In 2022, there were around *** abortions carried out per 1,000 live births in Georgia, which was the highest rate of abortions in Europe in that year. Sweden and Bulgaria had *** and *** abortions per 1,000 live births, respectively. In Poland, where until very recently abortion was banned apart for some exceptional circumstances, only *** abortions per 1,000 births were conducted in 2022. Births in Europe Bulgaria had the youngest mean age of woman at childbirth in the EU in 2022 at 27.8 years. Romania and Moldova both had mean age for childbirths at just over 28 years of age. On the other hand, the average age at childbirth in Ireland, Spain, and Luxembourg was over 32 years of age. In every EU country, the fertility rate for a woman is under *** children, with some of the lowest rates found in Italy and Spain at ***. Contraception use In 2022, Norway had the highest share of women aged 15 to 49 years using any sort of contraception in Europe, with ** percent using. Czechia and Finland both had high levels of contraception use among women at **** and ** percent respectively. Just over a quarter of women use any form of contraception in Montenegro, the lowest share in Europe.

In 2022, there were around 613 thousand legal abortions in the United States. The number of legal abortions in the United States has decreased significantly since the early 1990’s. This number will probably continue to decrease in the coming years since many states have severely limited or completely banned abortion after the overturning of Roe v. Wade by the Supreme Court in 2022. The states with the highest abortion rates In 2022, the rate of legal abortions per live births in the United States was 19.9 per 100. In comparison, in 1990 there were 34.4 abortions per 100 live births. The states with the highest rates of abortion per live births are New Mexico, Illinois, and Florida. In Florida, there were around 37 abortions per 100 live births in 2022. Florida had the highest total number of abortions that year, followed by New York and Illinois. Missouri and South Dakota had the lowest number of abortions in 2022. Out-of-state abortions Critics of the Supreme Court decision to overturn Roe v. Wade argue that while those who can afford it may be able to travel to other states for an abortion if their state bans the procedure, poorer residents will have no such choice. Even before the overturning of Roe v. Wade, out-of-state residents already accounted for a high share of abortions in certain states. In 2022, 69 percent of abortions in Kansas were performed on out-of-state residents, while out-of-state residents accounted for around 62 percent of abortions in New Mexico. Illinois had the highest total number of abortions performed on out-of-state residents that year, with around 16,849 procedures.

In 2021, policies surrounding abortion varied greatly from one European country to another. According to this ranking, based on the legal status of abortion, access, clinical care, delivery, and availability of relevant information, Sweden and Iceland had the most permissive and effective policies in Europe. On the other hand, Andorra and Malta held the last position in the ranking. In Andorra, a small state bordering France and Spain, abortion is illegal.

BackgroundIn 2010–2014, approximately 86% of abortions took place in low- and middle-income countries (LMICs). Although abortion incidence varies minimally across geographical regions, it varies widely by subregion and within countries by subgroups of women. Differential abortion levels stem from variation in the level of unintended pregnancies and in the likelihood that women with unintended pregnancies obtain abortions.ObjectivesTo examine the characteristics of women obtaining induced abortions in LMICs.MethodsWe use data from official statistics, population-based surveys, and abortion patient surveys to examine variation in the percentage distribution of abortions and abortion rates by age at abortion, marital status, parity, wealth, education, and residence. We analyze data from five countries in Africa, 13 in Asia, eight in Europe, and two in Latin America and the Caribbean (LAC).ResultsWomen across all sociodemographic subgroups obtain abortions. In most countries, women aged 20–29 obtained the highest proportion of abortions, and while adolescents obtained a substantial fraction of abortions, they do not make up a disproportionate share. Region-specific patterns were observed in the distribution of abortions by parity. In many countries, a higher fraction of abortions occurred among women of high socioeconomic status, as measured by wealth status, educational attainment, and urban residence. Due to limited data on marital status, it is unknown whether married or unmarried women make up a larger share of abortions.ConclusionsThese findings help to identify subgroups of women with disproportionate levels of abortion, and can inform policies and programs to reduce the incidence of unintended pregnancies; and in LMICs that have restrictive abortion laws, these findings can also inform policies to minimize the consequences of unsafe abortion and motivate liberalization of abortion laws. Program planners, policymakers, and advocates can use this information to improve access to safe abortion services, postabortion care, and contraceptive services.

