Ross John A
Independent Demographic Consultant, New Paltz, NY, United States.
Front Glob Womens Health. 2021 Sep 23;2:636581. doi: 10.3389/fgwh.2021.636581. eCollection 2021.
This article uses two large sets of internationally comparable national surveys to analyze urban patterns of contraceptive use, access to methods, and fertility. Urban areas show higher use of contraception and lower fertility rates than rural areas, with substantial differences in the method mix. Urban women tend more toward the long-term methods of the intrauterine device (IUD), implant, and sterilization and less toward short-term, resupply methods. The overall use increases with education and with higher wealth quintiles. By regions, contraceptive use is unbalanced between urban and rural sectors especially in sub-Saharan Africa, where the overall levels of use are lowest. Overall, the urban fertility rate is only 70% of the rural rate. Across countries, the fertility rate correlates negatively with contraceptive use. National family planning programs tend to raise contraceptive use and to improve access to the methods. About half of the unmarried, sexually active women use contraception, with great diversity in which method is preferred. This holds for all married women as well: regions and countries show quite different patterns of use. Therefore, planners and donors should focus on the circumstances in individual countries.
本文使用两组具有国际可比性的大型全国性调查数据，来分析城市地区的避孕措施使用情况、获取避孕方法的途径以及生育率。与农村地区相比，城市地区的避孕措施使用率更高，生育率更低，而且在避孕方法组合上存在显著差异。城市女性更倾向于使用宫内节育器（IUD）、植入剂和绝育等长效避孕方法，而较少使用短期、需补充的避孕方法。总体使用率随着教育程度和财富五分位数的提高而上升。按地区划分，城市和农村部门之间的避孕措施使用情况不均衡，特别是在撒哈拉以南非洲，那里的总体使用水平最低。总体而言，城市生育率仅为农村生育率的70%。在各个国家，生育率与避孕措施的使用呈负相关。国家计划生育项目往往会提高避孕措施的使用率，并改善获取避孕方法的途径。大约一半未婚且有性行为的女性使用避孕措施，在首选的避孕方法上存在很大差异。所有已婚女性的情况也是如此：不同地区和国家的使用模式差异很大。因此，规划者和捐助者应关注各个国家的具体情况。
