Modeling Contraception and Pregnancy in Malawi: A Thanzi La Onse Mathematical Modeling Study
Modeling Contraception and Pregnancy in Malawi: A Thanzi La Onse Mathematical Modeling Study
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DOI：
10.1111/sifp.12255
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发表时间：
2023-12-21
影响因子：
2.1
通讯作者：
Hallett，Timothy B.
中科院分区：
文献类型：
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作者：
Colbourn，Tim;Janouskova，Eva;Hallett，Timothy B.
马拉维有大量未得到满足的避孕需求，并制定了一项增加避孕用具使用量的国家计划。估计这种投资可能如何影响马拉维未来的人口规模，可以帮助政策制定者了解增加避孕采用率的政策的效果和价值。我们开发了一种新的避孕和怀孕模型，使用个体水平的数据，通过避孕方法捕捉避孕开始、切换、终止和失败的复杂性，考虑到个体特征的差异。我们通过人口运动增加避孕开始(POP)和产后计划生育干预(PPFP)，模拟了避孕规模的扩大。我们在没有对联合国《2019年世界人口展望》马拉维出生人口中期变量预测进行新干预的情况下校准了模型。在没有干预措施的情况下，马拉维的人口在2084年超过6000万；有了Pop和PPFP干预措施。到2100年，这一数字将达到3500万以下的峰值。我们比较了从2023年到2050年的避孕覆盖率和成本，按方法，有没有干预措施。我们估计，扩大避孕措施的投资仅相当于人均卫生总支出的0.9%，但可能会大幅减轻当前人口快速增长对卫生服务、学校、土地和社会的压力，帮助马拉维实现国家和全球卫生与发展目标。
Malawi has high unmet need for contraception with a costed national plan to increase contraception use. Estimating how such investments might impact future population size in Malawi can help policymakers understand effects and value of policies to increase contraception uptake. We developed a new model of contraception and pregnancy using individual‐level data capturing complexities of contraception initiation, switching, discontinuation, and failure by contraception method, accounting for differences by individual characteristics. We modeled contraception scale‐up via a population campaign to increase initiation of contraception (Pop) and a postpartum family planning intervention (PPFP). We calibrated the model without new interventions to the UN World Population Prospects 2019 medium variant projection of births for Malawi. Without interventions Malawi's population passes 60 million in 2084; with Pop and PPFP interventions. it peaks below 35 million by 2100. We compare contraception coverage and costs, by method, with and without interventions, from 2023 to 2050. We estimate investments in contraception scale‐up correspond to only 0.9 percent of total health expenditure per capita though could result in dramatic reductions of current pressures of very rapid population growth on health services, schools, land, and society, helping Malawi achieve national and global health and development goals.