Wealth-based inequalities in family planning and perinatal coverage among adolescent and young women: analyses of national surveys from Latin America and the Caribbean

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2026-01-01 Epub Date: 2025-12-04 DOI:10.1016/j.lana.2025.101318

Antonio Sanhueza , Sonja Caffe , Emmanuel Gonzalez-Bautista , Liliana Carvajal Velez , Oscar J. Mujica , Luis Paulo Vidaletti , Cesar G. Victora , Aluisio J.D. Barros

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引用次数: 0

Abstract

Background

This study aims to describe the coverage of key family planning (FP) and perinatal health indicators and to measure the associated social inequalities among adolescent and young women in the Latin American and Caribbean (LAC) region.

Methods

Nationally representative data from 20 LAC countries were analyzed using Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 2011 and 2016. Data were disaggregated by age group (15–19 and 20–24 years). Coverage was estimated for six key indicators, including FP, antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC). Socioeconomic inequalities in coverage were assessed using the Slope Index of Inequality (SII) and the Concentration Index (CIX).

Findings

Around 2015, median national coverage exceeded 90% for most ANC and PNC indicators, except for ANC with four or more visits and FP. Among adolescents, ANC coverage ranged from 44.6% in Uruguay (95% CI: 13.6–80.4) to 99.2% in Cuba (97.9–99.7); FP coverage was lowest in Guyana (16.7%, 11.7–23.3) and Haiti (28.7%, 22.7–35.6). Significant pro-rich inequalities were observed. The widest inequalities were observed, for ANC in Panama (SII = 46.5) and Haiti (SII = 48.8); for ANC quality in Guatemala (SII = 61.1); for SBA in Panama (SII = 90.0), and for FP inequalities in Guatemala (SII = 33.0).

Interpretation

Adolescents and young women in LAC face persistent and unequal coverage of FP and perinatal services. These baseline findings underscore the urgent need for youth-friendly, equity-focused interventions to meet SDG targets.

Funding

No direct funding was received.

查看原文本刊更多论文

青少年和年轻妇女计划生育和围产期覆盖率方面基于财富的不平等：拉丁美洲和加勒比国家调查分析

本研究旨在描述主要计划生育（FP）和围产期健康指标的覆盖率，并衡量拉丁美洲和加勒比（LAC）地区青少年和年轻妇女之间相关的社会不平等。方法利用2011年至2016年期间进行的人口与健康调查（DHS）和多指标类集调查（MICS）分析了来自20个拉丁美洲和加勒比地区国家的具有全国代表性的数据。数据按年龄组分类（15-19岁和20-24岁）。估计了六个关键指标的覆盖率，包括计划生育、产前护理（ANC）、熟练助产（SBA）和产后护理（PNC）。利用不平等斜率指数（SII）和浓度指数（CIX）评估覆盖范围的社会经济不平等。研究结果：2015年前后，除了四次或以上访问的非国大和计划生育外，大多数非国大和计划生育指标的全国覆盖率中位数超过90%。在青少年中，ANC覆盖率从乌拉圭的44.6%（95%置信区间：13.6-80.4）到古巴的99.2%（97.9-99.7）不等；计划生育覆盖率最低的是圭亚那（16.7%,11.7-23.3）和海地（28.7%,22.7-35.6）。观察到显著的亲富不平等。最不平等的是巴拿马（SII = 46.5）和海地（SII = 48.8）；危地马拉ANC质量（SII = 61.1）；巴拿马的SBA （SII = 90.0）和危地马拉的计划生育不平等（SII = 33.0）。拉丁美洲和加勒比地区的青少年和年轻妇女在计划生育和围产期服务方面长期面临不平等的覆盖。这些基线调查结果强调，迫切需要对青年友好、注重公平的干预措施，以实现可持续发展目标的具体目标。没有收到直接资金。

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.