Transcript Global Contraceptive Prevalence and Maternal Mortality – A Study of Women’s Reproductive Health and Rights By Olufunke (Funke) Akiyode Shout Global Health [email protected].

Global Contraceptive Prevalence
and Maternal Mortality – A Study
of Women’s Reproductive Health
and Rights
By
Olufunke (Funke) Akiyode
Shout Global Health
[email protected]
Presenting Author’s Disclosure
No financial relationship
What are contraceptives?
• Contraceptives are chemicals, medicines or
device that prevent conception8.
• It is the use of any practices, methods, or
devices to prevent pregnancy from
occurring in a sexually active woman3
• They are also known as Birth Controls or
Fertility Controls, and Family Planning3.
• Contraceptive methods are either designed to
prevent fertilization of egg or implantation of a
fertilized egg in the uterus3.
• Methods can be reversible or irreversible
Contraceptive Type
• 1. Continuous Abstinence4 – Not having sex
• 2. Natural Family Planning / Rhythm Method – Not
having sex on most fertile days
• 3.Barrier Methods – Sponge, cervical cap,
diaphragm, cervical shield, female condom, and
male condom.
• 4.Hormonal Methods- oral contraceptives, patch,
shot/ injections, and vaginal ring
• 5.Implantable Devices – Implantable rod,
Interuterine Devices (IUDs)9
• Permanent Birth Control Methods – Sterilizationsurgical and inplant9
• 6. Emergency contraception – Used if primary birth
control fails9.
Most Effective form of Contraceptive
•
•
•
•
•
•
•
•
•
1. Abstinence
2. Condoms
3. Birth control combination pill, patch or ring
4. Progestin only pills
5. Depo provera shot
6. Implanon
7.Inter uterine device
8.Emergency contraception
9 Essure5
Contraceptive Prevalence
• The United Nations defined “contraceptive
prevalence as the percentage of women who
are currently using, at least one method of
contraception, regardless of the method
used.7”
• Usually reported for women who are married
or in union between ages 15 to 19
Contraceptive Prevalence
Computed as –
Contraceptive Prevalence =
Women of reproductive age (15 – 49) who are married or in union
and are currently using any method of contraceptive
________________________________________________________ X 100
Total number of women of reproductive age (15 – 49) who are
married or in union7
Global Contraceptive Prevalence
World
High
Income
Countries
Low
Income
Countries
Any method Any
modern
method
62.9
56.1
Sterilization
69.7
58.6
8.1
4.8
61.7
55.7
22.3
2.5
Female Male
20.3
2.8
Global Contraceptive Prevalence (CP)
• Contraceptive prevalence is generally higher in
high income countries than in low income
countries
• CP in high income countries is higher that the CP
of the world
• There is a higher prevalence of sterilization
among female than among males all over the
world
• The rate of sterilization method is predominantly
higher in low income countries than in high
income countries
Contraceptive Prevalence (CP) by Regions
Any
method
Africa
Asia
Europe
Latin America
and the
Caribbean
Oceania
Any
Sterilization
modern Female
Male
method
28.0
21.9
1.5
0.0
67.0
70.5
61.1
56.3
25.2
3.8
3.1
2.6
71.7
64.3
29.5
1.3
58.6
52.5
12.1
9.9 7
Contraceptive Prevalence by Regions
• Africa has the least contraceptive prevalence
in the world while Latin America and the
Caribbean has the highest CP in the world.
• Sterilization is not popular in Africa and there
is zero prevalence rate in sterilization method
in males
• Asia has a slightly high CP and a high
prevalence in female sterilization as a method
of contraceptive
Contraceptive Prevalence and MMR
Africa
Asia
Europe
Latin America
and the
Caribbean
Oceania
Contraceptive
Prevalence
28.0
67.0
70.5
Maternal
Mortality Rate
460
150
20
80
71.7
58.6 7 200 7
Global Contraceptive Prevalence (CP)
and MMR
CP
World
62.9
High Income 69.7
Countries
Low Income 61.7
Countries
MMR
210
16
240 10
Contraceptive Prevalence and MMR
• There is an inverse relationship between
contraceptive Prevalence and Maternal
Mortality.
• There is a high Maternal Mortality rates in
region with low contraceptive prevalence
• Can we conclude that contraceptive
prevalence might be one of the contributory
factors of maternal mortality since more than
a quarter of all pregnancies are unwanted?
