5 research outputs found
Alternative solution for ex vivo lung perfusion, experimental study on donated human lungs non-accepted for transplantation
- Author
- Alessandro Wasum Mariani
- Arcasoy SM
- Aristides Tadeu Correia
- Barrett KE
- Carnevale R
- Christie JD
- Christie JD
- Costa da Silva F Jr
- Cypel M
- Cypel M
- Cypel M
- De Perrot M
- Egan TM
- Emaminia A
- Fischer S
- Fischer S
- Ingemansson R
- Israel Lopes de Medeiros
- Lucas Matos Fernandes
- Luís Gustavo Abdalla
- Marcos Naoyuki Samano
- Mariani AW
- Mauro Canzian
- Medeiros IL
- Natália Aparecida Nepomuceno
- Orens JB
- Paulo Manuel Pêgo-Fernandes
- Perrot M
- Pêgo-Fernandes PM
- Pêgo-Fernandes PM
- Pêgo-Fernandes PM
- Steen S
- Wierup P
- Wierup P
- Publication venue
- 'FapUNIFESP (SciELO)'
- Publication date
- Field of study
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
- Anwer Mariyah
- Anyanwu Lofty-John
- Apostolou Christos
- Apostolou Konstantinos
- Appiah-Kubi Adu
- Aprea Giovanni
- Arbab Hana
- Archer James
- Ardura Francisco
- Aremu Muyiwa
- Arif Tahera
- Arkani Samara
- Armatura Giulia
- Armijos Daniel
- Arnaout Ali
- Arnaoutoglou Eleni
- Arnaud Alexis P.
- Arneja Jugpal
- Arrangoiz Rodrigo
- Arshad Muhammad
- Arthur Joshua
- Ashcroft James
- Ashford Bruce
- Ashraf Fariha
- Asiimwe Daniel
- Asirifi Samuel Amoako
- Asla Amir
- Aslam Ramisha
- Aspide Raffaele
- Ataya Karim
- Ateca Ibabe Villalabeitia
- Atici Semra Demirli
- Atis Gokhan
- Atkins William
- Atkinson Kate
- Attwood Joseph
- Auerkari Aino
- Augestad Knut Magne
- Augustin Goran
- Aujayeb Avinash
- Avella Pasquale
- Awad Ahmed K.
- Awad Hadeel
- Awad Rabih
- Awad Selmy
- Ayad Kusay
- Ayana Birhanu
- Aydin Yener
- Ayeni Funbi
- Aytac Erman
- Azab Ahmed
- Azami Rizwan
- Azize Diallo Abdoul
- Azzam Ahmed Y.
- Azzis Olivier
- Baba Yabasin Iddrisu
- Babis George
- Bacalbasa Nicolae
- Badiani Sarit
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- Baduell Albert
- Baeesa Saleh
- Baertschiger Reto
- Bafaquh Mohammed
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- Bahrami-Hessari Michael
- Baia Marco
- Baidoo Ebikela Ivie
- Bailey Karen
- Baili Efstratia
- Bains Lovenish
- Baiocchi Gian Luca
- Baiocchi Glauco
- Baiyewu Lateef Ayodele
- Bajaj Ankur
- Bajunaid Khalid
- Balagobi Balasingam
- Balasubramanian Ishwarya
- Balduzzi Alberto
- Baldwin Alexander
- Balla Andrea
- Balogh Zsolt J.
- Balogun James A.
- Balogun Simon
- Baloyiannis Ioannis
- Ban Vin Shen
- Bandyopadhyay Samik Kumar
- Bandyopadhyay Soham
- Banerjee Sumit
- Banipal Gurpreet Singh
- Banky Balazs
- Bannone Elisa
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- Barberis Andrea
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- Bareka Metaxia
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- Barugola Giuliano
- Basendowah Mohammed
- Bashir Mahmod
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- Bass Gary Alan
- Basu Somprakas
- Bateman Antony
- Bateman Kellie
- Batista Sylvia
- Batstone Martin
- Bauer Marlies
- Bauset Juan Carlos Catalá
- Bawa Ashvind
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- Beamish Andrew
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- Bilfaqirah Majed
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- Bissacco Daniele
- BİŞGİN TAYFUN
- Blair James
- Blanco Jose
- Blencowe Natalie
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- Board Timothy
- Bobak Peter
- Boccalatte Luis
- Boedo Maria Jesus Maroño
- Bohmer Rob
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- Boligo Sofia
- Bolton William
- Bombardini Cristina
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- Bonci Eduard-Alexandru
- Bondurri Andrea
- Bonilla Antonio Ramos
- Bonsaana Gilbert Batieka
- Booth L.
