Abstract

Located in the South West Pacific region, with a population of 7.5 million, Papua New Guinea (PNG) is among a group of Pacific countries with sub-optimal health status. The maternal mortality ratio is 171 per 100,000 live births. Unmet need for contraception and family planning services, although poorly understood in PNG, may be one of the underlying causes of poor maternal health. This study set out to measure the prevalence and trends in unmet need for contraception and the identified socioeconomic factors associated with contraceptive use among women of reproductive age (15–49 years) in PNG. Data available from the Integrated Health and Demographic Surveillance System (IHDSS) were used in this study. A sub-population data set was extracted of 1434 women who gave birth in the preceding two years and resided in four rural surveillance sites: Asaro, Hides, Hiri and Karkar. Analyses of unmet need for contraception were performed with respect to birth spacing and limiting the number of births. Unmet need for contraception was 34% for the previous birth, 37% for the current pregnancy, and 49% for future family planning. The total unmet need for contraception was 35%, of which 49% was for spacing births and 51% for limiting births. Women’s age, education and household wealth are the most significant determinants of unmet need for contraception. The high level of unmet need for contraception may contribute to women’s poor health status in PNG. Urgent programming responses from the health sector for supporting effective interventions to increase availability and utilisation of contraceptives are required.

摘要

巴布亚新几内亚（PNG）位于西南太平洋地区，人口750万，是健康状况欠佳的太平洋国家之一。孕产妇死亡率为每 10 万活产儿 171 人。尽管巴布亚新几内亚对避孕和计划生育服务的需求未得到满足，但人们对此知之甚少，但这可能是孕产妇健康状况不佳的根本原因之一。本研究旨在衡量巴布亚新几内亚育龄妇女（15-49 岁）避孕需求未得到满足的普遍情况和趋势，以及已确定的与避孕药具使用相关的社会经济因素。本研究使用了综合健康和人口监测系统 (IHDSS) 提供的数据。提取了过去两年内生育过的 1434 名女性的子群体数据集，这些女性居住在四个农村监测点：阿萨罗 (Asaro)、希德斯 (Hides)、希里 (Hiri) 和卡卡 (Karkar)。对生育间隔和限制生育数量方面未满足的避孕需求进行了分析。上一次生育的避孕需求未得到满足的比例为 34%，当前怀孕的避孕需求为 37%，未来计划生育的避孕需求为 49%。未满足的避孕需求总量为35%，其中49%为间隔生育，51%为限制生育。妇女的年龄、教育程度和家庭财富是避孕需求未得到满足的最重要的决定因素。避孕需求未得到满足的严重程度可能导致巴布亚新几内亚妇女的健康状况不佳。卫生部门需要采取紧急规划应对措施，支持有效的干预措施，以提高避孕药具的供应和利用。