ABSTRACT
The production, compilation, and publication of death registration records is complex and usually involves many institutions. Assessing available data and the evolution of the completeness of the data compiled based on demographic techniques and other available data sources is of great importance for countries and for having timely and disaggregated mortality estimates. In this paper, we assess whether it is reasonable, based on the available data, to assume that there is a sex difference in the completeness of male and female death records in Peru in the last 30 years. In addition, we assess how the gap may have evolved with time by applying two-census death distribution methods on health-related registries and analyzing the information from the Demographic and Health Surveys and civil registries. Our findings suggest that there is no significant sex difference in the completeness of male and female health-related registries and, consequently, the sex gap currently observed in adult mortality estimates might be overestimated.
ABSTRACT
Expanding access to contraception and ensuring that need for family planning is satisfied are essential for achieving universal access to reproductive healthcare services, as called for in the 2030 Agenda for Sustainable Development. To quantify the gaps that remain in meeting needs among adolescents, this study provides a harmonised data set and global estimates and projections of family planning indicators for adolescents aged 15-19 years. We compiled a comprehensive dataset of family-planning indicators among women aged 15-19 from 754 nationally representative surveys. We used a Bayesian hierarchical model with country-specific annual trends to estimate contraceptive prevalence and unmet need for family planning, with 95% uncertainty intervals (UIs), for 185 countries, taking into account changes in proportions married or in a union and differences in sexual activity among unmarried women across countries. Among 300 million women aged 15-19 years in 2019, 29.8 million (95% UI 24.6-41.7) use any contraception, and 15.0 million (95% UI 12.1-29.2) have unmet need for family planning. Population growth and the postponement of marriage influence trends in the absolute number of adolescents using contraception or experiencing unmet need. Large gaps remain in meeting family-planning needs among adolescents. The proportion of the need satisfied by modern methods, Sustainable Development Goals (SDG) indicator 3.7.1, was 59.2% (95% UI 44.8-67.2) globally among adolescents, lower compared to 75.7% (95% UI 73.2%-78.0%) among all women age 15-49 years. It was less than one half of adolescents in need in Western Asia and Northern Africa (38.7%, 95%UI = 20.9-56.5), Central and Southern Asia (43.5%, 95%UI = 36.6-52.3), and sub-Saharan Africa (45.6%, 95%UI = 42.2-49.0). The main limitations of the study are: (i) the uncertainty surrounding estimates for countries with limited or biased data is large; and (ii) underreporting of contraceptive use and needs is likely, especially among unmarried adolescents.
Subject(s)
Contraception Behavior , Contraception , Family Planning Services , Health Services Accessibility , Adolescent , Adult , Bayes Theorem , Female , Humans , Young AdultABSTRACT
An increasing number of developing countries are experiencing below replacement fertility rates. Although the factors associated with low fertility in developed countries have been widely explored in the literature, studies of low fertility in middle- and low-income countries continue to be rare. To help fill this gap, Brazil was used as a case study to assess whether human development, gender equality and the ability of mothers with young children to work are associated with the likelihood of married or cohabiting women to have a child. For this purpose, multilevel logistic regressions were estimated using the 1991, 2000 and 2010 Brazilian Demographic Censuses. It was found that human development was negatively associated with fertility in the three periods analysed. Gender equality and the ability of mothers with young children to work were positively associated with the odds of having higher order births in Brazil in 2000 and 2010. In 1991, these variables were not associated with higher order births, and gender equality was negatively associated with first births. The positive association found in 2000 and 2010 may constitute a reversal of the relationship that in all likelihood prevailed earlier in the demographic transition when gender equality was most likely negatively correlated with fertility levels.