- Borg Elaine
- Borges Miguel Fróis
- Borges Nuno
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- Bruzzaniti Placido
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- Cross George W. V.
- Cruz Ricardo Pedrini
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- Cunningham Brian
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- D'Acapito Fabrizio
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- Dawson Jonathon
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- De La Infiesta García Carlos
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- Federer Simon
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- Sole-Sedeno Josep M.
- Soljic Martina
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- Tejero-Pintor Francisco J.
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- Van Goor Harry
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- Vanni Camilla
- Vas Aurelia
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- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
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- Vaysburg Dennis
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- Venkatappa Sunil Kumar
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- Verhoeff Kevin
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- Vijay Vardhini
- Vijgen Guy
- Vilaró Blanca Capdevila
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- Vissapragada Ravi
- Vivancos Laura Guillamon
- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Abate Yohannes Habtegiorgis
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abiodun Olumide
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abrigo Michael R M
- Abtahi Dariush
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abualruz Hasan
- Abubakar Bilyaminu
- Adal Tadele Girum Girum
- Adane Mesafint Molla
- Adeagbo Oluwafemi Atanda Adeagbo
- Adedoyin Rufus Adesoji
- Adekanmbi Victor
- Aden Bashir
- Adepoju Abiola Victor
- Adetokunboh Olatunji O
- Adetunji Juliana Bunmi
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Rotimi Felix
- Afyouni Shadi
- Afzal Muhammad Sohail
- Afzal Saira
- Aghamiri Shahin
- Agodi Antonella
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahlstrom Austin J
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Sajjad
- Ahmad Tauseef
- Ahmed Ali
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Meqdad Saleh
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Akalu Gizachew Taddesse
- Akbarialiabad Hossein
- Akinyemi Rufus Olusola
- Akkaif Mohammed Ahmed
- Akkala Sreelatha
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al Qadire Mohammad
- AL-Ahdal Tareq Mohammed Ali
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Eyadhy Ayman
- Al-Gheethi Adel Ali Saeed
- Al-Marwani Sabah
- Al-Mekhlafi Hesham M
- Al-Omari Basem
- Al-Raddadi Rajaa M
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Alalalmeh Samer O
- Alalwan Tariq A
- Alam Khurshid
- Alanezi Fahad Mashhour
- Alanzi Turki M
- Albakri Almaza
- Albashtawy Mohammed
- AlBataineh Mohammad T
- Alemi Hediyeh
- Alemi Sharifullah
- Alemu Yihun Mulugeta
- Alhabib Khalid F
- Alhajri Noora
- Alhalaiqa Fadwa Alhalaiqa Naji
