Method-related concerns represent an important cause of contraceptive non-use and discontinuation. User preferences must be incorporated into the design of new contraceptive technologies to ensure product success and improve family planning outcomes. We assessed preferences among potential users in Burkina Faso and Uganda for six contraceptive methods currently under development or ready for introduction: a new copper intra-uterine device (IUD), a levonorgestrel intra-uterine system, a new single-rod implant, a biodegradable implant, a longer-acting injectable, and a method of non-surgical permanent contraception. Questions were added to nationally-representative PMA2020 household surveys that asked 2,743 and 2,403 women in Burkina Faso and Uganda, respectively, their interest in using each new method. We assessed factors associated with interest through multivariable logistic regression models. We conducted qualitative interviews and focus groups with 398 women, 78 men, and 52 family planning providers and key informants to explore perceived advantages and disadvantages of the methods. Respondents expressed interest in using all new methods, with greatest interest in the longer-acting injectable (77% in Burkina Faso, 61% in Uganda), followed by a new single-rod implant. Least interest was expressed in a new copper IUD (26% Burkina Faso, 15% in Uganda). In both countries, women with less education had higher odds of interest in a longer-acting injectable. Interest in most new methods was associated with desiring a method lasting longer than one year and acceptance of lack of menstrual bleeding as a contraceptive side effect. Perceived advantages and disadvantages were similar between countries, including concerns about menstrual side effects and fear of the biodegradable nature of the biodegradable implant. Potential users, their partners, and providers are interested in new longer-acting methods, however, familiar forms including the injectable and implant may be the most immediately acceptable. A biodegradable implant will require clear counseling messages to allay potential fears.

Background: Unmet need remains high in developing regions. New contraceptive technologies may improve uptake and use. This study examines desirable product characteristics. Methods: We added a module to the female questionnaire of the PMA2020 surveys in Burkina Faso and Uganda and conducted 50 focus group discussions (FGDs) with women, 10 FGDs with men, and 37 in-depth interviews (IDIs) with providers across the two countries. FGDs with women and IDIs with providers included a semi-structured ranking exercise on pre-selected product characteristics. Results: Effectiveness, duration, few side effects, cost, and access were the characteristics most commonly reported as important in choosing a method by survey respondents across both countries. Half or more of women surveyed in each country would like a method that lasts at least one year, while 65% in Burkina Faso and 40% in Uganda said they would use a method causing amenorrhea. Qualitative findings show that women want methods with minimal and predictable side effects. Reactions to increased bleeding were negative, especially in Burkina Faso, but perspectives on reduced bleeding were more mixed. Women and providers preferred methods that are discreet and not user-dependent, and associate duration with convenience of use. Some women in Uganda expressed concerns about the invasive nature of long-acting methods, and cost was an important consideration in both countries. In the ranking exercise, discreet use and few side effects often ranked high, while causing amenorrhea and not requiring a pelvic exam often ranked low. Conclusion: Product development should consider user preferences for success in these settings.

This paper offers new evidence on the residential arrangements of couples in the context of migration and urbanisation in Africa, focusing on the case of Ouagadougou, Burkina Faso's capital city. We use a mixed-methods approach, combining data from a survey on the family histories of migrants merged with data from the Ouagadougou Health and Demographic Surveillance System and qualitative interviews. The objective is to analyse how the migrants themselves perceive "living apart together", the extent of this phenomenon, its timing, and the factors influencing it.The longitudinal nature of our data specifically allows for the study of the drivers of couple reunification in Ouagadougou and of the physical separation of partners, whereby one goes to live away from Ouagadougou. Our results reveal that 25% of migrants in a union had a partner living outside Ouagadougou in 2015, and that the residential arrangements of such couples were associated with gender relations, family cycle, and integration into the city.

Résumé Les possibilités d’éducation des enfants qui vivent dans un ménage dirigé par une femme en Afrique subsaharienne ont été bien décrites, mais on sait peu de choses sur la distribution de cet effet entre les différents enfants au sein du ménage. À partir des données censitaires de 2006 de Ouagadougou, l’article a comme double objectif de revisiter le résultat de la meilleure scolarisation des enfants par les femmes chefs de ménages en Afrique subsaharienne, et d’examiner si cette aptitude des femmes joue un rôle dans la réduction des inégalités scolaires selon le genre et le statut familial des enfants. Les résultats montrent que les enfants qui sont mieux scolarisés par les femmes que par les hommes chefs de ménage sont principalement les garçons qui leurs sont confiés. Ils montrent aussi que les ménages dirigés par les femmes sont plus discriminatoires à l’encontre des filles que ceux dirigés par les hommes.