亚洲地区1990-2030年避孕状况及未满足的计划生育需要

Status and tendency projection of contraceptive prevalence and unmet need for family planning in Asian area from 1990 to 2030

目的 分析亚洲各地区已婚/同居育龄女性的避孕状况和未满足的计划生育需要,为保障女性生殖健康权利和相关政策的制定提供依据.方法 选取1990-2030年间亚洲各地区避孕相关数据,分析亚洲各地区已婚/同居育龄女性的避孕率、未满足的计划生育需要(数据来源于《全球避孕方法使用状况2017》).结果 2017年亚洲地区避孕率由1990年的56.8%(95% CI=53.6%~60.3%)上升至66.0%(95% CI=60.9%~70.0%)、未满足的计划生育需要由1990年的14.2%(95%CI=12.6%~16.3%)下降至10.1%(95% CI=8.5%~12.4%).与1990年相比,2017年现代避孕方法使用比例升高.2017年中国的避孕率为83.3% (95% CI=70.8%~91.0%),与1990年的78.3% (95% CI=70.8%~84.5%)相比有所升高,但其差异无统计学意义;现代避孕方法的比例由1990年的98.6%上升为99.0%,中国的避孕率高于全亚洲的平均水平.2017年中亚、东亚、东南亚、南亚、西亚地区未满足的计划生育需要分别为13.1% (95% CI=9.7%~18.4%)、4.6%(95%CI=2.4%~9.5%)、12.2% (95% CI=10.2%~14.6%)、13.2%(95% CI=10.3%~16.7%)、14.1%(95% CI=11.7%~17.2%).中国未满足的计划生育需要较低(3.7%,95% CI=1.4%~8.3%).预测至2030年,中亚、东南亚、南亚及西亚未满足的计划生育需要将呈下降趋势(P<0.001),但是中国和东亚地区未满足的计划生育需要率将呈上升趋势(P<0.001),而未满足计划生育需要的绝对人数会逐年递减,出现双向效应.结论 2017年亚洲各地区避孕率升高,未满足的计划生育需要有所下降.预测至2030年,该状况仍有可能延续.但是中国应关注将会出现的计划生育需要率上升、绝对人数减少的双向效应,及时做出相应的计划生育服务调整和满足.

Objective To ensure the promotion of reproductive health and formulation of related policies through the analysis and estimation of contraceptive prevalence and unmet need for family planning of married or in union women of reproductive age in Asian area.Methods Data were selected from the open database of World Contraceptive Use 2017 to analyze the current status(1990-2017)and estimation(2018-2030)of unmet need for family planning and contraceptive prevalence in Asian area.Results The contraceptive prevalence in Asia increased from 56.8%(95%CI=53.6%-60.3%)in 1990 to 66.0%(95%CI=60.9%-70.0%)in 2017,whereas unmet need for family planning decreased from 14.2%(95%CI=12.6%-16.3%)to 10.1%(95%CI=8.5%-12.4%)and there was a change for the composition of contraceptive methods with an increase for modern contraceptive methods.The contraceptive prevalence of China in 2017 was higher than the counterpart in 1990,despite no statistical difference.In 2017,the unmet need for family planning in Central Asia,Eastern Asia,Southeast Asia,Southern Asia and Western Asia were 13.1%(95%CI=9.7%-18.4%),4.6%(95%CI=2.4%-9.5%),12.2%(95%CI=10.2%-14.6%),13.2%(95%CI=10.3%-16.7%),14.1%(95%CI=11.7%-17.2%)respectively.And the unmet need for family planning of China was 3.7%(95%CI=1.4%-8.3%)in 2017.It was predicted that until 2030,the unmet need for family planning in Central Asia,Southeast Asia,Southern Asia and Western Asia would show a downward trend(P<0.001)despite an upward trend of unmet need for family planning in China and Eastern Asia(P<0.001)as well as a decrease in absolute terms,called“bi-directional effect”.Conclusion Contraception increased in Asia from 1990 to 2017,and unmet need for family planning decreased.The situation was predicted to continue until 2030.It was essential for China to attach attention to the bi-directional effect with increase of unmet need of family planning and decrease of absolute number and make corresponding adjustment and promotion of family planning service.