1990年至2020年期间，作为“2030年计划生育倡议”的一部分，48个重点国家在减少现代避孕方法使用方面的社会经济不平等方面取得的进展：一项基于人群的分析。

Progress in reducing socioeconomic inequalities in the use of modern contraceptives in 48 focus countries as part of the FP2030 initiative between 1990 and 2020: a population-based analysis.

作者信息

Cardona Carolina, Rusatira Jean Christophe, Salmeron Carolina, Martinez-Baack Michelle, Rimon Jose G, Anglewicz Philip, Ahmed Saifuddin

机构信息

Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

出版信息

Lancet Glob Health. 2025 Jan;13(1):e38-e49. doi: 10.1016/S2214-109X(24)00424-8.

DOI:10.1016/S2214-109X(24)00424-8

PMID:39706659

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11659844/

Abstract

BACKGROUND

Despite increases in modern contraception use, socioeconomic inequalities in family planning persist. In this study, we aimed to measure progress in reducing socioeconomic inequalities in modern contraceptive prevalence rate (mCPR) and demand for family planning satisfied by modern methods (mDFPS) in 48 countries as part of the Family Planning 2030 (FP2030) initiative between 1990 and 2020 for which Demographic and Health Survey data were available.

METHODS

We analysed two rounds of Demographic and Health Survey data per country. Changes in concentration indices between two survey rounds were compared to measure reductions in overall socioeconomic-related inequalities in modern contraceptive use. Poisson regression models were used to measure the adjusted average annual rate of change across wealth quintiles.

FINDINGS

In this population-based analysis study, all countries reduced socioeconomic-related inequalities in modern contraceptive use among in-union women of reproductive age (15-49 years) during the observed 30-year period. On average, mCPR increased at an annual rate of 2·1% (95% CI 2·1-2·2), and the rate of increase for the poorest women was 3·1% (3·0-3·2), which outpaced the rate of increase for the richest women of 1·3% (1·3-1·4%). The pattern of progress was similar for mDFPS, but at a slower pace. Overall, levels of mCPR and mDFPS increased, and socioeconomic-related inequalities were reduced during this period.

INTERPRETATION

Substantial progress has been made in reducing socioeconomic-related inequalities in family planning across the 48 studied countries, which account for 86% of the population of the 82 FP2030 initiative countries. During the past three decades, poorer women have seen greater improvements in modern contraceptive use and demand satisfaction compared with richer women. As contraceptive prevalence rates are near their maximum, it is crucial to ensure marginalised and vulnerable groups are not left behind.

FUNDING

Bill & Melinda Gates Foundation.

TRANSLATIONS

For the French and Spanish translations of the abstract see Supplementary Materials section.

摘要

背景

尽管现代避孕措施的使用有所增加，但计划生育方面的社会经济不平等现象依然存在。在本研究中，作为“2030年计划生育”（FP2030）倡议的一部分，我们旨在衡量1990年至2020年期间48个国家在减少现代避孕普及率（mCPR）和现代方法满足的计划生育需求（mDFPS）方面的社会经济不平等方面取得的进展，这些国家可获取人口与健康调查数据。

方法

我们分析了每个国家两轮的人口与健康调查数据。比较两轮调查之间集中指数的变化，以衡量现代避孕使用中总体社会经济相关不平等现象的减少情况。使用泊松回归模型来衡量各财富五分位数的调整后平均年变化率。

结果

在这项基于人群的分析研究中，在观察到的30年期间，所有国家都减少了育龄（15 - 49岁）已婚女性在现代避孕使用方面的社会经济相关不平等现象。平均而言，mCPR以每年2.1%（95%CI 2.1 - 2.2）的速度增长，最贫困女性的增长率为3.1%（3.0 - 3.2），超过了最富有女性1.3%（1.3 - 1.4%）的增长率。mDFPS的进展模式相似，但速度较慢。总体而言，在此期间mCPR和mDFPS水平有所提高，社会经济相关不平等现象有所减少。