- Alhassan Robert Kaba
- Ali Abid
- Ali Beriwan Abdulqadir
- Ali Liaqat
- Ali Mohammed Usman
- Ali Rafat
- Ali Syed Shujait Shujait
- Alif Sheikh Mohammad
- Aligol Mohammad
- Alijanzadeh Mehran
- Aljasir Mohammad A M
- Aljunid Syed Mohamed
- Almazan Joseph Uy
- Almidani Omar
- Alomari Mahmoud A
- Alqahtani Jaber S
- Alqutaibi Ahmed Yaseen
- Altaf Awais
- Altirkawi Khalid A
- Aluh Deborah Oyine
- Alvi Farrukh Jawad
- Alvis-Guzman Nelson
- Alwafi Hassan
- Aly Hany
- Aly Safwat
- Alzoubi Karem H
- Ameyaw Edward Kwabena
- Amin Tarek Tawfik
- Amindarolzarbi Alireza
- Amini-Rarani Mostafa
- Amiri Sohrab
- Ampomah Irene Gyamfuah
- Amugsi Dickson A
- Amusa Ganiyu Adeniyi
- Ancuceanu Robert
- Anderlini Deanna
- Andrade Pedro Prata
- Andrei Catalina Liliana
- Andrei Tudorel
- Anil Abhishek
- Anil Sneha
- Ansar Adnan
- Ansari-Moghaddam Alireza
- Antony Catherine M
- Antriyandarti Ernoiz
- Anvari Saeid
- ANWAR SALEHA
- Anwer Razique
- Anyasodor Anayochukwu Edward
- Arabloo Jalal
- Arabzadeh Bahri Razman
- Arafa Elshaimaa A
- Arafat Mosab
- Aravkin Aleksandr Y
- Araújo Ana Margarida
- Aremu Abdulfatai
- Aripov Timur
- Arkew Mesay
- Armocida Benedetta
- Arooj Mahwish
- Artamonov Anton A
- Arulappan Judie
- Aruleba Raphael Taiwo
- Arumugam Ashokan
- Asadi-Lari Mohsen
- Asemi Zatollah
- Asgary Saeed
- Asghari-Jafarabadi Mohammad
- Asghariahmadabad Mona
- Ashemo Mubarek Yesse
- Ashraf Muhammad
- Ashraf Tahira
- Asika Marvellous O
- Athari Seyyed Shamsadin
- Atout Maha Moh'd Wahbi
- Atreya Alok
- Aujayeb Avinash
- Ausloos Marcel
- Avan Abolfazl
- Aweke Amlaku Mulat
- Ayele Getnet Melaku
- Ayyoubzadeh Seyed Mohammad
- Azadnajafabad Sina
- Azevedo Rui M S
- Azzam Ahmed Y
- Badar Muhammad
- Badiye Ashish D
- Baghdadi Soroush
- Bagheri Nasser
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- Bahmanziari Najmeh
- Bai Ruhai
- Baig Atif Amin
- Baker Jennifer L
- Bako Abdulaziz T
- Bakshi Ravleen Kaur
- Balasubramanian Madhan
- Baltatu Ovidiu Constantin
- Bam Kiran
- Banach Maciej
- Bandyopadhyay Soham
- Banik Biswajit
- Banik Palash Chandra
- Bansal Hansi
- Baran Mehmet Firat
- Barchitta Martina
- Bardhan Mainak
- Bardideh Erfan
- Barker-Collo Suzanne Lyn
- Barone-Adesi Francesco
- Barqawi Hiba Jawdat
- Barrow Amadou
- Barteit Sandra
- Basharat Zarrin
- Bashir Asma'u I J
- Bashiru Hameed Akande
- Basiru Afisu
- Basso João Diogo
- Basu Sanjay
- Batiha Abdul-Monim Mohammad
- Batra Kavita
- Baune Bernhard T
- Bayati Mohsen
- Begum Tahmina
- Behboudi Emad
- Behnoush Amir Hossein
- Beiranvand Maryam
- Bejarano Ramirez Diana Fernanda
- Bekele Alehegn
- Belay Sefealem Assefa
- Belgaumi Uzma Iqbal
- Bell Michelle L
- Bello Olorunjuwon Omolaja
- Beloukas Apostolos
- Bensenor Isabela M
- Berezvai Zombor
- Berhie Alemshet Yirga
- Bermudez Amiel Nazer C
- Bettencourt Paulo J G
- Bhagavathula Akshaya Srikanth
- Bhardwaj Nikha
- Bhardwaj Pankaj
- Bhardwaj Prarthna V
- Bhaskar Sonu
- Bhat Vivek
- Bhatti Gurjit Kaur
- Bhatti Jasvinder Singh
- Bhatti Manpreet S
- Bhatti Rajbir
- Biondi Antonio
- Bisignano Catherine
- Biswas Atanu
- Biswas Raaj Kishore
- Bitra Veera R
- Bjørge Tone
- Bliss Elye
- Boachie Micheal Kofi