Subject(s)
Developing Countries/statistics & numerical data , Fertility , Brazil , Child , Family Characteristics , Female , Humans , Population Dynamics , Statistics as Topic , Women's Rights/statistics & numerical data , Women, Working/statistics & numerical data , Young AdultABSTRACT
In this paper, we estimate the fiscal impact on population aging in Brazil from 2005 through 2050. We focus on three key areas of public spending: education, pensions, and health care. Our projections are based on a simple model in which aggregate public expenditures are driven by changes in the age structure of the population as well as by changes in the average public benefits received per age. We assess the likely increases in public spending over the coming decades, contrasting the divergent trends in public spending on education, pensions, and health care. We also assess the magnitude of these changes in terms of growth in spending relative to GDP annually through 2050 and estimate the present value of the increase in spending. We find that changing population age structure will lead to increasing cost pressures in health care and especially in pensions. Our projections show that beginning around 2015, public spending will begin a sustained and rapid increase lasting several decades rising from 18% of GDP to reach 27% of GDP by 2050. The needs for increased investment in students will compete against those for sustaining pension benefits and facing increasing demands for health care. In particular, our projections show that an ambitious educational reform aimed at reaching the OECD level of investment per youth within a decade would amount to only about one fourth of the projected cost increases in public health and pension programs.
Neste artigo estimamos a influência do envelhecimento populacional nas despesas em educação, previdência social e saúde no Brasil no período de 2005 a 2050. Os gastos fiscais foram estimados baseados em um modelo simples em que o gasto público agregado é determinado por mudanças na estrutura etária da população e no benefício médio recebido em diferentes idades. Estimamos o provável aumento no gasto público nas próximas décadas, contrastando diferentes tendências no gasto em educação, saúde e previdência social. O valor do crescimento no gasto fiscal é medido em relação ao Produto Interno Bruto (PIB) anual e o valor presente desse aumento em relação ao PIB atual. As projeções mostram que, a partir de 2015, depois de uma pausa, devido às reformas das pensões recentemente promulgadas, a despesa pública iniciará um aumento rápido e sustentado com duração de várias décadas. As necessidades crescentes de investimentos em educação irão competir com o crescente e sustentável aumento de demanda na saúde pública e na previdência social originado do considerável crescimento da proporção de idosos na população brasileira. Em particular, nossas projeções mostram que uma reforma educacional ambiciosa, com o objetivo de alcançar o nível de investimento por jovens em uma década de acordo com a OCDE, equivaleria a apenas cerca de um quarto dos aumentos de custos previstos em programas de saúde pública e de pensões.
En el presente artículo se estima el impacto fiscal sobre el envejecimiento de la población en Brasil entre 2005-2050. Enfocase las tres áreas fundamentales del gasto público: educación, previsión social y salud. Las proyecciones se basan en un modelo simple en el que los gastos públicos agregados son afectados por cambios en la estructura de edad de la población, así como por los cambios en los beneficios públicos promedio recibidos en función de la edad. Evaluase los probables aumentos en el gasto público en las próximas décadas comparando tendencias divergentes en los gastos públicos en las áreas de educación, previsión social y salud. Evaluase la magnitud de estos cambios en lo que se refiere al aumento de los gastos relativos al PIB anual durante los próximos 40 años y estimase el valor presente de este creciente gasto en comparación con el PIB corriente. Verificase que la cambiante estructura de edad de la población ocasionará una presión de aumento en el área de la salud y sobre todo en la seguridad social. Las proyecciones demuestran que alrededor del año de 2015, después de la tregua ocasionada por las reformas recientes en el ámbito de la previsión social, el gasto público iniciará un sostenido y rápido crecimiento durante varias décadas. La necesidad de aumentar las inversiones en el área de la educación competirá con la necesidad de aumentar los beneficios de la previsión social y con crecientes demandas en el sector de la salud, especialmente entre las personas mayores. En particular, nuestras proyecciones indican que una ambiciosa reforma educativa dirigida a alcanzar el nivel de la OCDE de la inversión por la juventud dentro de una década sería de sólo alrededor de una cuarta parte de los aumentos de los costos previstos en los programas de salud pública y de pensiones.
