Improvements in health and mortality, known as the health transition, played important roles in the rise of modern contraceptive prevalence across countries. We describe key mechanisms and selected research evidence that show how health transitions helped shape contraceptive transitions around the world. Mechanisms include how decreases in child mortality rates affect the motivation to use contraception and how the organization and expansion of health care affect key barriers to contraceptive use. Substantial increases in child survival resulting from health transitions increase demand for deliberate fertility regulation and contraceptive use. Improved access to primary health care, particularly maternal and child health services and expansion into rural communities, was associated with increases in modern method use. Country‐specific policies that affected the organization and delivery of health care led to the dominance of particular modern methods in some countries. Empirical evidence is limited on how the quality of health care has affected aggregate level increases in modern method use. Using modern contraceptive prevalence to define the contraceptive transition reflects current data limitations but future research on the relationship of health transitions with macrolevel contraceptive prevalence trends may be able to incorporate more comprehensive aspects of how health transitions impact contraceptive choice and agency.

中文翻译：

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健康转变和现代避孕普及率的上升：需求、获取和选择


健康和死亡率的改善（称为健康转型）在各国现代避孕药具普及率的上升中发挥了重要作用。我们描述了关键机制和选定的研究证据，表明健康转型如何帮助塑造世界各地的避孕转型。机制包括儿童死亡率的下降如何影响使用避孕药具的动机，以及医疗保健的组织和扩展如何影响避孕药具使用的主要障碍。健康转型导致儿童存活率大幅提高，增加了对有意识的生育调节和避孕药具使用的需求。初级卫生保健的普及，特别是孕产妇和儿童保健服务以及向农村社区的扩展，与现代方法使用的增加有关。影响卫生保健的组织和提供的具体国家政策导致特定现代方法在一些国家占据主导地位。关于医疗保健质量如何影响现代方法使用中总体水平增加的经验证据有限。使用现代避孕普及率来定义避孕转变反映了当前数据的局限性，但未来对健康转变与宏观避孕普及趋势之间关系的研究可能能够纳入健康转变如何影响避孕选择和机构的更全面的方面。