rate of contraceptive use in Burkina Faso
rate of contraceptive use in the Sahel region
out of 10 pregnancies in Burkina Faso are unwanted
Contraception and family planning
In 2017, the Ministry of Health, with support from technical and funding partners, produced a family planning development plan to step up efforts to improve family planning and increase the use of modern contraceptive methods to 32% by 2020.
In 2019, by making family planning including contraception free of charge1, contraceptive use in Burkina Faso had risen to 30.7%, from a rate of just 22.5% in 2015.
Nevertheless, in the Sahel region, contraceptive use remains low (11.1% in 2015). This is in part due to the security situation, but also because the measures to make family planning free of charge are focused on two regions and don’t apply to the Sahel region. The level of unmet need is still very high and the problem of sexual violence is becoming worse. Free family planning and availability of emergency contraception is vital for these communities living in a context of humanitarian crisis.
Legal framework for abortion
In Burkina Faso, abortion is legal2 in cases following rape or incest or if the mother’s health is endangered or the foetus has severe abnormalities. However, the number deaths linked to unwanted pregnancies and illegal induced abortions continues to grow. According to a study conducted by midwives in Burkina Faso between May 2018 and April 2019, illegal induced abortions were undertaken in 74.2% of cases of unwanted pregnancy, even though 3.7% of these would have been eligible for a legal abortion.
On the national scale, the Guttmacher data (2013) are still valid: three out of 10 pregnancies are unwanted and one third of them are terminated by abortion. According to the same source, 65% of women who choose to have an abortion are under the age of 24. Furthermore, 10% of the 330 maternal deaths per 100,000 live births3 are due to unsafe abortions.
In Burkina Faso, cervical cancer is the leading cause of death from cancer among women (22.2% according to the WHO)4. It is often only diagnosed at an advanced stage even though it is the most preventable cancer in women. The majority of people who contract cancer in Burkina Faso have no access to screening, early diagnosis, treatment or palliative care. This inadequate response is characterised by a nationwide lack of specific treatment facilities and equipment. In April 2016, the government introduced free screening for precancerous cervical lesions. However, this decision has not been implemented in practice due to a lack of human and financial resources.
Médecins du Monde has been working in the districts of Djibo since 2010 and Gorom-Gorom since 2016 and has already secured free assisted delivery and medical evacuation of patients to a location where they will receive appropriate care. We are now focusing on the prevention of unwanted pregnancies, especially among young people (aged 10-24).
More generally, we are working to improve family planning in the health districts of Djibo and Gorom-Gorom. Fifteen community organisations have been trained to work with young people and religious leaders on these issues. With the aim of strengthening the healthcare system, teams of healthcare workers are receiving training in sexual and reproductive health.
Healthcare facilities (consulting rooms and delivery suites) are also being refurbished and equipped to improve the availability and quality of care. Spaces for young people are being established to provide better access to care for children and young people.
In Burkina Faso teenage pregnancies have catastrophic consequences for both mothers and children:
- Health risks: teenage pregnancy is the leading cause of death among 15-19-year-olds and the leading cause of infant mortality in the world. These deaths are largely due to the lack of healthcare centres providing care during high-risk pregnancies, the absence of qualified, trained staff and lack of money to access care.
- School drop-out: after having a baby, girls rarely return to school.
- Social and cultural pressures and insecurity: young women who become pregnant outside of marriage and whose partners refuse to accept the pregnancy are often rejected by their families. The family’s sense of dishonour puts the young woman in a vulnerable position and she may be banished from her community.
Promoting access to contraception, comprehensive sexuality education and safe abortion
Médecins du Monde is proud of the major role it played in coalition with its national partners in the reforms to the Penal Code to include provisions that simplify the procedures for access to abortion. 2019 saw strong campaigns aimed at the public authorities calling for wider access to abortion in accordance with the Maputo Protocol which was signed and ratified by Burkina Faso in 2006.
To date more than 275 stakeholders (community activists, parliamentary and ministerial authorities, , journalists, midwives, gynaecologists and young people) have received training in how best to implement this positive regional framework. In 2019 we also focused on following up on pledges to roll out comprehensive sexuality education nationwide after it was launched in 2017 in just six out of 13 regions.
Tackling cervical cancer
Médecins du Monde helps with early screening and treatment of precancerous cervical lesions in women aged 22 to 55.
The prevalence of cervical cancer in Burkina Faso is 23% and it accounts for 22% of the cancer mortality rate. Access to screening is still limited due to lack of training and disruption of supplies.
We train healthcare staff in the Baskuy health district in Ouagadougou and provide health facilities with equipment and supplies for screening for the virus which causes cervical cancer (HPV). This enables the early detection and treatment of precancerous lesions. Médecins du Monde seeks to help women with advanced cancerous lesions to access appropriate treatment or palliative care.
The work is based on three new approaches:
- allowing women to choose the technique used to take samples;
- screening by testing for the virus that causes cervical cancer;
- use of thermocoagulation to treat precancerous lesions.
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1 Decision adopted on 26 December 2018.
2 Penal Code, Articles 513-13 and 14, Law on Reproductive Health (Article 21) and Law on Public Health (Article 93).
3 EDMS 2015 (Ministry of Health)