Epidemiological Aspects of the Use of Modern Contraceptive Methods in Urban and Rural Settings of Burundi

Abstract

Purpose: The main objective of this study was to investigate the epidemiological aspects of the use of modern contraceptive methods in urban and rural settings of Burundi.

Problem: The use of modern contraceptive methods can protect against unwanted pregnancies. Although the benefits of family planning are considerable, the use of modern contraceptive methods remains low in Burundi with an overall contraceptive prevalence of 31.3% in the eight provinces according to the Burundi Ministry of Public Health in 2014. Meanwhile, we noted a disproportion between areas with low use and those with high use which required special attention.

Methods: To tackle this issue, a descriptive cross-sectional methodological approach was used. The study was conducted in the city of Bujumbura, the economic capital of Burundi, at the community medicine centre (CMC) of Buyenyi and the third city of Ngozi at the health centre (CDS) of Kigarama. A retrospective convenience sampling from May to August 2019 identified 201 participants aged 13 to 45 years who consulted during the study period. All incomplete or unusable records were excluded. Data were collected using a pre-designed questionnaire. Data entry and compilation of the collected data was done on an Epi-Info 7 database. Statistic analyses were carried out with SPSS 20 software while including a test of comparison between the different groups of the urban and rural areas of Burundi. Following the statistical tests carried out, the results were considered significant for a P-Value < 0.05.

Conclusions: In our results, the most represented age group was 25 to 29 years old. The majority of participants aged less than 20 years old and more than or equal to 40 years old came from Ngozi while the remnant came mainly from Bujumbura. Most of the participants had a primary and secondary education (41.8% and 42.3% respectively). Almost all participants (95%) were married women. Injectable and oral methods were more commonly used in Bujumbura than in Ngozi. The intrauterine device (IUD) and the implant were more used in the Ngozi CDS. The educational level of participants using depot medroxyprogesterone acetate (DMPA) at the Ngozi CDS was significantly lower compared to those of Bujumbura CMC. In addition, the educational level of combined oral tablet users at the Ngozi CDS and Bujumbura CMC was significantly different. The average age of the participants using oral progestin-only tablets at the Bujumbura CMC was significantly higher than those of the Ngozi CDS. Prolonged breastfeeding was the main reason for using modern contraceptive methods. Other determinants of family planning use were obesity, irregular menstrual cycle, pelvic infections and antiretroviral treatment.

Significance: To increase the level of use of contraceptive methods, it is necessary to popularize injectable and oral methods in rural areas while insisting on information-education-communication (IEC) with a focus on women aged 27 to 33 years old. These results provide guidance on strategies to address barriers against the use of modern contraceptive methods among women in rural and urban areas in order to promote better birth planning.