Malawi has high unmet need for contraception with a costed national plan to increase contraception use. Estimating how such investments might impact future population size in Malawi can help policymakers understand effects and value of policies to increase contraception uptake. We developed a new model of contraception and pregnancy using individual-level data capturing complexities of contraception initiation, switching, discontinuation, and failure by contraception method, accounting for differences by individual characteristics. We modeled contraception scale-up via a population campaign to increase initiation of contraception (Pop) and a postpartum family planning intervention (PPFP). We calibrated the model without new interventions to the UN World Population Prospects 2019 medium variant projection of births for Malawi. Without interventions Malawi's population passes 60 million in 2084; with Pop and PPFP interventions. it peaks below 35 million by 2100. We compare contraception coverage and costs, by method, with and without interventions, from 2023 to 2050. We estimate investments in contraception scale-up correspond to only 0.9 percent of total health expenditure per capita though could result in dramatic reductions of current pressures of very rapid population growth on health services, schools, land, and society, helping Malawi achieve national and global health and development goals.

中文翻译：

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马拉维的避孕和怀孕建模：Thanzi La Onse 数学建模研究


马拉维的避孕需求未得到满足，该国制定了一项成本高昂的国家计划，旨在增加避孕措施的使用。估计此类投资如何影响马拉维未来的人口规模可以帮助政策制定者了解提高避孕普及率的政策的效果和价值。我们使用个体层面的数据开发了一种新的避孕和怀孕模型，该模型捕获了避孕方法避孕开始、转换、中断和失败的复杂性，并考虑了个体特征的差异。我们通过人口运动对避孕规模扩大进行建模，以增加避孕开始率 （pop） 和产后计划生育干预 （PPFP）。我们在没有新干预的情况下根据联合国世界人口展望 2019 马拉维出生人数的中等变体预测校准了该模型。如果不进行干预，马拉维的人口将在 2084 年超过 6000 万;与 Pop 和 PPFP 干预。到 2100 年，它达到 3500 万以下的峰值。我们比较了 2023 年至 2050 年按方法、有和无干预措施的避孕覆盖率和成本。我们估计，扩大避孕投资仅相当于人均卫生总支出的 0.9%，但可以大大减少当前人口快速增长对卫生服务、学校、土地和社会的压力，帮助马拉维实现国家和全球卫生和发展目标。