This is the fifth report in the series of publications which examine the prevalence of contraceptive use around the world. It contains data covering 160 countries, including 125 developing countries and 35 developed countries, representing 96 per cent of the world population. The review is based primarily on data obtained from nationally representative sample surveys, and includes two new chapters analysing contraceptive use dynamics and national policies relating to fertility, contraception and population growth.
This data booklet highlights estimates of the prevalence of individual contraceptive methods based on the World Contraceptive Use 2019 (which draws from 1,247 surveys for 195 countries or areas of the world) and additional tabulations obtained from microdata sets and survey reports. The estimates are presented for female and male sterilisation, intrauterine device (IUD), implant, injectable, pill, male condom, withdrawal, rhythm and other methods combined.
More than a quarter of pregnancies worldwide are unintended. Between 1995 and 2000, nearly 700,000 women died and many more experienced illness, injury, and disability as a result of unintended pregnancy. Children born from unplanned conception are at greater risk of low birth weight, of being abused, and of not receiving sufficient resources for healthy development. A wider range of contraceptive options is needed to address the changing needs of the populations of the world across the reproductive life cycle, but this unmet need has not been a major priority of the research community and pharmaceutical industry. New Frontiers in Contraceptive Research: A Blueprint for Action, a new report from the Institute of Medicine of the National Academies, identifies priority areas for research to develop new contraceptives. The report highlights new technologies and approaches to biomedical research, including genomics and proteomics, which hold particular promise for developing new products. It also identifies impediments to drug development that must be addressed. Research sponsors, both public and private, will find topics of interest among the recommendations, which are diverse but interconnected and important for improving the range of contraceptive products, their efficacy, and their acceptability.
This report covers 142 countries, representing 92 per cent of the world population. It examines the prevalence of contraceptive use at national, regional and global levels. Trends in contraceptive use from the 1970s are analysed for 86 countries. Specific methods of contraception are also examined: female sterilization accounts for a third, IUD for 22 per cent, and the oral pill 14 per cent. The report also includes estimates of the growth in contraceptive practice required if fertility is to decline in line with the UN population projections in "World population prospects: the 1998 revision" (1999, ISBN 9211513332)
Evaluates evidence for an increased risk of cancer in women using combined oral contraceptives, progestogen-only hormonal contraceptives, post-menopausal estrogen therapy, and post-menopausal estrogen-progestogen therapy. Although the carcinogenicity of these preparations has been extensively investigated, the book stresses the many complex methodological issues that must be considered when interpreting findings and weighing results. Evidence of an association between use of these preparations and positive effects on health, including a reduced risk of some cancers, is also critically assessed. The first and most extensive monograph evaluates evidence of an association between the use of combined oral contraceptives and cancer at nine sites. Concerning breast cancer, the evaluation concludes that, even if the association is causal, the excess risk for breast cancer associated with patterns of use that are typical today is very small. Studies of predominantly high-dose preparations found an increased risk of hepatocellular carcinoma in the absence of hepatitis viruses. Citing these findings, the evaluation concludes that there is sufficient evidence in humans for the carcinogenicity of combined oral contraceptives. The evaluation also found sufficient evidence for the carcinogenicity of some, but not all, combined preparations in animals. Combined oral contraceptives were classified as carcinogenic to humans. The evaluation also cites conclusive evidence that these agents have a protective effect against cancers of the ovary and endometrium. Progestogen-only contraceptives are evaluated in the second monograph, which considers the association with cancer at six sites. The evaluation found no evidence of an increased risk for breast cancer. Although the evaluation found sufficient evidence in animals for the carcinogenicity of medroxyprogesterone acetate, evidence for the carcinogenicity of progestogen-only contraceptives in humans was judged inadequate. Progestogen-only contraceptives were classified as possibly carcinogenic to humans. The third monograph, on post-menopausal estrogen therapy, considers evidence of an association with cancer at eight sites. Findings from a large number of epidemiological studies indicate a small increase in the risk of breast cancer in women who have used these preparations for five years or more. Studies consistently show an association between use of post-menopausal estrogen therapy and an increased risk for endometrial cancer. Data on the association with other cancers were either inconclusive or suggested no effect on risk. The evaluation concludes that post-menopausal estrogen therapy is carcinogenic to humans. The final monograph evaluates the association between the use of post-menopausal estrogen-progestogen therapy and cancer at four sites. The evaluation of limited data on breast cancer found an increased relative risk observed with long-term use. Data were judged insufficient to assess the effects of past use and of different progestogen compounds, doses, and treatment schedules. For endometrial cancer, the evaluation found an increase in risk relative to non-users when the progestogen was added to the cycle for 10 days or fewer. Post-menopausal estrogen-progestogen therapy was classified as possibly carcinogenic to humans. Concerning post-menopausal therapy in general, the book notes that evidence of carcinogenic risks must be placed in perspective of potential benefits. The prevention of osteoporotic fractures is cited as the best-established benefit. Evidence also suggests that estrogen prevents heart disease and may prevent memory loss and dementia.
According to the classic and widely accepted statement by Hauser and Duncan (1959: 2), demography is defined as “the study of the size, territorial distribution, and components of population, changes therein, and components of such changes.” Almost all disciplines of social sciences and most disciplines of natural sciences deal with human beings in one way or another, either directly or indirectly. Furthermore, demographic concepts (e.g., birth rate, death rate, and migration) and methods and analysis strategies (e.g., life table analysis) can be readily extended to other species (insects, animals, plants, etc.) and inanimate collectives (enterprises, automobiles, etc.). Clearly, demography is an important thematic field in science and it may provide the empirical foundation for studying human beings, animals, and inanimate collectives on which other relevant scientific research is built. The volume aims to be of value to the various audiences of both non-specialists and experts who seek a comprehensive understanding of issues related to human population. As reviewed in the very beginning of the Theme Introduction, “interdisciplinary” is one of the three major features of demography. Given the rapid development in techniques for collecting not only demographic data but also other related data concerning health, biomarkers, genetics, behaviors, and social and natural environments in conventional population surveys, as well as rapidly enhancing computing powers, this volume shows and concludes that demography will be even more interdisciplinary in the coming decades. A notable example is that the cross-field “marriage” between bio-medical sciences and demography will lead us to enter an era in which bio-medical and demographic methods will be well integrated. As indicated by James R. Carey and James W. Vaupel in Chapter 13 of this volume, the bio-demographic branches of demography are vibrant areas of demographic research that are rapidly growing and that have great potential to enrich and enlarge the domain of demography. Not only can demographers learn much from biologists and epidemiologists, but demographers can contribute much to research on life in general and to research on population health. The increasing availability of data sources and much enhanced computing/internet power will also lead demography to be more interactive with the other fields, such as psychology, environmental science, economics, business and management, etc. As discussed in this volume’s Chapter 11 by Swanson and Pol, for example, it is now possible to link conventional demographic data sources of census, surveys, and vital statistics with administrative records such as social security, tax reporting, medical insurance, hospital records, school registration, supermarket purchasing cards use, etc., while protecting individuals’ privacy. Such linkages will substantially increase the value of demographic methods, surveys and administrative records for scientific research and policy analysis, as well as the applicability of demography in business and governmental decision making processes.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
