IMPAIRED FERTILITY AND PERCEIVED DIFFICULTIES CONCEIVING IN GHANA: MEASUREMENT PROBLEMS AND PROSPECTS
IMPAIRED FERTILITY AND PERCEIVED DIFFICULTIES CONCEIVING IN GHANA: MEASUREMENT PROBLEMS AND PROSPECTS
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DOI：
10.1017/s0021932015000310
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发表时间：
2016-07-01
影响因子：
1.5
通讯作者：
Johnson, David R.
中科院分区：
文献类型：
--
作者：
Fledderjohann, Jasmine;Johnson, David R.
什么是衡量生育率受损的最适当尺度，以了解其在撒哈拉以南非洲的社会后果？该区域的调查缺乏主观衡量标准，因此无法对主观和客观衡量标准进行比较。对于离婚、污名化和痛苦等社会结果，认为怀孕困难可能比客观措施产生更大的影响。本研究比较了12个月（临床）和24个月（流行病学）的措施，从生物医学和5年和7年的措施，从人口统计学与生育能力受损的主观措施，使用相关性，随机效应模型和重测模型，以评估措施之间的关系，其与社会人口特征和稳定性的措施随着时间的推移。使用了1998-2004年1 350名年龄在15-49岁之间、婚姻状况各不相同的加纳妇女的次级小组数据。人口统计学指标要求的生育力受损的识别等待时间较长，导致更稳定的指标，但感知的怀孕困难与临床不孕症最密切相关（r = 0.61; p < 0.05）。流行病学不孕症也与主观测量密切相关。在纯粹根据等待时间确定为生育能力受损的人中，有很大一部分是成功的避孕者。在没有主观衡量标准的情况下，流行病学（24个月）衡量标准可能最适合研究生育能力受损的社会后果。统计避孕药具的使用情况对于避免误报十分重要。未来的研究应考虑各种措施的感知困难怀孕和自我认定的不孕症，以评估哪一个是最有效的，为了实现这一点，这是必要的，不孕症的主观措施，包括在撒哈拉以南非洲的社会调查。
What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- and 7-year measures from demography with a subjective measure of impaired fertility using correlations, random effects models and test-retest models to assess relationships between measures, their association with sociodemographic characteristics and the stability of measures across time. Secondary panel data (1998-2004) from 1350 Ghanaian women aged 15-49 of all marital statuses are used. Longer waiting times to identification of impaired fertility required by demographic measures result in more stable measures, but perceived difficulties conceiving are most closely aligned with clinical infertility (r = 0.61; p < 0.05). Epidemiological infertility is also closely aligned with the subjective measure. A large proportion of those identified as having impaired fertility based purely on waiting times are successful contraceptors. Where subjective measures are not available, epidemiological (24-month) measures may be most appropriate for studies of the social consequences of impaired fertility. Accounting for contraceptive use is important in order to avoid false positives. Future research should consider a variety of measures of perceived difficulties conceiving and self-identified infertility to assess which is most valid; in order to accomplish this, it is imperative that subjective measures of infertility be included in social surveys in sub-Saharan Africa.