- Bobirca Anca Vasilica
- Bodolica Virginia
- Bodunrin Aadam Olalekan
- Bogale Eyob Ketema
- Bogale Kassawmar Angaw
- Bonakdar Hashemi Milad
- Bora Basara Berrak
- Bouaoud Souad
- Braithwaite Dejana
- Brauer Michael
- Breitborde Nicholas J K
- Bryazka Dana
- Bulamu Norma B
- Buonsenso Danilo
- Burkart Katrin
- Burns Richard A
- Bustanji Yasser
- Butt Nadeem Shafique
- Butt Zahid A
- Bärnighausen Till Winfried
- Caetano dos Santos Florentino Luciano
- Calina Daniela
- Campos-Nonato Ismael R
- Cao Fan
- Cao Shujin
- Capodici Angelo
- Carreras Giulia
- Carugno Andrea
- Castañeda-Orjuela Carlos A
- Castelpietra Giulio
- Cattaruzza Maria Sofia
- Caye Arthur
- Cegolon Luca
- Cembranel Francieli
- Cerin Ester
- Chadwick Joshua
- Chahine Yaacoub
- Chakraborty Chiranjib
- Chalek Julian
- Chan Jeffrey Shi Kai
- Charalampous Periklis
- Chattu Vijay Kumar
- Chaturvedi Sarika
- Chavula Malizgani Paul
- Chen An-Tian
- Chen Haowei
- Chen Simiao
- Chi Gerald
- Chichagi Fatemeh
- Chien Ju-Huei
- Ching Patrick R
- Cho William C S
- Choi Sungchul
- Chong Bryan
- Chopra Hitesh
- Choudhari Sonali Gajanan
- Christopher Devasahayam J
- Chu Dinh-Toi
- Chukwu Isaac Sunday
- Chung Eric
- Chung Sheng-Chia
- Cindi Zinhle
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- Soleimani Hamidreza
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- Solomon Yonatan
- Song Yimeng
- Sorensen Reed J D
- Spartalis Michael
- Sreeramareddy Chandrashekhar T
- Srivastava Vijay Kumar
- Stanikzai Muhammad Haroon
- Starodubov Vladimir I
- Starodubova Antonina V
- Stefan Simona Cătălina
- Steiropoulos Paschalis
- Stokes Mark A
- Subramaniyan Vetriselvan
- Suleman Muhammad
- Suliankatchi Abdulkader Rizwan
- Sultana Abida
- Sun Jing
- Swain Chandan Kumar
- Sykes Bryan L
- Szarpak Lukasz
- Szeto Mindy D
- Szócska Miklós
- Tabaee Damavandi Payam
- Tabarés-Seisdedos Rafael
- Tabatabaei Malazy Ozra
- Tabatabaeizadeh Seyed-Amir
- Tabatabai Shima
- Tabb Karen M
- Tabish Mohammad
- Taheri Soodejani Moslem
- Taiba Jabeen
- Tajbakhsh Ardeshir
- Talaat Iman M
- Talukder Ashis
- Tampa Mircea
- Tamuzi Jacques Lukenze
- Tan Ker-Kan
- Tang Haosu
- Tareke Derbie Alemu DA
- Tariku Mengistie Kassahun
- Tat Vivian Y
- Tavangar Seyed Mohammad
- Teimoori Mojtaba
- Temsah Mohamad-Hani
- Temsah Reem Mohamad Hani
- Teramoto Masayuki
- Terefa Dufera Rikitu
- Tesler Riki
- Teye-Kwadjo Enoch
- Thakur Ramna
- Thangaraju Pugazhenthan
- Thankappan Kavumpurathu Raman
- Thapar Rekha
- Tharwat Samar
- Thayakaran Rasiah
- Thomas Nihal
- Tichopad Ales
- Ticoalu Jansje Henny Vera
- Tiruye Tenaw Yimer
- Titova Mariya Vladimirovna
- Tonelli Marcello
- Tovani-Palone Marcos Roberto
- Traini Eugenio
- Tran Jasmine T
- Tran Nghia Minh
- Trihandini Indang
- Tromans Samuel Joseph
- Truyen Thien Tan Tri Tai
- Tsatsakis Aristidis
- Tsermpini Evangelia Eirini
- Tumurkhuu Munkhtuya
- Tyrovolas Stefanos
- Uddin Sayed Mohammad Nazim
- Udoakang Aniefiok John
- Udoh Arit
- Ullah Atta
- Ullah Saeed
- Ullah Sana
- Umakanthan Srikanth
- Umeokonkwo Chukwuma David
- Unim Brigid
- Unnikrishnan Bhaskaran
- Upadhyay Era
- Usman Jibrin Sammani
- Vacante Marco
- Vahabi Seyed Mohammad
- Vaithinathan Asokan Govindaraj
