Socioeconomic Status and Fertility Decline in Burkina Faso, 2003-2015

The paper proposes to clarify whether fertility decline in Burkina Faso between 2003 and 2015 is explained by the differential distributions (composition effect and response effect) with focus on socioeconomic status (women’s education, women’s occupation and poverty). Using data from 2003 demographic and health survey (DHS) and 2015 demographic and health module of the Multisectoral Continuous Survey, we applied an extension of Blinder-Oaxaca decomposition approach to quantify the percentage of fertility decline attributable to distribution of the socio-economic status (composition effect) and the percentage attributable to women’s fertility behavior (response effect) attributable to socio-economic status. We find the fertility decline is mainly explain to changes in the distribution of women according the different factors. Indeed, the composition effect represents 88% and only 12% for the response effect.  Moreover, composition effect for socio-economic factors is estimated to 85.13% and the response effect is estimated to 34.23%. These results suggest (i) to encourage girl’s education by enrolling them in school but particularly by ensuring that they go at least to secondary school; (ii) create a minimum package of services for the promotion of modern methods of contraception, particularly for women working in agriculture and trade sector as well as those from poor households and living in rural areas; (iii) promote domestic work to allow more women to be interested

Quality of care and client willingness to pay for family planning services at Marie Stopes International in Burkina Faso

Many sexual and reproductive health programs operating in a limited-resource setting face a challenging balancing act between making services accessible and affordable to clients, including those most in need, and remaining financially sustainable. To achieve these dual objectives, the Population Council, with Marie Stopes International in Burkina Faso (MSI BF), launched a willingness-to-pay (WTP) study that examined the current situation and numerous pricing options, proposing optimal prices for products and services. The process of implementing the WTP survey was insightful for MSI BF as it provided evidence on client satisfaction with services and willingness to contribute to the cost of their implant or IUD. In light of the findings, MSI BF decided to increase prices for implants and IUDs both in centers and on outreach. However, balancing the benefit from slightly increased revenue with the risk that some poor clients might be dissuaded by higher prices from seeking family planning services, MSI BF decided to implement only an incremental price increase

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

Background: In sub-Saharan Africa, few studies have stressed the importance of spatial heterogeneity analysis in modern contraceptive use and the relationships with high-risk births. Objective: This paper aims to analyse the association between modern contraceptive use, distribution of birth risk, and under-five child mortality at both national and regional levels in Burkina Faso. Design: The last three Demographic and Health Surveys _ conducted in Burkina Faso in 1998, 2003, and 2010 _ enabled descriptions of differentials, trends, and associations between modern contraceptive use, total fertility rates (TFR), and factors associated with high-risk births and under-five child mortality. Multivariate models, adjusted by covariates of cultural and socio-economic background and contact with health system, were used to investigate the relationship between birth risk factors and modern contraceptive prevalence rates (mCPR). Results: Overall, Burkina Faso’s modern contraception level remains low (15.4% in 2010), despite significant increases during the last decade. However, there are substantial variations in mCPR by region, and health facility contact was positively associated with mCPR increase. Women’s fertility history and cultural and socio-economic background were also significant factors in predicting use of modern contraception. Low modern contraceptive use is associated with higher birth risks and increased child mortality. This association is stronger in the Sahel, Est, and Sud-Ouest regions. Even though all factors in high-risk births were associated with under-five mortality, it should be stressed that short birth spacing ranked as the highest risk in relation to mortality of children. Conclusions: Programmes that target sub-national differentials and leverage women’s health system contacts to inform women about family planning opportunities may be effective in improving coverage, quality, and equity of modern contraceptive use. Improving the demand satisfied for modern contraception may result in a reduction in the percentage of women experiencing high-risk births and may also reduce child mortality