Overview of the process for data compilation, adjustments, indicator ...

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

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

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

Source: Ahmed et al. 2012. The Lancet, doi:10.1016/S0140-6736(12)60478-4

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

Indicator 5.3
Contraceptive prevalence rate

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.

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.

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

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

Comprehensive data on
contraceptive prevalence
www.unpopulation.org

Indicator 5.3 Contraceptive prevalence
Data availability

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

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.

Trends in contraceptive prevalence
since 1990
Bangladesh Bhutan Cambodia

Trends in contraceptive prevalence
since 1990
China Indonesia Iran

Trends in contraceptive prevalence
since 1990
Lao Mongolia Myanmar

Trends in contraceptive prevalence
since 1990
Nepal Pakistan Papua New
Guinea

Trends in contraceptive prevalence
since 1990
Philippines Thailand Afghanistan

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

Regional and global estimates

Contraceptive prevalence
1990 and 2010

Indicator 5.6
Unmet need for family planning

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.

Method of computation
• Numerator: Women who are...
– married or in union, aged 15-49
– 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

http://mdgs.un.org

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.

Indicator 5.6 Unmet need for family
planning -- Data availability

Number of MDG data points on unmet
need by data source

Comparison of unmet need
computation (old and revised)
Nepal
Indonesia
Philippines
Source: Bradley et al. 2012; See also http://measuredhs.com/Topics/Unmet-Need.cfm

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

Unmet need for family planning,
1990 and 2010
Eastern Asia
4
LAC
10
Northern Africa
South-eastern Asia
Caucasus and Central Asia
12
13
13
1990
2010
Southern Asia
Western Asia
16
17
Sub-Saharan Africa
25
0 10 20 30 40 50

Indicator 5.4
Adolescent birth rate

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 15-19.

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.

Data sources
• Civil registration data
• Surveys
• Censuses

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) --
www.unpopulation.org

www.unpopulation.
org

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

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.

Indicator 5.4 Adolescent birth rate
Data availability

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)

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

Thank you!
www.unpopulation.org
http://mdgs.un.org

Indicator 5.4 Adolescent birth rate
Nepal