Family planning in West Africa: Dr. Madeleine Touré highlights the obstacles to women’s autonomy

A team of researchers from the Reproductive Health Research Unit (CERREGUI) presented the results of a major study carried out between January 2024 and March 2025 in Guinea, Ivory Coast and Burkina Faso. The objective was therefore to understand why many women stop using contraceptive methods, and above all what factors influence their ability to decide, autonomously, to access family planning.

For Guinea, where contraceptive prevalence remains low (12%) and maternal mortality is still high, according to this study, researchers believe that these results could help guide more effective public policies.

A cohort study to understand contraceptive continuity

Questioned after her presentation during the 4th Guinean public health scientific days, Dr Touré Madeleine, research assistant at CERREGUI, recalled that the work is part of a prospective cohort carried out in the three countries. At each site, 720 women aged 15 to 49 initiating a new episode of contraceptive use were followed, in urban and rural areas.

“We wanted to understand the reasons that push young women and adult women to stop their contraceptive method, but also the factors that influence their decision-making autonomy. This is essential in countries where contraceptive prevalence remains low and maternal mortality remains a real public health problem,” affirms the researcher in her presentation.

A context where unmet needs remain very high

In many developing countries, access to family planning remains insufficient. “In many developing countries, however, the use of planning services remains very low at 40% and 225 million of these women have unmet need for family planning,” explains Dr. Madeleine Touré, research assistant at CERREGUI.

According to the data from this study, in sub-Saharan Africa, the differences in prevalence are glaring. “In many sub-Saharan African countries, there is a disparity in planning method contraceptive prevalence ranging from 6.7% in Chad to 72% in Namibia,” explains the researcher.

The countries in the study are well below the continental average.

“In Burkina Faso, Ivory Coast and Guinea, according to the results of demographic and health surveys, there are contraceptive prevalences of 30%, 21% and 12% respectively. One of the contributing factors to this low prevalence in these countries remains partly linked to the lack of empowerment of women in supporting their decisions to access family planning services., adds Dr. Touré.

However, according to Sustainable Development Goal 5, women's empowerment is an essential condition for improving sexual and reproductive health.

Only 48.9% of women decide independently

The study reveals that, of the 2,383 participants in this survey, less than one in two women (i.e., 48.9) have decision-making autonomy in the use of family planning. This proportion varies considerably depending on the country. “63.83% in Guinea (the highest score), 46.3% in Burkina Faso, 35.59% in Ivory Coast”, reports Dr. Touré Madeleine.

What factors influence women’s autonomy?

Statistical analyzes including multivariate logistic regression highlighted several major determinants.

“In Burkina Faso, Ivory Coast and Guinea, the factors that were associated with women's decision-making autonomy were mainly marital status, the age of the last child, the age of the partner, the place of residence and the women's profession,” she indicates in her presentation.

These factors, already known in the scientific literature, are confirmed in the three countries studied. The weight of social norms, financial dependence and power relations within couples remain obstacles to free contraceptive choice.

Strong implications for public health

The results of this study are clear. For Dr. Touré Madeleine, understanding why women interrupt their contraception and what factors limit their autonomy can help reduce maternal mortality, which remains very high in our country.

The researchers therefore recommend: “strengthen gender policies in health programs, improve access to family planning services, promote the participation of partners and communities, and combat economic and sociocultural obstacles. »

Beyond the figures, this study reminds us that family planning is not only a question of the availability of contraceptive methods. It is first and foremost an issue of autonomy, the right to health, and the ability of women to make decisions for their own lives.

Valuable data which should now feed into national strategies, at a time when reducing maternal mortality remains an urgent priority in West Africa.

Mamadou Kindy Bah