - | ||
Capability | Ideal number of children | 0 to 4 | 661 | 26.4 | 6.0 |
5 to 6 | 625 | 34.2 | 5.5 | ||
7 to 25 | 345 | 21.9 | 2.3 | ||
Up to God/DNK | 339 | 17.5 | 7.4 | ||
Can decide when to have another child | Do not agree/doubtful | 636 | 33.3 | 5.5 | |
Agree/strongly agree | 1338 | 66.7 | 5.1 | ||
Can decide alone what to do with FP | Do not agree/doubtful | 1490 | 74.8 | 5.2 | |
Agree/strongly agree | 484 | 25.2 | 5.5 | ||
Endowment/ Conversion factors | Age group | 15–24 | 677 | 34.5 | 5.9 |
25–39 | 1039 | 52.6 | 5.3 | ||
40–49 | 258 | 12.9 | 3.4 | ||
Education | No education | 1055 | 63.8 | 3.8 | |
Primary | 351 | 16.2 | 5.1 | ||
Secondary or higher | 568 | 20.0 | 10.0 | ||
Place of residence | Rural | 1064 | 77.8 | 3.9 | |
Urban | 910 | 22.2 | 9.9 | ||
Wealth tercile | Lower | 522 | 36.5 | 3.0 | |
Middle | 488 | 32.4 | 3.5 | ||
Higher | 964 | 31.1 | 9.9 | ||
Number of children | No child | 284 | 11.9 | 6.3 | |
One to Three | 964 | 44.7 | 6.9 | ||
Four or more | 726 | 43.4 | 3.3 | ||
Marital status | Not in union | 329 | 11.9 | 12.2 | |
In Union | 1645 | 88.1 | 4.3 | ||
Community-level FP acceptance | Low | 670 | 31.3 | 6.2 | |
Middle | 648 | 36.0 | 6.1 | ||
High | 656 | 32.8 | 3.5 | ||
Community-level of fertility support | Low | 717 | 40.5 | 4.0 | |
Middle | 619 | 34.5 | 4.6 | ||
High | 638 | 25.0 | 8.3 | ||
Total number of women | 1974 | 100.0 | 5.3 |
Women’s Characteristics | OR of Overuse among All Women | OR of Overuse among Users of a Modern Method |
---|---|---|
OR [95% CI] (p-Value) | OR [95% CI] (p-Value) | |
Ideal number of children (Ref = 0–4) | ||
5 to 6 | 1.55 [0.9–2.67] (0.111) | 1.59 [0.95–2.66] (0.079) |
7 to 25 | 0.82 [0.4–1.68] (0.587) | 0.94 [0.44–2.01] (0.865) |
Up to God | 2.04 [1.07–3.89] (0.029) | 2.42 [1.24–4.73] (0.01) |
Can decide on another child (Réf = Disagree) | ||
Agree | 0.89 [0.54–1.48] (0.665) | 0.9 [0.54–1.49] (0.673) |
Can decide what to do with FP (Réf = Disagree) | ||
Agree | 1.13 [0.66–1.95] (0.655) | 0.85 [0.44–1.63] (0.626) |
Age (Ref = 15–24) | ||
25–39 | 1.21 [0.69–2.14] (0.503) | 0.9 [0.46–1.76] (0.761) |
40–49 | 0.77 [0.31–1.9] (0.567) | 0.54 [0.19–1.51] (0.239) |
Education (Ref = No education) | ||
Primary | 1 [0.5–1.96] (0.991) | 1.07 [0.54–2.12] (0.836) |
Secondary or higher | 1.47 [0.85–2.53] (0.167) | 1.08 [0.62–1.86] (0.795) |
Household wealth (Ref = Low tercile) | ||
Middle | 1.14 [0.52–2.49] (0.742) | 1.11 [0.5–2.45] (0.797) |
Higher | 2.71 [1.56–4.71] (0) | 2.84 [1.55–5.23] (0.001) |
Marital status (Ret = Not in union) | ||
In Union | 0.42 [0.25–0.69] (0.001) | 0.68 [0.38–1.21] (0.19) |
Community FP * acceptance (Ref = Low) | ||
Middle | 0.85 [0.5–1.45] (0.558) | 0.64 [0.37–1.13] (0.127) |
High | 0.67 [0.34–1.31] (0.238) | 0.49 [0.24–1] (0.05) |
Community-level fertility support (Ref = Low) | ||
Middle | 1.03 [0.54–1.99] (0.922) | 1.1 [0.57–2.11] (0.775) |
High | 1.24 [0.73–2.1] (0.418) | 1.16 [0.67–2.01] (0.605) |
Type of methods (Ref = Short-term) | ||
Long-acting | 1.43 [0.89–2.29] (0.141) | |
Decision of FP use (Ref = Self) | ||
Joint/partner/provider | 0.6 [0.38–0.95] (0.028) | |
Method information level (Ref: low) | ||
Middle | 0.49 [0.29–0.83] (0.008) | |
High | 0.8 [0.46–1.42] (0.448) | |
N | 1974 | 924 |
Wald chi2 | 78.3 | 79.62 |
p-value | 0.000 | 0.000 |
LR test (compared to the empty model) chi 2 | 54.803 | 60.341 |
LR test p-value | 0.000 | 0.000 |
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Zan, M.L.; Sauvain-Dugerdil, C.; Rossier, C. Using Modern Contraception While Wanting a Child: What Does Contraceptive Over-Use Mean for the Human Rights-Based Approach in Burkina Faso? Insights from PMA2020 Data. Soc. Sci. 2024, 13, 447. https://doi.org/10.3390/socsci13090447
Zan ML, Sauvain-Dugerdil C, Rossier C. Using Modern Contraception While Wanting a Child: What Does Contraceptive Over-Use Mean for the Human Rights-Based Approach in Burkina Faso? Insights from PMA2020 Data. Social Sciences. 2024; 13(9):447. https://doi.org/10.3390/socsci13090447
Chicago/Turabian StyleZan, Moussa Lonkila, Claudine Sauvain-Dugerdil, and Clémentine Rossier. 2024. "Using Modern Contraception While Wanting a Child: What Does Contraceptive Over-Use Mean for the Human Rights-Based Approach in Burkina Faso? Insights from PMA2020 Data" Social Sciences 13, no. 9: 447. https://doi.org/10.3390/socsci13090447