Trends and patterns of modern contraceptive use and relationships with high-risk births and child mortality in Burkina Faso

Figures & data

Table 1 Categories of risks related to fertility behaviour

Category	Definition	Abbreviation
No risk
Not in any risk category	Second and third birth order born to mother between age 18 and 34 years and birth interval >23 months	No risk
Unavoidable risk
First birth at age 18–34 years	First child born to mother between ages 18 and 34 years	1st birth+MA=18–34 y
Single high risk
Mother's age <18 years	Mother's age at birth <18 years, birth order <4, and birth interval >23 months	MA<18 y+BO<4+BI>23 m
Mother's age >34 years	Mother's age at birth >34 years, birth order <4, and birth interval >23 months	MA>34 y+BO<4+BI>23 m
Birth interval <24 months	Birth interval <24 months, mother's age at birth 18–34 years, and birth order <4	BI<24 m+MA=18–34 y+BO<4
Birth order >3	Birth order >3, mother's age at birth 18–34 years, and birth interval >23 months	BO>3+MA=18–34 y+BI>23 m
Multiple high risk
Mother's age <18 years and birth interval <24 months	Mother's age at birth <18 years and birth interval <24 months or mother's age at birth <18 years and birth order >3	MA<18 y+(BI<24 m∣BO>3)
Mother's age >34 years and birth interval <24 months	Mother's age at birth >34 years, birth interval <24 months and birth order <4	MA>34 y+BI<24 m+BO<4
Mother's age >34 years and birth order >3	Mother's age at birth >34 years, birth order >3, and birth interval >23 months	MA>34 y+BO>3+BI>23 m
Birth interval <24 months and birth order >3	Birth interval <24 months, birth order >3, and mother's age at birth 18–34 years	BI<24 m+BO>3+MA=18–34 y
Mother's age at birth >34 years, birth interval <24 months, and birth order >3	Mother's age at birth >34 years, birth interval <24 months, and birth order >3	MA>34 y+BI<24 m+BO>3

MA, mother's age at childbirth (y, years); BI, birth interval (m, months); BO, birth order.

Fig. 1 Modern contraceptive use by women in a union by year and by location of residence in Burkina Faso.

Table 2 Distribution of women in a union with at least one child by regional modern contraceptive prevalence rates and change over time

	mCPR 2003		mCPR 2010		mCPR change 2003–2010		Unweighted number
Region	%	95% CI	%	95% CI	%	Sig.	2003	2010
Boucle du Mouhoun	11.0	(7.5–16.0)	12.1	(9.0–16.1)	1.1	ns	697	1,429
Cascades	13.8	(9.9–19.0)	18.8	(15.3–22.9)	5.0	ns	293	495
Centre	27.1	(21.6–33.4)	31.3	(27.5–35.4)	4.2	ns	791	1,337
Centre-Est	5.5	(3.4–8.9)	9.3	(7.0–12.2)	3.8	ns	747	964
Centre-Nord	7.3	(5.1–10.3)	9.8	(7.7–12.5)	2.5	ns	814	965
Centre-Ouest	6.5	(4.7–9.0)	9.8	(6.9–13.9)	3.3	ns	631	987
Centre-Sud	5.6	(4.2–7.5)	17.1	(13.8–20.9)	11.5	**	517	587
Est	2.5	(1.3–4.9)	11.4	(9.3–14.1)	8.9	**	724	1,199
Hauts-Bassins	12.1	(8.3–17.2)	28.1	(24.3–32.3)	16.0	**	1,111	1,409
Nord	8.9	(6.0–13.1)	10.8	(8.2–14.0)	1.9	ns	924	935
Plateau Central	5.1	(3.2–8.0)	14.9	(11.8–18.6)	9.8	**	453	610
Sahel	3.5	(1.6–7.2)	7.5	(5.1–10.8)	4.0	ns	656	1,014
Sud-Ouest	7.5	(4.0–13.7)	10.6	(8.0–13.9)	3.1	ns	431	537
Total	9.3	(8.0–10.7)	15.4	(14.2–16.7)	6.1	**	8,788	12,467

**Change significant at p<0.05; ns, change not significant at p<0.05; mCPR, modern contraceptive prevalence rates; CI, confidence interval; ns, not significant; sig., significance.

Table 3 Trends of total fertility rates and standard errors of total fertility rates by location of residence in Burkina Faso

	Rural areas		Urban areas		Nationwide
Year	TFR	SE-TFR	TFR	SE-TFR	TFR	SE-TFR
1998	7.31	(0.10)	4.05	(0.16)	6.80	(0.11)
2003	6.86	(0.10)	3.74	(0.20)	6.24	(0.13)
2010	6.85	(0.07)	3.92	(0.13)	6.09	(0.10)

TFR, total fertility rates; SE-TFR, standard errors of TFR.