Among respondents surveyed in 29 countries, Sweden and France had the largest population in favor of abortion. The Netherlands followed with 76 percent of respondents in favor. On the contrary, India, Malaysia and Indonesia had the lowest percentages of people in favor of abortion.

Abortion remains a controversial topic in the United States and has been an exceptionally political topic since the Supreme Court overturned Roe v. Wade in 2022. This ruling has allowed individual states to completely ban the procedure if they choose, which a number of states have since done. In 2022, the year of the overturning of Roe v. Wade, the highest rates of legal abortion in the United States were among women aged 25 to 29 years, with around **** abortions per 1,000 women. How many abortions are there in the United States each year? In 2022, there were an estimated ******* legal abortions in the United States. This was a decrease from the year before, and in general, the number of legal abortions per year in the U.S. has decreased since the late 1990s. The rate of abortion has also decreased significantly. In 1997, the rate of legal abortions per 100 live births was ****, but this had dropped to **** per 100 live births by the year 2022. At that time, the states with the highest rates of abortion were New Mexico, Illinois, and Kansas. Public opinion on abortion As of 20234, around ** percent of U.S. adults considered themselves pro-choice, while ** percent were pro-life. However, these numbers have fluctuated over the years, with a larger share of people identifying as pro-life just five years earlier. Nevertheless, a poll from 2024 indicated that only a small minority of U.S. adults want abortion to be illegal in all cases, with younger people more likely to support the legalization of abortion in any circumstance. Furthermore, surveys have shown that since the overturning of Roe v. Wade, U.S. adults have expressed being much more dissatisfied with abortion policy in the country, desiring less strict policy.

IntroductionDespite the Sustainable Development Goal to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, abortion remains one of the top five causes of maternal mortality in low and middle-income countries. However, there is a lack of comprehensive data on the pooled prevalence and determinants of abortion in sub-Saharan Africa (SSA). Therefore, this study aims to investigate the pooled prevalence and determinants of abortion among women of reproductive age in 24 SSA countries using the most recent Demographic and Health Surveys.MethodsThe most recent Demographic and Health Survey (DHS) data from 24 Sub-Saharan African (SSA) countries were analyzed, using a weighted sample of 392,332 women of reproductive age. To address the clustering effects inherent in DHS data and the binary nature of the outcome variable, a multilevel binary logistic regression model was employed. The results were reported as adjusted odds ratios with 95% confidence intervals to indicate statistical significance. Additionally, the model with the lowest deviance was identified as the best fit for the data.ResultsThe pooled prevalence of abortion in SSA were 6.93% (95%CI: 5.38, 8.48). Older age (AOR = 3.71; 95%CI: 3.46, 3.98), ever married (AOR = 3.87; 95%CI: 3.66, 4.10), being educated (AOR = 1.35; 95%CI: 1.28, 1.44), having formal employment (AOR = 1.19; 95%CI: 1.16, 1.23), traditional contraceptive use (AOR = 1.27; 95%CI: 1.19, 1.36) and media exposure (AOR = 1.37; 95%CI: 1.32, 1.41) found to be a predisposing factors for abortion. While high parity (AOR = 0.72; 95%CI: 0.68, 0.76), rural residence (AOR = 0.87; 95%CI: 0.85, 0.91), and rich (AOR = 0.96; 95%CI: 0.93, 0.99) wealth index were a protective factors.ConclusionThe study found that the pooled prevalence of abortion in Sub-Saharan Africa is 7%. Potential interventions include comprehensive sexual education to inform and empower women, increased access to modern contraceptives to reduce unintended pregnancies, improved healthcare services especially in rural areas, economic empowerment through education and employment opportunities, media campaigns to disseminate information and reduce stigma, and policy development to ensure safe and legal access to abortion services. These interventions aim to improve reproductive health outcomes and reduce unsafe abortions in SSA.

Abstract

The 1993 Romanian Reproductive Health Survey (RRHS-93) is a household-based survey designed to collect information from a representative sample of women of reproductive age throughout Romania. This nationwide probability survey of reproductive health is the first to be carried out in Romania since 1978.

