Explaining inconsistencies between data on condom use and condom sales

BACKGROUND: Several HIV prevention programs use data on condom sales and survey-based data on condom prevalence to monitor progress. However, such indicators are not always consistent. This paper aims to explain these inconsistencies and to assess whether the number of sex acts and the number of condoms used can be estimated from survey data. This would be useful for program managers, as it would enable estimation of the number of condoms needed for different target groups. METHODS: We use data from six Demographic and Health Surveys to estimate the total annual number of sex acts and number of condoms used. Estimates of the number of sex acts are based on self-reported coital frequency, the proportion reporting intercourse the previous day, and survival methods. Estimates of the number of condoms used are based on self-reported frequency of use, the proportion reporting condom use the previous day and in last intercourse. The estimated number of condoms used is then compared with reported data on condom sales and distribution. RESULTS: Analysis of data on the annual number of condoms sold and distributed to the trade reveals very erratic patterns, which reflect stock-ups at various levels in the distribution chain. Consequently, condom sales data are a very poor indicator of the level of condom use. Estimates of both the number of sexual acts and the number of condoms used vary enormously based on the estimation method used. For several surveys, the highest estimate of the annual number of condoms used is tenfold that of the lowest estimate. CONCLUSIONS: Condom sales to the trade are a poor indicator of levels of condom use, and are therefore insufficient to monitor HIV prevention programs. While survey data on condom prevalence allow more detailed monitoring, converting such data to an estimated number of sex acts and condoms used is not straightforward. The estimation methods yield widely different results, and it is impossible to determine which method is most accurate. Until the reliability of these various estimation methods can be established, estimating the annual number of condoms used from survey data will not be feasible. Collecting survey data on the number of sex acts and the number of condoms used in a fixed time period may enable the calculation of more reliable estimates of the number of sex acts and condoms used

Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform

Temporal changes in key maternal and fetal factors affecting birth outcomes: A 32-year population-based study in an industrial city

<p>Abstract</p> <p>Background</p> <p>The link between maternal factors and birth outcomes is well established. Substantial changes in society and medical care over time have influenced women's reproductive choices and health, subsequently affecting birth outcomes. The objective of this study was to describe temporal changes in key maternal and fetal factors affecting birth outcomes in Newcastle upon Tyne over three decades, 1961–1992.</p> <p>Methods</p> <p>For these descriptive analyses we used data from a population-based birth record database constructed for the historical cohort <b>Pa</b>rticulate <b>M</b>atter and <b>P</b>erinatal <b>E</b>vents <b>R</b>esearch (PAMPER) study. The PAMPER database was created using details from paper-based hospital delivery and neonatal records for all births during 1961–1992 to mothers resident in Newcastle (out of a total of 109,086 singleton births, 97,809 hospital births with relevant information). In addition to hospital records, we used other sources for data collection on births not included in the delivery and neonatal records, for death and stillbirth registrations and for validation.</p> <p>Results</p> <p>The average family size decreased mainly due to a decline in the proportion of families with 3 or more children. The distribution of mean maternal ages in all and in primiparous women was lowest in the mid 1970s, corresponding to a peak in the proportion of teenage mothers. The proportion of older mothers declined until the late 1970s (from 16.5% to 3.4%) followed by a steady increase. Mean birthweight in all and term babies gradually increased from the mid 1970s. The increase in the percentage of preterm birth paralleled a two-fold increase in the percentage of caesarean section among preterm births during the last two decades. The gap between the most affluent and the most deprived groups of the population widened over the three decades.</p> <p>Conclusion</p> <p>Key maternal and fetal factors affecting birth outcomes, such as maternal age, parity, socioeconomic status, birthweight and gestational age, changed substantially during the 32-year period, from 1961 to 1992. The availability of accurate gestational age is extremely important for correct interpretation of trends in birthweight.</p

Improving risk management for violence in mental health services: a multimethods approach

contractual_start_date: 07-2008 editorial_review_begun: 07-2014 accepted_for_publication: 06-2015contractual_start_date: 07-2008 editorial_review_begun: 07-2014 accepted_for_publication: 06-2015contractual_start_date: 07-2008 editorial_review_begun: 07-2014 accepted_for_publication: 06-2015contractual_start_date: 07-2008 editorial_review_begun: 07-2014 accepted_for_publication: 06-201

Historic Mortality and Population Data, 1901-1992

Abstract copyright UK Data Service and data collection copyright owner.In the analysis of any particular set of mortality data, a pivotal role is frequently played by national death rates by age, sex and cause. For example, the analysis of cause specific time trends and their correlates generally draws upon data of this sort. At a broader level, international comparisons utilise the rates of several nations in order to make meaningful inferences about possible causal associations. By contrast, local mortality studies, including sub-sets and sub-divisions of the national population, call upon national rates to provide a reference set of background mortality levels against which local experience can be measured. However, the extent to which this can be done is dependent upon the availability of national rates on computer. In recognition of this, OPCS has constructed a database comprising the basic building bricks for constructing any aggregate database. In this instance the basic components of the database comprise number of deaths, held to the lowest level to which cause was routinely coded. The calculation of rates is made possible with this set of data by the provision of a comparable tape of estimates of population at risk. The data comprise two files, the deaths file and the population file. Each count held on the deaths file is stored in a separate record, referenced by cause, sex, age and year to which it refers. The population data are held in an identical format to that used for the death file with the exception of the cause variable, which is set to zero.Main Topics:Variables The OPCS historic deaths file contains number of deaths in England and Wales by year, sex, age and ICD (International Classification of Disease) cause. In all there have been nine revisions of the international classification. Each of these provides a coding frame for cause of death which differs, to varying degrees, from the previous revision. The years for which each ICD revision was used in the tabulation of England and Wales mortality data are shown in the documentation which accompanies this dataset. For most years, data are held in the following age groups: under one; one to four; five year age groups from five to eighty four and then all aged eighty five and over. Exceptions to this rule are the years 1901-1910, during which ages 25-84 are stored in ten year age groups and 1921-1941 when figures at ages 80 and over are not sub-divided. Full details are provided in the documentation. The OPCS population file contains population estimates by sex, year and age. Age groupings for each year correspond to those used for the death data for that year. Please note: this study does not include information on named individuals and would therefore not be useful for personal family history research.<br

Making a population estimate in England and Wales

4.00Available from British Library Document Supply Centre- DSC:6219.25(OPCS-OP--37) / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo