Crises sécuritaires et accès des femmes aux services de santé maternelle au Sahel : analyse comparative des accouchements à domicile entre les régions en conflits et non en conflits au Burkina Faso, Mali et Niger

Abstract

This study analyzes disparities in the prevalence of home births in relation to the impact of security crises (crisis-affected areas vs. non-crisis areas) and identifies the related factors among reproductive age among women across the three member countries of the Sahel Alliance. The research draws data from Demographic and Health Surveys (DHS) conducted respectively in 2012, 2018, and 2021 in Niger, Mali, and Burkina Faso. The analyses were conducted at univariate, bivariate, and multivariate levels (logistic regression models). A total of 19,633 most recent completed pregnancies by reproductive age women within the past five years of the surveys were included in the study. The findings indicate an overall prevalence of home births at 35.8%, with a slight increase in crisis-affected areas (37.4%) compared to non-crisis areas (35.0%). At the national level, the prevalence of home births is notably higher in Niger (66.1%) compared to Mali (29.3%) and Burkina Faso (5.7%). Security crises exacerbate barriers to healthcare access, particularly in Burkina Faso and Mali, where home birth rates are double in crisis zones relative to non-crisis zones. The study highlights an increased risk of home births among households headed by women in crisis-affected regions. It recommends strengthening healthcare systems, deploying mobile clinics, and training traditional birth attendants to enhance maternal and neonatal care during home births in affected areas.