Media Release, 2 May 2019

 

Decline in access to contraceptives with younger and poorer Asian women at risk

 

A global congress on fertility health in Hong Kong this week will hear of disturbing gaps in access to female contraception across the Asia Pacific region with the poor and young most vulnerable.

 

Assistant Professor Susan Logan, a Singapore-based specialist in sexual and reproductive health, said public access to contraception and broader reproductive health services increasingly had to compete for funding support against other human rights and health-related priorities including management of infectious diseases, such as HIV, and chronic conditions.

 

“Unmet contraceptive need has plateaued over the past two decades and funding for contraceptive provision has not increased in recent years,” she said.

 

“An initial increase in access to contraception has tailed off because of lack of prioritisation and the decline in funding support.

 

“With the global population projected to increase from around 6 billion people in 2000 to 9.8 billion by 2050, the implications of this access gap are very concerning. Over this period, the population in Asia is expected to increase by 41 per cent and across the wider Oceania region by 84 per cent.

 

“Around 85,000 women across the Asia Pacific region die each year from conditions related to pregnancy and childbirth, and up to 90 per cent of these deaths are preventable.

 

“National surveys have reported improvement in access to contraceptives among married women and those in long-term relationships, but the data among unmarried women and sexually active adolescent females is extremely limited.”

 

Assistant Professor Logan, Senior Consultant in the Division of Reproductive Endocrinology and Infertility at Singapore’s National University, will highlight concerning access gaps to contraception at the ASPIRE 2019 Congress at the Hong Kong Convention and Exhibition Centre.

 


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The Asia Pacific Initiative on Reproduction (ASPIRE) embraces 21 countries across the region with a mission to enhance competencies in assisted reproduction while improving access to and quality of fertility-related health services.

 

Assistant Professor Logan said the benefits of contraception were huge in terms of advancing public health, peace, prosperity and care of the environment.

 

However, she highlighted problems related to “Six As” – awareness, availability, accessibility, accommodation, acceptability and affordability – of contraception and other reproductive health services including safe abortion care, maternal and new born care, prevention and control of sexually transmitted infections and gender based violence and treatment for infertility.

 

At the ASPIRE Congress, Assistant Professor Logan will highlight data on access and use of traditional and modern contraceptive methods.

 

She said out of 1,000 women per year, the expected failure rate of the withdrawal method is 250; condom use 180 and the pill 90. In contrast, long-acting reversible methods have rates comparable to or better than female sterilization, with 8 and 0.5 failures expected with IUCD and implant use respectively.

 

Assistant Professor Logan will present case studies including a Myanmar woman aged 35 who had an unsuccessful abortion resulting in a disabled child.  She was subsequently prescribed the contraceptive pill, but received no advice on how and when to take the medication.

 

She will highlight the case of a Timor-Leste woman who became pregnant at 16 years of age, ultimately giving birth to six children with two miscarriages and one stillbirth, and who practices the withdrawal method with her husband, who is often drunk and violent.

 

Assistant Professor Logan said there were often with specific location-based barriers to accessing reproductive health information and services.

 

About 1,600 delegates including scientists, clinicians, embryologists, nurses and fertility counsellors will attend the ASPIRE 2019 Congress from today until Sunday.

 

For further information, go to the Congress website www.aspire2019.com

 

亚洲年轻贫困女性群体获取避孕药愈发困难

 

本周在香港举行的全球生殖医学大会上将听到亚太地区最弱势贫困年轻女性群体获取避孕药方面存在令人担忧的情况。

 

新加坡性健康和生殖健康专家Susan Logan助理教授表示，为公众提供的避孕药和其他生殖健康服务，不得不与其他人权及健康相关优先事物竞争经费支持，包括传染病，如艾滋病和慢性病的管理。

 

她说：“在过去二十年中，未满足的避孕药需求一直居高不下，但避孕措施的资金没有增加。”

 

“由于避孕优先次序缺乏和资金支持的减少，取用避孕药的初期增长现已减少。

 

“2050年，预计全球人口将从2000年的约60亿人增加到98亿人，因此获取障碍的现状非常令人担忧。在此期间，预计亚洲人口将增加41％，整个大洋洲将增加84％。

 

“亚太地区约有85,000名妇女每年死于与妊娠和分娩有关的疾病，其中高达90％的死亡是可以预防的。

 

“各国调查显示，已婚女性和存在长期关系的女性避孕的情况有所改善，但未婚女性和处在性活跃的青春期女性的相关数据不足。”

 

新加坡国立大学生殖内分泌和不孕症部高级顾问助理Logan教授将在香港会议展览中心召开的ASPIRE 2019大会上介绍令人担忧的避孕药获取障碍。

 

亚太地区生殖医学会议（ASPIRE）涵盖21个国家，召开会议的目的在于提高辅助生殖能力，同时改善生育相关卫生服务的获取途径和品质。

 

助理教授Logan表示，避孕的巨大好处体现在促进公共卫生，社会和平、繁荣和保护环境。

 

然而，她强调了避孕和其他生殖健康服务（包括流产的护理，孕产妇和新生儿护理，预防和控制性传播感染，性别暴力和不孕症的治疗）的“六个 A”相关问题，即认识性（awareness），可获得性（availability），可及性（accessibility），调和性（accommodation），可接受性（acceptability）和可负担性（affordability）。

 

在ASPIRE大会上，助理教授Logan将重点介绍传统和现代避孕方法相关的获取和使用数据。

 

她说，每年每1000名女性，采用体外射精预期失败率为250人；使用避孕套失败率为180人和使用避孕药失败率为90人。相比之下，长效可逆法与女性绝育法效果相当甚至更好，子宫内避孕器和植入式避孕预期失败率分别为8人和0.5人。

 

助理教授Logan也将进行个案研究的介绍，其中包括一名35岁的缅甸女性，该女性流产失败导致儿童出生残疾。随后她获得了处方避孕药，但没有得到关于如何以及何时服药的建议。

 

她也将重点介绍来自东帝汶，一位16岁时怀孕的女性的情况，该女性最终生产6次，其中2次流产，1次死产，她和丈夫经常采取体外射精的避孕方法，其丈夫经常醉酒和使用暴力。

 

助理教授Logan表示，在获取生殖健康信息和服务方面往往存在着特定的基于地点的障碍。

 

包括科学家，临床医生，胚胎学家，护士和生殖顾问在内的约1,600名代表将从今天至星期日参加2019年ASPIRE大会。