Table 4 Distribution of births by risk category, changes over time, and relationships to under-five child mortality

	Births in the 5 years preceding each survey (%)			Under-five mortality rates in the 5 years preceding each survey (per 1,000)		Unweighted number of births
Birth risk categories	2010	Change	1998–2010	2010	Change 1998–2010	1998	2010
Not in any high risk category	28.2	4.7	**	101.7	−94.7	1,410	4,177
Unavoidable risk category
First birth between ages 18 and 34 years	13.4	1.2	ns	106.0	−143.3	730	1,985
Single high risk category
Mother's age <18 years	4.6	−0.9	ns	161.7	−123.5	330	677
Mother's age >34 years	0.5	−0.2	ns	91.8	91.8	15	79
Birth interval <24 months	3.8	−0.9	ns	190.6	−43.1	280	569
Birth order >3	29.0	0.1	ns	123.6	−57.5	1,737	4,296
Subtotal	38.0	−1.3	ns	134.9	−68.7	2,363	5,620
Multiple high risk category
Age <18 years and birth interval <24 months	[0.2]	[−0.5]	**	[291.6]	[75.3]	41	31
Age >34 years and birth interval <24 months	#	#	#	#	#	2	5
Age >34 years and birth order >3	13.8	−1.7	ns	112.1	−85.1	932	2,045
Birth interval <24 months and birth order >3	4.8	−2.0	**	212.4	−78.6	410	714
Age >34 years and birth interval <24 months and birth order >3	1.4	−0.6	ns	270.1	−5.4	119	212
Subtotal	20.3	−4.7	**	155.1	−79.9	1,504	3,006
In any high-risk category	58.3	−6.1	**	142.0	−73.9	3,867	8,626
Total	100	–		126.2	−89.4	6,008	14,789

**Change significant at p<0.05; ns, change not significant at p<0.05; [x], estimates based on unweighted cases between 25 and 50; #, estimates based on fewer than 25 unweighted cases.

Fig. 2 Distribution of high-risk births by location of residence over time in Burkina Faso.

Fig. 3 Distribution of births by risk factors and by region (total fertility rate: TFR) in 2010 in Burkina Faso.

Fig. 4 Modern contraceptive prevalence rates by region in 2003 in Burkina Faso.

Fig. 5 High-risk births distribution by region among children born between 2003 and 2008 in Burkina Faso.

Fig. 6 Under-five mortality rates by region among children born between 2003 and 2008 in Burkina Faso.

Table 5 Adjusted odds ratios from logistic regression models of modern contraceptive use by women in a union with a child born in the preceding 5 years in Burkina Faso