During the previous regime, contraceptives and sex education were generally unavailable and importation and sale of contraceptives was forbidden; traditional contraceptive methods, with their high failure rates, were almost the only means to avoid unintended pregnancies.

In the absence of modern contraception, illegal abortions, most of them self-induced or induced by lay persons, were widely used to avert unwanted births. Although the extent of the prevalence of illegal abortions was impossible to assess, the dramatic effect on women's health was obvious to government officials but concealed from the public for many years. The true scope of the impact this policy had on reproductive health came to worldwide attention only after the December 1989 revolution and the change of government. During the last decade (1979-1989), Romania had the highest maternal mortality rate in Europe, a rate ten times higher than that of any other European country, and most of these maternal deaths were abortion-related (Stephenson et al., 1992). The magnitude of abortion complications is difficult to quantify but unofficial estimates suggest that nearly 20% of the 4.9 million women of reproductive age are thought to have impaired fertility (UNFPA 1990). The high number of unwanted pregnancies resulting in children abandoned in overcrowded orphanages by families who had been too frightened to attempt an illegal abortion, but who were too poor to afford to raise their child, was another shocking disclosure.

After revoking the restrictive law on abortion and contraception at the end of December 1989, the availability of safe abortion resulted in a drastic decline in me maternal mortality rate and improved women's health and their reproductive rights. However, the health planners who strived to design a family planning program were confronted with a difficult mission: to formulate and implement strategies aimed at improving family planning practices in a climate of economic and political changes and resistance to modern contraception by both the public and the health care providers. Also, insufficient infrastructure, absence of family planning logistics and managerial skills, and the shortage or uneven distribution of the contraceptive supplies were other critical factors that have diminished the impact of the newly founded program.

The survey was specifically designed to meet the following objectives: -to assess the current situation in Romania concerning abortion, contraception and various other reproductive health issues; -to enable policy makers, program managers and researchers to evaluate and improve existing programs and to develop new strategies; -to measure changes in fertility and contraceptive prevalence rates and study factors which affect these changes, such as geographic and socio-demographic factors, breastfeeding patterns, use of induced abortion, and availability of family planning; -to identify and focus further reproductive health studies toward high risk groups.

Geographic coverage

The 1993 RRHS was designed to collect information from a representative sample of women of reproductive age throughout Romania.

Analysis unit

Women of reproductive age

Universe

The universe from which the respondents were selected included all females between the ages of 15 and 44, regardless of marital status, who were living in Romania when the survey was carried out.

Kind of data

Sample survey data [ssd]

Sampling procedure

The 1993 RRHS was designed to collect information from a representative sample of women of reproductive age throughout Romania. The universe from which the respondents were selected included all females between the ages of 15 and 44, regardless of marital status, who were living in Romania when the survey was carried out.

The survey employed a stratified sample with independent estimates for Bucharest, the capital city, and the 40 judets outside of Bucharest, or the Interior. Bucharest, together with its surroundings, the Agricultural Sector of Ilfov, is the equivalent of a judet. The 1992 census was used as the sampling frame (Comisia Nationala pentru Statistica, 1992). Since there were roughly equal numbers of urban and rural households in the Interior, the Interior sample was designed to be self-weighting. With a projected area probability sample of 5,000 women, 1,000 in Bucharest and 4,000 in the Interior, regional estimates are also possible for the Interior. Based on census data (percentage of households with at least one women 15-44 and unoccupied households) and a projected response rate of 90%, a total of 12,387 households were sampled to obtain complete interviews for approximately 5,000 women. Bucharest was oversampled and represents 22 percent of the sample, although it includes 11 percent of the total population.

The first stage of the three-stage sample design was a selection of "Census Sectors" with probability proportional to the number of households recorded in the 1992 Census. This was accomplished using a systematic sample with a random start in both strata or domains. In the second stage of sampling, clusters of households were randomly selected in each Census Sector chosen in the first stage. Cluster size determination was based on the number of households required to obtain 15 interviews per cluster, on average, in Bucharest, and 20 in the Interior. To obtain an average of 15/20 interviews, cluster sizes varied from 39 to 50 households due to different proportions of unoccupied household and variations in the proportion of households containing females 15-44 years of age by geographic area. Finally, one woman between the ages of 15 and 44 was selected at random for interviewing in each of the households.

