by Rachidatou Compaoré, Danielle Belemsaga Yugbaré, Siaka Lougué, Abdoul Aziz Kinda, Kadari Cissé, Relwendé Nacanabo, Souleymane Bandaogo, Henri Gautier Ouedraogo, Seni Kouanda
First published: 17 February 2026, https://doi.org/10.1002/ijgo.70880
Abstract
Objective
Despite legal provisions allowing access to safe abortion under specific criteria in Burkina Faso, the availability of care services remains limited. The present study evaluated the effectiveness of interventions aimed at strengthening health services’ capacity to provide legal termination of pregnancy in Burkina Faso.
Methods
We conducted a quasi-experimental “before-after” study without a control group across 179 public health facilities comprising 132 primary healthcare facilities (CSPS/CM) and 47 referral hospitals. We used data from the Harmonized Health Facility Assessment (HHFA) survey conducted in 2020 as the baseline, and the endline survey was performed in December 2022 using CSPRO electronic questionnaires. We evaluated the availability and provision of legal termination of pregnancy services using the McNemar and Wilcoxon tests (Stata 18), with statistical significance set at p < 0.05.
Results
Service availability for the legal termination of pregnancy showed significant improvements from 2020, with notable changes in service delivery patterns across all levels. In primary healthcare facilities (CSPS/CM), misoprostol utilization increased substantially from 28.6% to 95.2% (p = 0.0455), while manual vacuum aspiration availability improved from 28.6% to 100% (p = 0.0455). Patient referrals from the CSPS/CM increased markedly from 1.5% to 97.4% (p < 0.0001). At the hospital level, although legally authorized abortion services decreased from 100% to 76.6% (p = 0.0009), post-abortion family planning coverage improved from 89.4% to 100% (p = 0.0253). Hospital referrals increased significantly from 10.6% to 51.2% (p < 0.0001), whereas misoprostol usage remained stable at approximately 83%.
Conclusion
The findings indicated a substantial shift in the legal termination of pregnancy delivery patterns and strengthened referral networks between different levels of care. These changes suggest the successful strengthening of the health system’s capability to provide comprehensive abortion care services.
Note also, on the same page as this new study, reference to a well-known study carried out in Burkina Faso in 2012 (Macha et al), which reported some of the first serious efforts to improve provision of safe abortion services in the country and, with the findings of this new 2026 report, the extent of the improvements achieved in the decade leading up to the 2026 report.