Monitoring MDG 5.B Indicators on Reproductive Health UN Population Division and UNFPA

Transcription

1 Monitoring MDG 5.B Indicators on Reproductive Health UN Population Division and UNFPA 9-13 July 2012 UNSD/ESCAP Workshop on MDG Monitoring, Bangkok

2 MDG 5. Improve maternal health Target 5.B: Achieve, by 2015, universal access to reproductive health Indicator 5.3 Contraceptive prevalence rate Indicator 5.4 Adolescent birth rate Indicator 5.6 Unmet need for family planning

3 Rationale Preventing unwanted pregnancy and childbearing at young ages Health implications (reduce maternal deaths, improve infant survival) Social and economic development implications Rights implications

4 Source: Ahmed et al The Lancet, doi: /s (12)

5 Overview Definition and methods of computation Data sources and availability Data limitations, including comparability Estimation of regional and global averages

6 Indicator 5.3 Contraceptive prevalence rate

7 Indicator 5.3 Contraceptive prevalence Definition The percentage of women married or inunion aged 15 to 49 who are currently using, or whose sexual partner is using, at least one method of contraception, regardless of the method used.

8 Definition: Methods Any method, modern methods, condom use Modern methods: female and male sterilization, oral hormonal pills, the intra-uterine device (IUD), condoms, injectables, implants, vaginal barrier methods and emergency contraception. Traditional methods: rhythm, withdrawal, lactational amenorrhea method (LAM) and folk methods.

9 Data Nationally-representative survey data Administrative data sources not used Difficult comparability Miss traditional method use Miss private sector sources (shops)

10 Obtaining survey data Published reports from Demographic and Health Surveys (DHS) Reproductive Health Surveys (RHS) Multiple Indicator Cluster Surveys (MICS) Fertility and Family Surveys (FFS) Other nationally-sponsored surveys

11 Comprehensive data on contraceptive prevalence

12 Indicator 5.3 Contraceptive prevalence Data availability

13 Limitations of data Characteristics of reference population Time frame used to assess contraceptive prevalence Survey question variability and effect on reporting

14 Data point selection MDG database: One point per year Married or in-union women aged 15 to 49 Next most comparable group (sexuallyactive women; ever-married women) If no data on current use, data on use at last sexual intercourse or during the previous year.

15 Trends in contraceptive prevalence since 1990 Bangladesh Bhutan Cambodia

16 Trends in contraceptive prevalence since 1990 China Indonesia Iran

17 Trends in contraceptive prevalence since 1990 Lao Mongolia Myanmar

18 Trends in contraceptive prevalence since 1990 Nepal Pakistan Papua New Guinea

19 Trends in contraceptive prevalence since 1990 Philippines Thailand Afghanistan

20 Common reasons for discrepancies Different survey data sources Modifications in the case of known errors in the reported figures For MDG database, modern methods do not include LAM or folk methods

21 Regional and global estimates

22 Contraceptive prevalence 1990 and 2010

23 Indicator 5.6 Unmet need for family planning

24 Indicator 5.6 Unmet need for FP Definition Women who want to delay or stop childbearing but are not using any method of contraception. Unmet need is the gap between women's reproductive intentions and their contraceptive behaviour.

25 Method of computation Numerator: Women who are... married or in union, aged fecund not using any method of contraception not wanting any more children or wanting to delay the next child for 2+ years Denominator: Married or in-union women aged 15-49

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27 Data Nationally-representative sample survey data from the DHS, RHS and national surveys that Are based on similar methodologies Include detailed questions to identify population at risk Differences in definition used are flagged with footnotes in the data series.

28 Indicator 5.6 Unmet need for family planning -- Data availability

29 Number of MDG data points on unmet need by data source

30 Comparison of unmet need computation (old and revised) Nepal Indonesia Philippines Source: Bradley et al. 2012; See also

31 Common reasons for discrepancies Use of old versus revised computation of unmet need (for DHS data) Different computations from same source (surveys other than DHS) Different survey data sources

32 Unmet need for family planning, 1990 and 2010 Eastern Asia 4 LAC 10 Northern Africa South-eastern Asia Caucasus and Central Asia Southern Asia Western Asia Sub-Saharan Africa

33 Indicator 5.4 Adolescent birth rate

34 Indicator 5.4 Adolescent birth rate Definition The annual number of births to women 15 to 19 years of age per 1,000 women in that age group. Represents the risk of childbearing among adolescent women 15 to 19 years of age. Also referred to as the age-specific fertility rate for women aged

35 Method of computation A ratio Numerator: Number of live births to women 15 to 19 years of age Denominator: Number of women 15 to 19 years of age Calculated differently for civil registration, survey and census data.

36 Data sources Civil registration data Surveys Censuses

37 Civil registration data Used if registration systems cover 90 per cent or more of all live births. Priority of sources for number of births UN estimate of number of women (from World Population Prospects) --

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39 Survey and census data Used if no civil registration system or where system coverage < 90 per cent of all live births. Surveys: Birth history data (reference period and year ~2.5 years before survey interview) Census: Provides both the numerator and the denominator for the rates

40 Obtaining data Civil registration data: UNSD, regional Statistics Divisions or statistical units Surveys: DHS, RHS, MICS, other national surveys Censuses: Estimates from published reports, adjusted rates only when reported by National Statistical Office.

41 Indicator 5.4 Adolescent birth rate Data availability

42 Data limitations Civil registration data: Completeness of birth registration Accuracy of age of mother data Other Survey and census data: Age and date misreporting Birth omissions and displacements Sampling variability (surveys)

43 Common reasons for discrepancies WPP population estimate vs. other data for denominator Inclusion of births to women under 15 years of age Different reference periods used Different data source selected

44 Thank you!

45 Indicator 5.4 Adolescent birth rate Nepal