Since only one woman was selected from each household containing women of reproductive age, all results have been weighted to compensate for the fact that some households included more than one eligible woman. Survey results are also weighted to adjust for the oversampling of households in Bucharest.

Mode of data collection

Face-to-face [f2f]

Research instrument

The questionnaire was first drafted by CDC/DRH consultants based on a core questionnaire used in the 1993 Czech Republic RHS. This core questionnaire was modified, including adding modules targeted to explore important issues for Romania, such as induced abortion and maternal mortality. The survey instrument was then reviewed by Romanian experts in reproductive health and family planning, as well as by AID and AID cooperating agencies who have worked in Eastern Europe. Based on these reviews, a pretest questionnaire was developed and field tested in April 1993.

The RRHS questionnaire covered a wide range of topics related to reproductive health in Romania. The specific areas included were: - Social, economic and demographic characteristics - Pregnancy history - Knowledge and use of contraceptive methods - Sexuality and contraception among young adults - Use of maternal and child health services - Morbidity during pregnancy - Women's health issues - Knowledge and attitudes about contraception - Knowledge about HIV/AIDS

The questionnaire had two components: (1) A short household module that was used to collect residential and geographic information, as well as selected characteristics about all women of childbearing age living in sampled households, and information on interview status. This module was also used to select a respondent randomly when there was more than one eligible woman in the household. (2) The longer individual questionnaire collected information on reproductive health topics discussed below. For Hungarian language speakers, the interview was conducted in their native language.

The major subjects on which information was collected are: pregnancies and childbearing (a history of all pregnancies and births, including use of abortion and planning status of pregnancies); family planning (knowledge and history of use of methods of preventing pregnancy, reasons for use of less effective methods of contraception, pregnancy intentions, and fecundity); maternal and child health (health information about the most recent pregnancy and birth and the use of services); young adult reproductive health (information on sexual relations and pregnancy among females 15-24 years old); women's health (health behavior and use of women's health services); reproductive health knowledge and attitudes (especially regarding birth control pills and IUDs); knowledge about HIV/AIDS transmission and prevention; and socioeconomic characteristics of women and their husbands/families. The sisterhood module to estimate maternal mortality was also part of the questionnaire.

Response rate

Of the 12,387 households selected, 5,283 included at least one 15- to 44 year-old woman. Of this number, 4,861 were successfully interviewed, for a response rate of 92.0%. Only 1.1% the of selected women refused to be interviewed, while another 6.1% could not be located. Response rates were slightly better in Bucharest and other urban areas (93%) than in rural areas (89%).

Data appraisal

The age distribution of the RRHS sample closely reflected that of the female population as a whole (Comisia Nationala pentru Statistica, 1993A). The sample population is essentially within two percentage points of the census

Abortions in the Soviet Union became much more accessible under the Khrushchev administration in 1953, and the USSR's abortion rate subsequently developed into the highest in the world. The Soviet government did not begin releasing official statistical data until the 1970s, however it is believed that around six or seven million abortions were carried out each year in the 1950s and 1960s; a figure that remained fairly consistent until the late 1980s**. This high rate was, in-part, due to rapid urbanization and a desire for smaller families, as well as the lack of quality contraceptives produced by the Soviet government, and the widespread belief that abortion was safer than the side-effects of hormonal regulation via the pill. Relative to population size, there were between 97 and 106 abortions carried out per 1,000 women aged between 15 and 49 in the given years, which is roughly equal to one in ten women of childbearing age having an abortion each year (estimates for Russia alone suggest that this number was one in six in the 1960s). There were however regional disparities across the Soviet Union, as abortions were much more accessible and common in the European part of the country, and less available or socially acceptable in the Muslim-majority and rural regions of Asia. Abortion in the U.S. In the U.S. during this time, the abortion rate was much lower due to previous legal restrictions and lack of access, societal attitudes, and better access to contraceptives. Prior to 1973, abortions were either banned outright or only available under specific circumstances in all-but-four states. The Supreme Court case Roe v. Wade then saw the removal of most federal restrictions relating to abortion in the first trimester of pregnancy. This granted women across the country greater access to legal abortions; in 1975 there were over one million legal abortions performed in the U.S., and between 1.5 and 1.6 million in the 1980s. Proportional to population size, this equated to 29 abortions per 1,000 women aged between 15 and 45 in 1980, which is roughly equal to one in 34 women of childbearing age having an abortion in this year. Legacy During the decline and dissolution of the Soviet Union, the government began to promote the use of contraceptives, however the poor quality and supply of these reinforced former perceptions that they were more harmful than abortions. Additionally, medical institutions received much higher sums from the government when abortions were performed (relative to income from contraceptives), and these incentives delayed the drop in Russian and other post-Soviet states' abortion rates. While it is now generally accepted that contraception is safer than abortion, and awareness of the risks of infertility and maternal death has become more widespread, today, Soviet successor states have some of the highest abortion rates in the world by a considerable margin.

