Determinants of unmet need for family planning among married women of reproductive age in Burundi: a cross-sectional study.

Background: High unmet need for family planning (32.4%) characterized Burundi in 2010. However, there has not been any study examining the relationship between unmet need and associated factors in Burundi. The present study aims at determining the demographic, socioeconomic and other factors underlying the unmet need for contraception among married women aged 15-49 in Burundi.

Methods: This study used data from the 2010 Burundi Demographic and Health Survey. Total unmet need, unmet need for spacing and for limiting were used as outcomes and demographic, socioeconomic and other factors as independent variables. After a descriptive analysis of the study population ( n  = 5421), the association between the three outcomes and the independent variables were analysed using logistic regression. Odds ratios with their 95% confidence intervals were calculated with statistical significance at p  < 0.05.

Results: This study showed that the likelihood of total unmet need decreased with age after 35+, with an adjusted Odds Ratio = 0.586 and 95% CI = 0.423-0.811, compared to women aged 15-24. Women with 4-5 and 6+ living children had higher odds [aOR = 1.850 (1.322-2.590) and 2.390 (1.616-3.534) respectively]. Odds of unmet need were lower among women with primary [aOR = 0.741 (0.618-0.888)] and secondary education [aOR = 0.555 (0.399-0.771)]. Women whose husband desired more children than them [aOR = 1.824 (1.411-2.358)] and those ignoring the husband's desired children [aOR = 2.700 (2.176-3.350)] had higher odds than those desiring the same number as the husband. Women who had experienced the death of 1+ sons had higher odds [aOR = 1.285 (1.038-1.591)]. Middle [aOR = 0.670 (0.530-0.846)] and rich [aOR = 0.664 (0.541-0.817)] compared to poor, women living in the North [aOR = 0.611 (0.412-0.904)] compared to those from Bujumbura, had lower odds. Rural women had higher odds [aOR = 1.373 (1.018-1.852)] and those who had visited a health facility [aOR = 0.765 (0.608-0.961)] or had access to TV [aOR = 0.562 (0.375-0.843)] had lower odds.

Conclusion: Tackling the unmet need for FP in Burundi requires scaling-up male involvement, promoting spousal communication, client-centred services, greater use of media, women's education, child survival, and pro-poor policies.