	Model 1 – rural area			Model 2 – urban area			Model 3 – nationwide
Risk birth factors and other background characteristics	aOR	95% CI		aOR	95% CI		aOR	95% CI
Mother's age at birth
<18	0.82	(0.41–1.63)	ns	1.08	(0.33–3.57)	ns	0.91	(0.51–1.62)	ns
18–34	1.12	(0.78–1.61)	ns	1.42	(0.69–2.92)	ns	1.19	(0.86–1.66)	ns
35–49	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Parity/birth order
1	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
2–3	1.22	(0.85–1.76)	ns	1.88	(1.25–2.84)	***	1.42	(1.08–1.87)	**
>3	1.21	(0.78–1.89)	ns	2.17	(1.10–4.27)	**	1.49	(1.02–2.17)	**
Birth interval
First birth	n/a			na			na
9–23 months	1.61	(1.20–2.17)	***	0.94	(0.50–1.77)	ns	1.41	(1.07–1.85)	**
24–35 months	0.98	(0.79–1.21)	ns	0.70	(0.52–0.95)	**	0.89	(0.75–1.06)	ns
36+ months	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Missing	2.63		ns	0.67	(0.10–4.56)	ns	0.75	(0.09–6.06)	ns
Sons born within preceding 5 years
0	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
1	1.34	(1.07–1.67)	**	1.09	(0.77–1.56)	ns	1.24	(1.02–1.49)	**
2–3	1.16	(0.79–1.73)	ns	0.88	(0.47–1.64)	ns	1.06	(0.76–1.49)	ns
Daughters born within preceding 5 years
0	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
1	1.16	(0.91–1.47)	ns	1.11	(0.79–1.56)	ns	1.13	(0.93–1.38)	ns
2–3	1.20	(0.80–1.80)	ns	0.95	(0.49–1.86)	ns	1.09	(0.77–1.55)	ns
Time since last birth
<1 year	0.20	(0.15–0.28)	***	0.26	(0.16–0.40)	***	0.22	(0.17–0.29)	***
1–2 years	0.83	(0.67–1.03)	*	0.75	(0.55–1.01)	*	0.81	(0.68–0.97)	**
3+ years	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Told about FP at health facility?
No	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Yes	3.17	(2.52–3.99)	***	2.21	(1.63–3.00)	***	2.81	(2.34–3.38)	***
Did not visit health facility	0.76	(0.58–0.99)	**	0.77	(0.53–1.12)	ns	0.75	(0.60–0.93)	***
Postnatal check at health facility?
No	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Yes	1.04	(0.80–1.36)	ns	1.19	(0.81–1.74)	ns	1.10	(0.89–1.37)	ns
Missing	1.01	(0.60–1.71)	ns	0.84	(0.43–1.63)	ns	0.98	(0.66–1.47)	ns
Location of residence
Urban	–			–			1.26	(0.99–1.60)	*
Rural	–			–			1.00	(ref.)
Administrative region
Boucle du Mouhoun	0.38	(0.23–0.62)	***	1.34	(0.65–2.74)	ns	0.69	(0.46–1.03)	*
Cascades	0.36	(0.18–0.68)	***	0.71	(0.41–1.21)	ns	0.58	(0.36–0.93)	**
Centre	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Centre-Est	0.38	(0.21–0.67)	***	0.69	(0.44–1.09)	ns	0.60	(0.40–0.88)	***
Centre-Nord	0.44	(0.28–0.71)	***	0.82	(0.43–1.57)	ns	0.69	(0.46–1.03)	*
Centre-Ouest	0.36	(0.20–0.66)	***	0.78	(0.48–1.27)	ns	0.60	(0.38–0.94)	**
Centre-Sud	0.73	(0.48–1.12)	ns	0.92	(0.51–1.65)	ns	1.09	(0.77–1.55)	ns
Est	0.50	(0.31–0.82)	***	1.89	(0.75–4.79)	ns	0.85	(0.56–1.29)	ns
Hauts-Bassins	0.86	(0.54–1.39)	ns	1.17	(0.73–1.85)	ns	1.24	(0.86–1.80)	ns
Nord	0.40	(0.26–0.62)	***	0.96	(0.57–1.64)	ns	0.66	(0.46–0.95)	**
Plateau Central	0.45	(0.28–0.72)	***	0.54	(0.27–1.10)	*	0.67	(0.44–1.01)	*
Sahel	0.65	(0.33–1.28)	ns	1.25	(0.58–2.71)	ns	0.94	(0.53–1.67)	ns
Sud-Ouest	0.34	(0.12–1.01)	*	0.84	(0.45–1.57)	ns	0.64	(0.35–1.17)	ns
Wealth quintile
Poorest	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Poorer	1.31	(1.01–1.69)	**	1.83	(0.95–3.51)	*	1.30	(1.02–1.66)	**
Middle	1.25	(0.96–1.61)	*	2.16	(0.97–4.84)	*	1.30	(1.02–1.66)	**
Richer	1.95	(1.48–2.56)	***	2.96	(1.59–5.51)	***	2.08	(1.62–2.68)	***
Richest	3.93	(2.71–5.70)	***	4.88	(2.55–9.32)	***	3.55	(2.63–4.80)	***
Educational attainment
No education	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Primary	1.77	(1.38–2.28)	***	1.12	(0.82–1.53)	ns	1.48	(1.21–1.80)	***
Secondary or greater	5.53	(3.43–8.93)	***	2.24	(1.57–3.21)	***	3.00	(2.24–4.02)	***
Ethnicity
Mossi	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Bobo	2.15	(1.43–3.23)	***	1.29	(0.82–2.03)	ns	1.88	(1.37–2.58)	***
Peulh	0.54	(0.33–0.87)	**	0.94	(0.52–1.69)	ns	0.62	(0.42–0.90)	**
Gourmantche	0.74	(0.47–1.16)	ns	0.58	(0.17–1.98)	ns	0.74	(0.49–1.10)	ns
Gourounsi	0.72	(0.38–1.37)	ns	1.51	(0.74–3.06)	ns	0.85	(0.53–1.34)	ns
Lobi/Dagara	1.53	(0.55–4.28)	ns	1.26	(0.69–2.29)	ns	1.28	(0.74–2.23)	ns
Bissa	1.30	(0.80–2.09)	ns	1.13	(0.65–1.95)	ns	1.24	(0.88–1.76)	ns
Other ethnicity	1.08	(0.68–1.72)	ns	0.92	(0.52–1.62)	ns	0.96	(0.67–1.36)	ns
Other country	0.71	(0.16–3.03)	ns	1.01	(0.40–2.55)	ns	0.87	(0.37–2.05)	ns
Religion
Muslim	1.00	(ref.)		1.00	(ref.)		1.00	(ref.)
Catholic	1.16	(0.92–1.46)	ns	1.44	(1.02–2.03)	**	1.28	(1.06–1.55)	**
Protestant	2.22	(1.54–3.21)	***	0.97	(0.59–1.58)	ns	1.78	(1.30–2.45)	***
Traditional	0.55	(0.37–0.82)	***	0.54	(0.24–1.19)	ns	0.56	(0.39–0.81)	***
Mother's age at time of survey	1.03	(0.91–1.18)	ns	0.95	(0.76–1.18)	ns	0.99	(0.89–1.11)	ns
Mother's age squared at time of survey	1.00	(1.00–1.00)	ns	1.00	(1.00–1.00)	ns	1.00	(1.00–1.00)	ns

*p<0.10, *p<0.05, ***p<0.01. ns, not significant; na, not applicable; aOR, adjusted odds ratio; CI, confidence interval; ref., value of reference.