Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it
Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it
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DOI：
10.1016/j.contraception.2008.03.002
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发表时间：
2008-07-01
期刊：
影响因子：
2.9
通讯作者：
McGinn, Erin
中科院分区：
文献类型：
--
作者：
Hubacher, David;Mavranezouli, Ifigeneia;McGinn, Erin
背景：意外怀孕继续给撒哈拉以南非洲的许多国家带来负担。我们的目的是估计该地区意外怀孕的数量，并模拟以牺牲短期激素避孕方法为代价扩大使用皮下埋植避孕方法的影响。研究设计：对于撒哈拉以南非洲大陆的 42 个国家，我们估计了当前意外怀孕的水平、激素避孕药具的使用流行率以及因早期停药和典型方法失败率而导致的意外怀孕数量。使用决策分析模型，我们估计了更广泛使用埋植避孕法的潜在影响。结果：在撒哈拉以南非洲地区，每年大约发生 1400 万例意外怀孕，其中相当大一部分是由于短期激素方法使用不当造成的。如果使用口服避孕药或注射避孕药的 1760 万名妇女中的 20% 需要长期保护并改用埋植避孕药，那么在 5 年内可以避免超过 180 万例意外怀孕。结论：不良的短期激素避孕药使用模式（高停药率和不正确使用）在很大程度上导致了撒哈拉以南非洲地区的意外怀孕问题。更多地提供并广泛使用高效方法（例如埋植避孕法）将改善该地区的生殖健康。 (C) 2008 Elsevier Inc. 保留所有权利。
Background: Unintended pregnancies continue to burden many countries in sub-Saharan Africa. Our aim was to estimate the number of unintended pregnancies in the region and model the impact of expanding use of contraceptive implants at the expense of short-term hormonal birth control methods.Study Design: For the 42 countries in mainland sub-Saharan Africa, we estimated current levels of unintended pregnancy, prevalence of hormonal contraceptive use and number of unintended pregnancies stemming from early discontinuation and typical method failure rates. Using a decision-analytic model, we estimated the potential impact of more widespread use of the contraceptive implant.Results: Every year in sub-Saharan Africa, approximately 14 million unintended pregnancies occur and a sizeable proportion is due to poor use of short-term hormonal methods. If 20% of the 17.6 million women using oral contraceptives or injectables wanted long-term protection and switched to the contraceptive implant, over 1.8 million unintended pregnancies could be averted over a 5-year period.Conclusion: Poor patterns of short-term hormonal contraceptive use (high discontinuation rates and incorrect use) contribute significantly to the problem of unintended pregnancy in sub-Saharan Africa. More availability and widespread use of highly effective methods, such as the contraceptive implant, will improve reproductive health in the region. (C) 2008 Elsevier Inc. All rights reserved.