Does women’s age matter in the SDGs era: coverage of demand for family planning satisfied with modern methods and institutional delivery in 91 low- and middle-income countries

Autor: Aluísio J D Barros, Anita Raj, Fernanda Everling, Cesar G. Victora, Carine Ronsmans, Franciele Hellwig, Jennifer Requejo, Inácio Crochemore Mohnsam da Silva, Lenka Benova
Rok vydání: 2020
Předmět:
Adult
medicine.medical_specialty
Adolescent
Inequality
media_common.quotation_subject
Reproductive medicine
Sustainable development goals
Distribution (economics)
lcsh:Gynecology and obstetrics
Young Adult
03 medical and health sciences
0302 clinical medicine
Pregnancy
medicine
Humans
Maternal Health Services
030212 general & internal medicine
10. No inequality
Developing Countries
Health inequalities
lcsh:RG1-991
Reproductive health
media_common
030219 obstetrics & reproductive medicine
Multiple Indicator Cluster Surveys
business.industry
Research
Public health
Age Factors
1. No poverty
Attendance
Obstetrics and Gynecology
Middle Aged
Patient Acceptance of Health Care
Sustainable Development
Delivery
Obstetric
Age patterns
Geography
Reproductive Medicine
Family planning
Family Planning Services
Female
business
Maternal Age
Demography
Zdroj: Reproductive Health, Vol 17, Iss 1, Pp 1-9 (2020)
Reproductive Health
ISSN: 1742-4755
DOI: 10.1186/s12978-020-0903-6
Popis: Background The Sustainable Development Goals (SDGs) include specific targets for family planning (SDG 3.7) and birth attendance (SDG 3.1.2), and require analyses disaggregated by age and other dimensions of inequality (SDG 17.18). We aimed to describe coverage with demand for family planning satisfied with modern methods (DFPSm) and institutional delivery in low- and middle-income countries across the reproductive age spectrum. We attempted to identify a typology of patterns of coverage by age and compare their distribution according to geographic regions, World Bank income groups and intervention coverage levels. Methods We used Demographic and Health Survey and Multiple Indicator Cluster Surveys. For DFPSm, we considered the woman’s age at the time of the survey, whereas for institutional delivery we considered the woman’s age at birth of the child. Both age variables were categorized into seven groups of 5 year-intervals, 15–19 up to 45–49. Five distinct patterns were identified: (a) increasing coverage with age; (b) similar coverage in all age groups; (c) U-shaped; (d) inverse U-shaped; and (e) declining coverage with age. The frequency of the five patterns was examined according to UNICEF regions, World Bank income groups, and coverage at national level of the given indicator. Results We analyzed 91 countries. For DFPSm, the most frequent age patterns were inverse U-shaped (53%, 47 countries) and increasing coverage with age (41%, 36 countries). Inverse-U shaped patterns for DFPSm was the commonest pattern among lower-middle income countries, while low- and upper middle-income countries showed a more balanced distribution between increasing with age and U-shaped patterns. In the first and second tertiles of national coverage of DFPSm, inverse U-shaped was observed in more than half of countries. For institutional delivery, declining coverage with age was the prevailing pattern (44%, 39 countries), followed by similar coverage across age groups (39%, 35 countries). Most (79%) upper-middle income countries showed no variation by age group while most low-income countries showed declining coverage with age (71%). Conclusion Large inequalities in DFPSm and institutional delivery were identified by age, varying from one intervention to the other. Policy and programmatic approaches must be tailored to national patterns, and in most cases older women and adolescents will require special attention due to lower coverage and because they are at higher risk for maternal mortality and other poor obstetrical outcomes.
Databáze: OpenAIRE
Externí odkaz: