Phiri Million, Odimegwu Clifford, Kalinda Chester
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Population Studies, School of Humanities and Social Sciences, University of Zambia, Lusaka, Zambia.
Contracept Reprod Med. 2023 Jan 11;8(1):3. doi: 10.1186/s40834-022-00198-5.
BACKGROUND: Closing the gap of unmet needs for family planning (FP) in sub-Saharan Africa remains critical in improving maternal and child health outcomes. Determining the prevalence of unmet needs for family planning among married women in the reproductive age is vital for designing effective sexual reproductive health interventions and programmes. Here, we use nationally representative data drawn from sub-Saharan countries to estimate and examine heterogeneity of unmet needs for family planning among currently married women of reproductive age. METHODS: This study used secondary data from Demographic and Health Surveys (DHS) conducted between January 1, 1995 to December 31, 2020 from 37 countries in sub-Saharan African. An Inverse Heterogeneity model (IVhet) in MetaXL application was used to estimate country and sub-regional level pooled estimates and confidence intervals of unmet needs for FP in SSA. RESULTS: The overall prevalence of unmet need for family planning among married women of reproductive age in the sub-region for the period under study was 22.9% (95% CI: 20.9-25.0). The prevalence varied across countries from 10% (95% CI: 10-11%) in Zimbabwe to 38% (95% CI: 35-40) and 38 (95% CI: 37-39) (I2 = 99.8% and p-value < 0.0001) in Sao Tome and Principe and Angola, respectively. Unmet needs due to limiting ranged from 6%; (95% CI: 3-9) in Central Africa to 9%; (95% CI: 8-11) in East Africa. On the other hand, the prevalence of unmet needs due to spacing was highest in Central Africa (Prev: 18; 95% CI: 16-21) and lowest in Southern Africa (Prev: 12%; 95% CI: 8-16). Our study indicates that there was no publication bias because the Luis Furuya-Kanamori index (0.79) was within the symmetry range of -1 and + 1. CONCLUSION: The prevalence of unmet need for FP remains high in sub-Saharan Africa suggesting the need for health policymakers to consider re-evaluating the current SRH policies and programmes with the view of redesigning the present successful strategies to address the problem.
背景：缩小撒哈拉以南非洲地区计划生育未满足需求的差距对于改善母婴健康结果仍然至关重要。确定育龄已婚妇女中计划生育未满足需求的患病率对于设计有效的性健康和生殖健康干预措施及项目至关重要。在此，我们使用来自撒哈拉以南国家的具有全国代表性的数据，来估计和检验育龄期目前已婚妇女中计划生育未满足需求的异质性。 方法：本研究使用了1995年1月1日至2020年12月31日期间在撒哈拉以南非洲37个国家进行的人口与健康调查（DHS）的二手数据。在MetaXL应用程序中使用逆异质性模型（IVhet）来估计撒哈拉以南非洲地区计划生育未满足需求的国家和次区域层面的合并估计值及置信区间。 结果：在所研究期间，该次区域育龄已婚妇女中计划生育未满足需求的总体患病率为22.9%（95%置信区间：20.9 - 25.0）。患病率在各国之间有所不同，从津巴布韦的10%（95%置信区间：10 - 11%）到圣多美和普林西比的38%（95%置信区间：35 - 40）以及安哥拉的38%（95%置信区间：37 - 39）（I2 = 99.8%，p值 < 0.0001）。因生育限制导致的未满足需求从非洲中部的6%（95%置信区间：3 - 9）到东非的9%（95%置信区间：8 - 11）。另一方面，因生育间隔导致的未满足需求患病率在非洲中部最高（患病率：18；95%置信区间：16 - 21），在南部非洲最低（患病率：12%；95%置信区间：8 - 16）。我们的研究表明不存在发表偏倚，因为路易斯·古谷 - 金森指数（0.79）在 -1至 +1的对称范围内。 结论：撒哈拉以南非洲地区计划生育未满足需求的患病率仍然很高，这表明卫生政策制定者需要考虑重新评估当前的性健康和生殖健康政策及项目，以期重新设计当前成功的策略来解决这一问题。
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