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

Abstract Background The sustainable development goal 5.6 calls for “universal access to sexual and reproductive health and reproductive rights” to fulfil sexual and reproductive practices. The capabilities approach helps refine the analysis of contraceptive use by going beyond the dichotomous view of contraceptive use as use/non-use to focus on women’s freedom to choose what they have good reason to value. Using the case of Burkina Faso, we probe more deeply into whether contraceptive use reflects real progress in women’s reproductive rights to realise the fertility projects they value. Methods We use PMA2020 data collected in Burkina Faso between December 2018 and January 2019. The survey included 3,329 women with a participation rate of 97.7%. The PMA2020 female core questionnaire solicits information on fertility and contraceptive behavior, much like the DHS. We asked a series of specific questions about cognitive and psychosocial access relating to FP. We examined bivariate associations between our outcome measure “contraceptive behavior” and the set of independent variables. We also used logistic regression models to evaluate associations with endowments/conversion and capability factors and current functioning by focusing on overuse (i.e., use of contraceptives despite desiring pregnancy within the next 12 months). Results Women who said their ideal number of children was “up to God” had the highest level of overuse, which was also higher among women living in communities with medium acceptance of contraception and greater support for fertility. Women with higher and middle levels of information tend to engage less in overuse than those with lower information levels. Conclusion We conclude that overuse (contraceptive use when desiring a child soon) reveals a lack of rights, as it is associated with a lack of information about contraceptives and women’s inability to conceive an ideal number of children. Efforts should be made to enhance women’s level of contraceptive information.