Investigating Seasonal Agriculture, Contraceptive Use, and Pregnancy in Burkina Faso

Abstract

Seasonal shifts in community-level agricultural production and their impact on the severity of the annual hunger season and household coping behaviors are important themes in climate change–health research. The relationship between seasonal variability, childbearing, and reproductive health, however, is less well understood. In this research, we combine detailed, spatially referenced Performance Monitoring for Action (PMA) data collected for Burkina Faso in 2017 and 2018 and a community-specific measure of seasonal agricultural quality to assess the relationship between seasonal agricultural variation and individual-level fertility and two dimensions of reproductive health: contraceptive use and pregnancy. We also incorporate data related to the family planning service environment. Results from cross-sectional regression models indicate that a better than average agricultural season might increase contraceptive use among all women, and analyses of monthly behaviors during and just after the growing season suggest that better than average growing season conditions might actually reduce contraceptive use among women who have no children or who are in their prime childbearing years. The results therefore indicate that women who are building their families might be less likely to use contraception and are perhaps more interested in timing births to occur following better than average growing seasons.

社区农业生产的季节性变化及其对年度饥荒季节的严重程度和家庭应对行为的影响, 是气候变化与健康的重要研究课题。然而, 我们缺乏对季节性变化、生育和生殖健康之间关系的理解。本文结合2017年和2018年布基纳法索的“绩效监测促进行动”空间数据、社区农业季节性质量监测数据, 评估了季节性农业变化与个人生育率和生殖健康(避孕药具的使用和怀孕)之间的关系。还考虑了计划生育服务环境数据。截面回归模型结果表明, 优于平均水平的农业季节可能会改善所有妇女的避孕药具使用情况。分析了生长季节及其之后短期内的月活动, 结果显示, 优于平均生长季节的条件会降低无子女或处于最佳生育年龄妇女的避孕药具使用。正在组建家庭的妇女不太可能使用避孕措施, 可能更倾向于在优于平均生长季节之后进行生育。

Los cambios estacionales en la producción agrícola a nivel comunitario y su impacto sobre la severidad de la estación anual de hambre y sobre los comportamientos hogareños para enfrentar los problemas concomitantes, son temas importantes en la investigación sobre el cambio climático. Sin embargo, la relación entre la variabilidad estacional, la maternidad y la salud reproductiva, es menos bien entendida. En esta investigación, combinamos los datos detallados y espacialmente referenciados del Performance Monitoring for Action (PMA), que se recopilaron en Burkina Faso en 2017 y 2018, y una medida específicamente referida al nivel comunitario sobre la calidad agrícola estacional, para evaluar la relación entre la variación agrícola estacional y la fertilidad a nivel individual, y dos dimensiones de la salud reproductiva: el uso de preservativos y el embarazo. También incorporamos datos relacionados con el entorno de los servicios de planificación familiar. Los resultados, derivados del uso de modelos de regresión transversal, indican que una estación agrícola mejor que el promedio podría incrementar el uso de anticonceptivos en todas las mujeres, y los análisis de los comportamientos mensuales durante y justo después de la temporada de desarrollo de los cultivos, sugieren que condiciones del cultivo mejores que el promedio podrían realmente reducir el uso de anticonceptivos entre las mujeres sin hijos o que se encuentran en sus mejores años de fertilidad. En consecuencia, los resultados indican que las mujeres que se encuentran formando sus familias podrían estar menos inclinadas al uso de métodos anticonceptivos y quizás más interesadas en la programación de los nacimientos, para que éstos ocurran tras temporadas de desarrollo del cultivo mejores que el promedio.

Key Words:

• Africa
• climate change
• contraceptive use
• fertility
• seasonality

关键词::

• 非洲
• 气候变化
• 避孕药具的使用
• 生育率
• 季节性。

Palabras clave::

• África
• cambio climático
• estacionalidad
• fertilidad
• uso de anticonceptivos

Acknowledgments

Much of this work was completed during some of the most challenging months of the COVID-19 pandemic and to complete this work the authors heavily relied on the support of many people. The authors thank Jane Lawrence Sumner, Corey Sparks, Nicholas Nagle, and Jude Mikal for extremely useful comments and supportive feedback on earlier drafts of the article. They also appreciate the vital technical support of Will Turner and Matt Gunther.

Notes

1 The analysis includes both fertility awareness-based methods and modern contraception as technologies or approaches to manage pregnancies. We use the terms contraceptive use and family planning use interchangeably in this article.

2 This information was gained through correspondence with the Johns Hopkins University team involved in this part of the PMA data collection.

3 From our correspondence with the PMA data development team at Johns Hopkins University, enumerators do not make decisions about which SDPs to survey; rather it is the responsibility of the in-country enumerator supervisor to randomly select up to three facilities from a comprehensive list of all private SDPs within the EA boundary. The supervisor also consults with the local health authority to determine the lowest level health post or clinic, the intermediate-level health center, and the district or referral hospital that serves the residents of the EA and personally conducts the interview at the public facilities. We acknowledge that the number of methods available could be subject to spurious changes in which facilities had a respondent available and willing to be interviewed. See https://www.pmadata.org/media/96/download?attachment.

4 We also exclude women who have an infant less than six months of age at the time of the start of the growing season because breastfeeding practices and other cultural practices could significantly affect their contraceptive use and likelihood of pregnancy.

Additional information

Funding

This research was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Development, Grant Numbers 2R01HD069471-11 and R01 HD099182-01A1.

Notes on contributors

Kathryn Grace

KATHRYN GRACE is an Associate Professor in the Department of Geography, Environment and Society at the University of Minnesota, Twin Cities, Minneapolis, MN 55455. E-mail: [email protected]. Her research interests include the impacts of climate change and agricultural variability on the health outcomes of women and children.

Devon Kristiansen

DEVON KRISTIANSEN is a Senior Data Analyst at the Institute for Social Research and Data Innovation within the University of Minnesota-Twin Cities, Minneapolis, MN 55455. E-mail: [email protected]. Her published work concerns topics surrounding unmet need, migration, and nutrition.

Elizabeth Heger Boyle

ELIZABETH HEGER BOYLE is a Professor of Sociology at the University of Minnesota, Twin Cities, Minneapolis, MN 55455. E-mail: [email protected]. Her research interests include women and children’s rights, particularly the right to health.

Maya Luetke

MAYA LUETKE is an early career social epidemiologist at the University of Minnesota, Twin Cities, Minneapolis, MN 55455. E-mail: [email protected]. Her research is broadly focused on the intersection of climate change, economics, sexual health, and the prevention of gender-based violence in the United States and in low- and middle-income countries.