International Center for Equity in Health (ICEH), Federal University of Pelotas, Rua Marechal Deodoro 1160, 3o piso, Pelotas, RS, 96020-220, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
Reprod Health. 2020 Jun 1;17(1):82. doi: 10.1186/s12978-020-00931-w.
Contraception is a key component of sustainable development, empowering women, reducing the risk of maternal and child mortality and promoting economic growth. It is part of the Sustainable Development Goals agenda, where the aim is to achieve universal access to sexual and reproductive health. Our objective was to evaluate trends and inequalities in modern contraceptive prevalence, and according to the type of modern contraceptive, in 11 low- and middle-income countries that are partners of the Family Planning 2020 initiative.
Analyses were performed using 62 Performance Monitoring and Accountability 2020 (PMA2020) surveys from 11 countries. Forty surveys were nationally representative, while 22 had regional coverage. Regional surveys were analyzed separately, totalizing 15 geographies from 11 countries. We described trends on modern contraceptive prevalence, and its subtypes (short- and long-acting reversible contraceptives, and permanent methods), by calculating absolute average annual changes. Absolute inequalities on the prevalence of modern contraceptives were assessed for the most recent survey of each geography using the slope index of inequality, and according to wealth, education and age.
The overall prevalence of modern contraception increased in most geographies analyzed, reaching a 7.2 percentage points increase per year in Lagos, Nigeria. This increase was mostly influenced by the long-acting reversible contraceptives, which increased in 73% of the geographies. Although the largest share of modern contraception is represented by short-acting reversible contraceptives, these are reducing and giving space for the long-acting methods. The exception was Rajasthan, India, where the permanent methods accounted for 70% of the modern contraception share, and their prevalence was almost 40%. Inequalities were identified in favor of richer, older and better educated women.
Out of the 15 geographies analyzed, 11 demonstrated an increase in overall modern contraceptive use - mainly driven by the uptake of long-acting reversible contraception. However, even in the groups with the highest prevalence, modern contraceptive use was at most 60% in most geographies. So, we are far from reaching the desired universal coverage proposed by the Sustainable Development Goals.
避孕是可持续发展的关键组成部分，它赋予了妇女权力，降低了母婴死亡率，并促进了经济增长。它是可持续发展目标议程的一部分，目标是实现所有人都能获得性健康和生殖健康。我们的目标是评估 11 个计划生育 2020 倡议合作伙伴的低收入和中等收入国家中现代避孕方法的流行率趋势和不平等现象，并按现代避孕方法的类型进行评估。
使用来自 11 个国家的 62 项绩效监测和问责制 2020 年（PMA2020）调查进行分析。其中 40 项调查具有全国代表性，而 22 项调查具有区域覆盖范围。分别对区域调查进行了分析，总计来自 11 个国家的 15 个地区。我们通过计算绝对年均变化来描述现代避孕方法流行率及其亚类（短效和长效可逆避孕方法以及永久性方法）的趋势。我们使用不平等斜率指数并根据财富、教育和年龄评估了每个地区最近一次调查中现代避孕方法流行率的绝对不平等情况。
在大多数分析的地区，现代避孕方法的总体流行率有所增加，在尼日利亚拉各斯每年增加 7.2 个百分点。这种增加主要受到长效可逆避孕方法的影响，在 73%的地区增加了。尽管短期可逆避孕方法在现代避孕方法中占最大份额，但它们正在减少，为长效方法留出了空间。印度拉贾斯坦邦是个例外，那里永久性方法占现代避孕方法的 70%，其流行率几乎为 40%。调查发现，富有、年长和受教育程度较高的妇女享有更多的不平等。
在所分析的 15 个地区中，有 11 个地区的整体现代避孕方法使用率有所增加 - 主要是由于长效可逆避孕方法的采用。然而，即使在流行率最高的群体中，在大多数地区，现代避孕方法的使用率最多也只有 60%。因此，我们远未达到可持续发展目标所提议的理想普遍覆盖目标。
