Trends and factors associated with pregnancy termination among women of reproductive age in Burkina Faso: an analysis of repeated cross-sectional Demographic and Health Surveys from 2003 to 2021
DOI:
https://doi.org/10.64707/revstss.v49i1.2326Keywords:
pregnancy termination; trends; Burkina Faso; Demographic and Health Surveys (DHS); associated factors; longitudinal analysis.Abstract
Introduction. Unsafe pregnancy termination remains a major cause of maternal mortality in sub-Saharan Africa, in a context of legal restrictions and strong social stigma. In Burkina Faso, approximately 90% of pregnancy terminations are estimated to occur under unsafe conditions. Data allowing long-term trends to be tracked remain scarce. The objective of this study was to analyze temporal trends and factors associated with pregnancy termination among women aged 15–49 in Burkina Faso between 2003 and 2021, and to examine regional disparities.
Methods. Secondary analysis of DHS data from 2003 (n=7,428), 2010 (n=10,485) and 2021 (n=9,274). Multivariable binary logistic regression models, estimated separately for each survey round and accounting for complex survey design, were used to identify independent determinants. The outcome variable (v228) captures any pregnancy not resulting in a live birth, without allowing distinction between induced abortions and spontaneous losses. Variables with more than 25% missing values were excluded from multivariate models, retaining 93–94% of the analytical sample.
Results. The prevalence of pregnancy termination decreased significantly between 2003 (14.8%; 95%CI: 13.6–16.0) and 2010 (12.2%; 95%CI: 11.5–13.0), before a moderate increase in 2021 (13.3%; 95%CI: 12.4–14.3). Age was the strongest determinant, with a cumulative gradient consistent with the lifetime nature of v228 (AOR 40–49: 5.7–7.9 across waves). Professional activity was significant in 2003 (AOR=1.6) and 2021 (AOR=1.5). Permission to access healthcare was protective in 2010 (AOR=0.8) and 2021 (AOR=0.7). Polygamy and early marriage were significant in 2010 and 2003 respectively. Persistent regional disparities were observed, with higher levels in the Cascades, Hauts-Bassins and Centre regions.
Conclusion. Pregnancy termination remains an important phenomenon in Burkina Faso, shaped by individual, relational and contextual determinants. Findings underscore the need to strengthen access to modern contraception, promote reproductive autonomy, and tailor interventions to regional realities.
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