- Valizadeh Rohollah
- Van den Eynde Jef
- Varavikova Elena
- Varga Orsolya
- Vart Priya
- Varthya Shoban Babu
- Vasankari Tommi Juhani
- Vellingiri Balachandar
- Venugopal Deneshkumar
- Verghese Nicholas Alexander
- Verma Madhur
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Vervoort Dominique
- Villafañe Jorge Hugo
- Vinayak Manish
- Violante Francesco S
- Vishwakarma Mukesh
- Vladimirov Sergey Konstantinovitch
- Vlassov Vasily
- Vo Bay
- Vollset Stein Emil
- Volovat Simona Ruxandra
- Vos Theo
- Vujcic Isidora S
- Wafa Hatem A
- Waheed Yasir
- Wakwoya Elias Bekele
- Wang Cong
- Wang Denny
- Wang Fang
- Wang Shu
- Wang Yanzhong
- Wang Yuan-Pang
- Ward Paul
- Wassie Emebet Gashaw
- Watson Stefanie
- Weaver Marcia R
- Weerakoon Kosala Gayan
- Weiss Daniel J
- Wells Katherine M
- Wen Yi Feng
- Westerman Ronny
- Wiangkham Taweewat
- Wickramasinghe Dakshitha Praneeth
- Wickramasinghe Nuwan Darshana
- Willeit Peter
- Wondimagegene Yohannes Addisu
- Wu Felicia
- Xia Juan
- Xiao Hong
- Xu Gelin
- Xu Suowen
- Xu Xiaoyue
- Yadollahpour Ali
- Yaghoobpoor Shirin
- Yaghoobpour Tina
- Yaghoubi Sajad
- Yahaya Zwanden Sule
- Yang Danting
- Yang Lin
- Yano Yuichiro
- Yaribeygi Habib
- Ye Pengpeng
- Yesodharan Renjulal
- Yesuf Subah Abderehim
- Yezli Saber
- Yigezu Amanuel
- Yip Paul
- Yon Dong Keon
- Yonemoto Naohiro
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuan Chun-Wei
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zamagni Giulia
- Zandi Milad
- Zandieh Ghazal G Z
- Zangiabadian Moein
- Zastrozhin Mikhail Sergeevich
- Zhang Haijun
- Zhang Meixin
- Zhang Yunquan
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Zielińska Magdalena
- Zou Zhiyong
- Zyoud Samer H
- Ärnlöv Johan
- Publication venue
- Elsevier
- Publication date
- 20/03/2024
- Field of study
BackgroundAccurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. MethodsTo estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. FindingsDuring the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. InterpretationFertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world. FundingBill & Melinda Gates Foundation
Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
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- Aadam Olalekan Bodunrin (18346572)
- Abanoub Riad (12229703)
- Abbas Mosapour (9154247)
- Abdalla Z Mohamed (18346983)
- Abdallah M Samy (8383428)
- Abdallah Y Naser (18347016)
- Abdoljalal Marjani (18346929)
- Abdollah Mohammadian-Hafshejani (9714923)
- Abdul-Monim Mohammad Batiha (12229466)
- Abdulaziz T Bako (18346515)
- Abdulfatai Aremu (9536881)
- Abdulkareem Kabir (18346809)
- Abdullah A Mamun (8383290)
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- Abhishek Shankar (18207631)
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- Publication venue
- Publication date
- 16/05/2024
- Field of study
BackgroundAccurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios.MethodsTo estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline.FindingsDuring the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction.InterpretationFertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world.</p