Contraceptive Prevalence and Other
Health Status Indicators
CP
Africa
Asia
Europe
Latin America
and the
Caribbean
Oceania
Infant
Mortality
Rates
Life
Expectancy
28.0 70.76 11 5012
67.0 36.90 11 70 11
70.5 6.15 11 72 12
71.7 35 2
74 12
58.6 17.53 11 72.7 13
Contraceptive Prevalence and Other
Health Status Indicators
• Infant Mortality Rates are higher in regions with
low contraceptive prevalence than in regions with
high contraceptive prevalent rates.
• Life expectancy is lower in regions with low
contraceptive rate than in regions with high
contraceptive prevalence rate.
• Low heath status are an indication of a failed
health system, therefore we may infer that low
contraceptive prevalence is also an indication of
failed health system
Global Contraceptive Prevalence (CP)
and Abortion Rate
CP
World
62.9
High Income 69.7
Countries
Low Income 61.7
Countries
Abortion
Rate
28
24
29 1
Contraceptive Prevalence and
Abortion Rate
Africa
Asia
Europe
Latin America
and the
Caribbean
Oceania
Contraceptive
Prevalence
28.0
67.0
70.5
Abortion Rate
29
28
27
32
71.7
58.6 17
1
Global Contraceptive Prevalence (CP)
and Abortion
• The higher the contraceptive prevalence, the
lower the abortion rates and hence abortion
deaths
• Unwanted pregnancy often times lead to
Abortion.
• Abortion accounts for 13% of maternal
mortality. 1
• These deaths rate can be greatly reduced with
a high Contraceptive Prevalence.
Global Contraceptive Prevalence (CP)
and Abortion
• The estimated number of deaths due to
unsafe abortion in 2008 was 47,000.1
• When Eastern Europe made contraception
widely available, abortion rate reduced by
50% 1.
• A woman’s likelihood of committing abortion
is higher in the developing countries where
the contraceptive prevalence is lower and
where unsafe abortion is prominent.
Contraceptive Prevalence and
Reproductive Health
• Reproductive Health has been defined according to
the International Conference on Population and
Development as a ‘state of complete physical,
mental and social well being and not merely
absence of disease or infirmity in all matters
relating to the reproductive system and to its
function and processes’
• In countries and places with low contraceptive
prevalence women are more exposed to unwanted
pregnancies, resulting in higher rate of maternal
mortality, abortion rate and unsafe abortion.
Contraceptive Prevalence and
Reproductive Health Rights
• Reproductive health rights as defined in the
Beijing Platform of action are certain human
rights recognized in the national and
international legal and human rights documents,
including the basic rights of all couples and
individuals to decide freely and responsibly the
number and spacing of their children, and to have
information, education and means to do so; the
right to make decisions concerning reproduction
free of discrimination, coercion and violence
Contraceptive Prevalence and
reproductive Health Rights
• Low contraceptive prevalence will deny
couples “means” to freely decide the
spacing and number of children they
want to have, thus violating their RHR
• Low contraceptive prevalence is an
indication of low access to family
planning services which is a violation of
reproductive health rights
Conclusions and Recommendations
• Places with low contraceptive prevalence rates
tend to have high Abortion rate, unsafe
abortion, abortion deaths and relatively high
maternal mortality rate.
• Places with an improvement in contraceptive
rates have experienced a considerable
decrease in Abortion Rates and deaths.
Conclusions and Recommendation
• Thus an increase in contraceptive prevalence will lead to
decrease In Abortion rates, unsafe abortion, and abortion
deaths
• Efforts should be made to improve contraceptive rates
globally (especially in the low income countries) in order to
improve maternal mortality rates, reproductive health and
rights.
• Efforts should also be made by countries to make effective
form of contraceptives readily available.
• Countries should improve access to information on issues
of contraception.
• The mass media can be used as a way to disseminate
information about reproductive health needs.
Bibliography
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1. Infoplease, 2012; Global Abortion Rates; internet accessed at <http://www.infoplease.com/science/health/globalabortion-rates.html >, August, 2012
2. Ellen M Gee; 2012; Mortality; internet accessed at < http://www.deathreference.com/Me-Nu/Mortality-Infant.html>
August, 2012
3. Medicine Net; ; 2012 "Definition of Birth control". Internet accessed at
http://www.medterms.com/script/main/art.asp?articlekey=53351
4. Planned Parenthood 2012; internet accessed at
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7. United Nations, Department of Economic and Social Affairs, Population Division (2009). World Contraceptive Use 2009
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