Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports

<p>Abstract</p> <p>Background</p> <p>Adolescent pregnancy has significant health and socio-economic consequences for women, their families and communities. Efforts to prevent too-early pregnancy rely on accurate information about adolescents' knowledge, behaviours and access to family planning, however available data are limited in some settings. Demographic and Health Survey (DHS) reports are recognised as providing nationally representative data that are accessible to policymakers and programmers. This paper reviews DHS reports for low and lower middle income countries in East Asia and the Pacific to determine what information regarding adolescent fertility and family planning is available, and summarises key findings.</p> <p>Methods</p> <p>The most recent DHS reports were sought for the 33 low and lower middle income countries in the East Asia and Pacific region as defined by UNICEF and World Bank. Age-disaggregated data for all indicators relevant to fertility and current use, knowledge and access to family planning information and services were sought to identify accessible information. Reported data were analysed using an Excel database to determine outcomes for adolescents and compare with adult women.</p> <p>Results</p> <p>DHS reports were available for eleven countries: Cambodia, Indonesia, Marshall Islands, Nauru, Papua New Guinea, Philippines, Samoa, Solomon Islands, Timor-Leste, Tuvalu and Vietnam. Twenty seven of 40 relevant DHS indicators reported outcomes for adolescent women aged 15-19 years. There were limited data for unmarried adolescents. A significant proportion of women commence sexual activity and childbearing during adolescence in the context of low contraceptive prevalence and high unmet need for contraception. Adolescent women have lower use of contraception, poorer knowledge of family planning and less access to information and services than adult women.</p> <p>Conclusion</p> <p>DHS reports provide useful and accessible data, however, they are limited by the failure to report data for unmarried adolescents and report age-disaggregated data for some indicators. Further research is required to better understand the barriers that both married and unmarried adolescents face accessing reproductive health information and services, and their information and service delivery preferences.</p

Mortality trends and the epidemiological transition in Nauru

This article aims to examine the epidemiological transition in Nauru through analysis of available mortality data. Mortality data from death certificates and published material were used to construct life tables and calculate age-standardized mortality rates (from 1960) with 95% confidence intervals. Proportional mortality was calculated from 1947. Female life expectancy (LE) varied from 57 to 61 years with no significant trend. Age-standardized mortality for males (15-64 years) doubled from 1960-1970 to 1976-1981 and then decreased to 1986-1992, with LE fluctuating since then from 49 to 54 years. Proportional mortality from cardiovascular disease and diabetes increased substantially, reaching more than 30%. Nauru demonstrates a very long period of stagnation in life expectancy in both males and females as a consequence of the epidemiological transition, with major chronic disease mortality in adults showing no sustained downward trends over 40 years. Potential overinterpretation of trends from previous data due to lack of confidence intervals was highlighted. © 2011 APJPH