Postpartum family planning utilization in Burundi and Rwanda: a comparative analysis of population based cross-sectional data

Abstract

IntroductionPromotion of modern family planning is a major policy action for Africa to harness the demographic dividend. Family planning is an important public health intervention for maternal and child health.MethodsAnalysis was based on data from Demographic and Health Surveys conducted in 2010 on samples of women from Burundi (3396) and Rwanda (4670). Descriptive and multivariate logistic regression analyses to examine the contribution and comparison of the various predictors of uptake of modern contraceptives during the postpartum period (PPFP) in the two countries were carried out using STATA statistical software.ResultsDescriptive findings show only 20% of the samples of women in Burundi used while more than half of the women (51%) were using PPFP. Utilization of PPFP was significantly associated with primary (OR = 1.3, 95% CI = 1.1-1.6) and higher education (OR = 2.2, 95% CI = 1.6-3.1) in Burundi. Similarly in Rwanda increased use of PPFP in primary was (OR = 1.4, 95% CI = 1.2-1.6) while secondary education (OR = 1.6, 95% CI = 1.2-2.1). Protestant women were less likely to use PPFP in both Burundi (OR = 0.75, 95% CI = 0.6-0.9) and Rwanda (OR = 0.69, 95% CI = 0.6-0.8). Other significant variables in the regression models of both countries included wealth status, age of woman, number of living children and exposure to media. Professional birth delivery assistance was significant only in Rwanda.ConclusionEnhancing postpartum contraceptive use should target women with low education, low wealth status, and that the media has an important role to play in this transformation. Policies and programs must be put in place to ensure that the rural urban differences are eradicated.

Postpartum Contraceptive Use and Its Determinants in Ethiopia: A Systematic Review and Meta-analysis

“…Accordingly, in this study, postpartum contraceptive use was significantly higher in secondary and above level of educated mothers as compared to those mothers who had no formal education. This finding is consistent with studies conducted in Rwanda [52], Uganda [48], and Burundi [52]. This significant difference between mothers who had no formal education as compared to secondary and above level of education could be explained by the fact that educated mothers have better understanding of benefits of contraception, risks of short interval pregnancies, and socioeconomical burdens.…”

“…The potential explanation could be attributed to the difference in socioeconomic status, sociocultural values, norms, religious beliefs, and study setting and area. Similarly, our result is substantially lower as compared with the review conducted at Chiang Mai University Hospital, Thailand (97.6%) [53], and Rwanda (51.1%) [52]. This divergence might be due to the differences in health policy of the respective countries, difference in culture and study design, accessibility of contraceptives, male involvement, and study participant level of understanding towards the health benefits of using a postpartum contraceptive.…”

“…Even if there was no analogous meta-analysis study conducted on this specific research question within the area, the prevalence reported in the present study is incomparable with the survey carried out at the time of 6 months after birth, in Malawi is 86% [63] and in America is 88% [64]. However, the prevalence of postpartum contraceptive use is more than that reported for Uganda (28%) [48] and Burundi (20%) [52]. The potential explanation could be attributed to the difference in socioeconomic status, sociocultural values, norms, religious beliefs, and study setting and area.…”

“…Lastly, in this meta-analysis, we observed that those mothers who had ANC and PNC follow-up were more likely to use contraceptive as compared to their counterparts, respectively. This finding is supported by previous studies conducted in Kenya [55], Uganda [48], Rwanda [52], and America [64]. These studies reported that having antenatal as well as postnatal care services were positively associated with contraceptive uses.…”

“…Additionally, 12 primary articles were excluded because of the study population and outcome of interest. Among these, eight of the studies were conducted in Uganda [48,49], Ghana [50,51], Burundi and Rwanda [52], Thailand [53], International Journal of Reproductive Medicine India [54], and Kenya [55]. From the remaining four studies, one was conducted in Addis Ababa, Ethiopia [56] and excluded because of the unreported outcome of interest.…”