Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool
Levels and trends in contraceptive prevalence, unmet need, and demand for family planning for 29 states and union territories in India: a modelling study using the Family Planning Estimation Tool
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DOI：
10.1016/s2214-109x(17)30033-5
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发表时间：
2017-03-01
影响因子：
34.3
通讯作者：
Alkema, Leontine
中科院分区：
文献类型：
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作者：
New, Jin Rou;Cahill, Niamh;Alkema, Leontine
改善获得生殖健康服务和商品的机会对发展至关重要。评估这方面进展的努力主要集中在国家估计上，但这种分析可能掩盖地方差异。我们评估了印度次国家生殖健康服务的进展情况。方法建立统计模型，对亚人群计划生育指标的水平和趋势进行估计和预测。该模型以联合国人口司的计划生育估计模型为基础，并使用了多轮人口与健康调查、地区一级住户和设施调查以及年度健康调查的数据。我们提出了1990年至2030年印度29个邦和联邦属地现代避孕药具使用率水平和趋势的年度估计和预测，以及未满足的计划生育需求和需求。我们还将现代方法所满足的需求预测与75%的拟议目标进行了比较。发现印度存在很大的异质性，2015年各次区域现代避孕药具使用差异高达55.1个百分点（95%不确定区间为46.4-62.1）。安得拉邦（Andhra Pradesh）等邦对现代方法的需求满意度为92.7%(90.9-94.2)，远高于全国平均水平（71.8%,56.7-83.6），而曼尼普尔邦（Manipur）的需求满意度为26.8%(16.7-38.5)，梅加拉亚邦（Meghalaya）的需求满意度为45.0%(40.1-50.0)，一直落后于全国其他地区。曼尼普尔邦和梅加拉亚邦要求提高现代避孕药具使用率，到2030年使现代避孕药具使用率达到75%。就绝对人数而言，北方邦需要增加的人数最多，到2030年需要增加920万（550 - 1260万）现代避孕药具使用者，才能实现75%的目标。印度各邦和联邦属地对计划生育的需求是高度多样化的。北方邦、曼尼普尔邦和梅加拉亚邦需要得到最大的关注，以实现联合国的目标。这种分析可以推广到其他国家以及其他亚群。版权(C)作者(s)。Elsevier Ltd.出版。这是一篇基于CC BY许可的开放获取文章。
Background Improving access to reproductive health services and commodities is central to development. Efforts to assess progress on this front have been largely focused on national estimates, but such analyses can mask local disparities. We assessed progress in reproductive health services subnationally in India.Methods We developed a statistical model to generate estimates and projections of levels and trends in family planning indicators for subpopulations. The model builds onto the UN Population Division's Family Planning Estimation Model and uses data from multiple rounds of the Demographic and Health Survey, the District Level Household & Facility Survey, and the Annual Health Survey. We present annual estimates and projections of levels and trends in the prevalence of modern contraceptive use, and unmet need and demand for family planning for 29 states and union territories in India from 1990 to 2030. We also compared projections of demand satisfied with modern methods with the proposed goal of 75%.Findings There is a large amount of heterogeneity in India, with a difference of up to 55.1 percentage points (95% uncertainty interval 46.4-62.1) in modern contraceptive use in 2015 between subregions. States such as Andhra Pradesh, with 92.7% (90.9-94.2) demand satisfied with modern methods, are performing well above the national average (71.8%, 56.7-83.6), whereas Manipur, with 26.8% (16.7-38.5) of demand satisfied, and Meghalaya, with 45.0% (40.1-50.0), consistently lag behind the rest of the country. Manipur and Meghalaya require the highest percentage increase in modern contraceptive use to achieve 75% demand satisfied with modern methods by 2030. In terms of absolute numbers, Uttar Pradesh requires the greatest increase, needing 9.2 million (5.5-12.6 million) additional users of modern contraception by 2030 to meet the target of 75%.Interpretation The demand for family planning among the states and union territories in India is highly diverse. Greatest attention is needed in Uttar Pradesh, Manipur, and Meghalaya to meet UN targets. The analysis can be generalised to other countries as well as other subpopulations. Copyright (C) The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license.