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    Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015–2019
    (BMJ Global Health, 2022-03-24) Bearak, Jonathan Marc; Popinchalk, Anna; Beavin, Cynthia; Ganatra, Bela; Moller, Ann-Beth; Tunçalp, Özge; Alkema, Leontine
    Introduction: Internationally comparable estimates of unintended pregnancy and abortion incidence can illuminate disparities in sexual and reproductive health and autonomy. Country-specific estimates are essential to enable international comparison, and to inform country-level policy and programming. Methods: We developed a Bayesian model which jointly estimated unintended pregnancy and abortion rates using information on contraceptive needs and use, contraceptive method mix, birth rates, the proportions of births from unintended pregnancies and abortion incidence data. Main outcomes were the estimated rates of unintended pregnancy and abortion for 150 countries and territories, reported for the 5-year period 2015–2019, as annual averages per 1000 women aged 15–49 years. Results: Estimated unintended pregnancy rates ranged from 11 (80% uncertainty interval: 9 to 13) in Montenegro to 145 (131 to 159) in Uganda per 1000 women aged 15–49 years. Between-country heterogeneity was substantial in all Sustainable Development Goal (SDG) regions, but was greatest in sub-Saharan Africa. Estimated abortion rates ranged from 5 (5 to 6) in Singapore to 80 (55 to 113) in Georgia. Variation between country estimates was similar in all SDG regions except for Europe and Northern America, where estimated abortion rates were generally lower. Conclusion: The estimates reflect variation in the degree to unintended pregnancy and abortion that are experienced in countries throughout the world. This evidence highlights the importance of investing in access to contraception and comprehensive abortion care, including in regions which may have lower rates of unintended pregnancy or abortion, respectively, as countries may differ substantially from regional averages.
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    The state of global abortion data: an overview and call to action
    (BMJ Sexual & Reproductive Health, 2021-07) Popinchalk, Anna; Beavin, Cynthia; Bearak, Jonathan
    Abortion, an experience shared by tens of millions of people around the world, is an important component of sexual and reproductive health (SRH) care. Data on abortion incidence is needed to examine disparities in people’s ability to safely terminate a pregnancy. Abortion, however, is legally restricted in much of the world and often stigmatised regardless of legal status, making it challenging to measure and document. This contributes to disparities in understanding the SRH needs of people in different contexts around the world. Due to the difficulty in measuring abortion, we developed model-based estimates following a clear and transparent protocol.1 These estimates utilised all global data on the number of abortions by country by year.2 While these are the most comprehensive estimates currently available, our data collection and research underscored that empirical data on abortion incidence are scarce and of variable quality. To address these gaps, there is an urgent need for investing in robust abortion data collection systems and research.