Department for Population Studies, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, England.
Bull World Health Organ. 2011 Feb 1;89(2):137-43. doi: 10.2471/BLT.10.077925. Epub 2010 Nov 4.
To review progress towards adoption of contraception among married or cohabiting women in western and eastern Africa between 1991 and 2004 by examining subjective need, approval, access and use.
Indicators of attitudes towards and use of contraception were derived from Demographic and Health Surveys, which are nationally representative and yield internationally comparable data. Trends were examined for 24 countries that had conducted at least two surveys between 1986 and 2007.
In western Africa, the subjective need for contraception remained unchanged; about 46% of married or cohabiting women reported a desire to stop and/or postpone childbearing for at least two years. The percentage of women who approved of contraception rose from 32 to 39 and the percentage with access to contraceptive methods rose from 8 to 29. The proportion of women who were using a modern method when interviewed increased from 7 to 15% (equivalent to an average annual increase of 0.6 percentage points). In eastern African countries, trends were much more favourable, with contraceptive use showing an average annual increase of 1.4 percentage points (from 16% in 1986 to 33% in 2007).
In western Africa, progress towards adoption of contraception has been dismally slow. Attitudinal resistance remains a barrier and access to contraceptives, though improving, is still shockingly limited. If this situation does not change radically in the short run, the United Nations population projections for this subregion are likely to be exceeded. In eastern Africa, the prospects for a future decline in fertility are much more positive.
通过考察主观需求、可及性和使用情况，回顾 1991 年至 2004 年期间，在西非和东非地区，已婚或同居的女性采用避孕措施的进展情况。
利用具有全国代表性且能产生国际可比数据的人口与健康调查，得出有关避孕态度和使用情况的指标。对在 1986 年至 2007 年期间至少进行了两次调查的 24 个国家进行了趋势分析。
在西非，对避孕的主观需求保持不变；约 46%的已婚或同居女性表示希望至少在两年内停止和/或推迟生育。赞成避孕的女性比例从 32%上升到 39%，可获得避孕方法的比例从 8%上升到 29%。在接受访谈时，使用现代避孕方法的女性比例从 7%上升到 15%（相当于年均增长率为 0.6 个百分点）。在东非国家，趋势要好得多，避孕措施的使用年均增长率为 1.4 个百分点（从 1986 年的 16%上升到 2007 年的 33%）。
在西非，采用避孕措施的进展非常缓慢。态度上的抵制仍然是一个障碍，尽管可及性有所改善，但仍令人震惊地有限。如果这种情况在短期内没有根本性改变，那么联合国对该次区域的人口预测很可能会被突破。在东非，生育率下降的前景要乐观得多。