In the U.S., following the peak of almost 30 abortions per 1,000 women aged 15 to 44 in the 1980s, the abortion rate has gradually fallen with each decade, even dropping below the 1973 level in 2017. Although this is a side effect of improvements in contraception and education, a large part of this decline can be attributed to restricted access to abortion, particularly in rural and southern regions. While the majority of U.S. adults support Roe v. Wade, the Supreme Court overturned the ruling in June 2022, granting states the right to determine their own abortion laws.

Hungary Vital Statistics: Induced Abortions: per 100 Live Born data was reported at 24.350 NA in Sep 2018. This records a decrease from the previous number of 26.222 NA for Aug 2018. Hungary Vital Statistics: Induced Abortions: per 100 Live Born data is updated monthly, averaging 43.129 NA from Jan 2002 (Median) to Sep 2018, with 201 observations. The data reached an all-time high of 67.400 NA in Feb 2002 and a record low of 24.350 NA in Sep 2018. Hungary Vital Statistics: Induced Abortions: per 100 Live Born data remains active status in CEIC and is reported by Hungarian Central Statistical Office. The data is categorized under Global Database’s Hungary – Table HU.G003: Vital Statistics.

BackgroundZimbabwe has the highest contraceptive prevalence rate in sub-Saharan Africa, but also one of the highest maternal mortality ratios in the world. Little is known, however, about the incidence of abortion and post-abortion care (PAC) in Zimbabwe. Access to legal abortion is rare, and limited to circumstances of rape, incest, fetal impairment, or to save the woman’s life.ObjectivesThis paper estimates a) the national provision of PAC, b) the first-ever national incidence of induced abortion in Zimbabwe, and c) the proportion of pregnancies that are unintended.MethodsWe use the Abortion Incidence Complications Method (AICM), which indirectly estimates the incidence of induced abortion by obtaining a national estimate of PAC cases, and then estimates what proportion of all induced abortions in the country would result in women receiving PAC. Three national surveys were conducted in 2016: a census of health facilities with PAC capacity (n = 227), a prospective survey of women seeking abortion-related care in a nationally-representative sample of those facilities (n = 127 facilities), and a purposive sample of experts knowledgeable about abortion in Zimbabwe (n = 118). The estimate of induced abortion, along with census and Demographic Health Survey data was used to estimate unintended pregnancy.ResultsThere were an estimated 25,245 PAC patients treated in Zimbabwe in 2016, but there were critical gaps in their care, including stock-outs of essential PAC medicines at half of facilities. Approximately 66,847 induced abortions (uncertainty interval (UI): 54,000–86,171) occurred in Zimbabwe in 2016, which translates to a national rate of 17.8 (UI: 14.4–22.9) abortions per 1,000 women 15–49. Overall, 40% of pregnancies were unintended in 2016, and one-quarter of all unintended pregnancies ended in abortion.ConclusionZimbabwe has one of the lowest abortion rates in sub-Saharan Africa, likely due to high rates of contraceptive use. There are gaps in the health care system affecting the provision of quality PAC, potentially due to the prolonged economic crisis. These findings can inform and improve policies and programs addressing unsafe abortion and PAC in Zimbabwe.

In 2022, there were roughly **** abortions per 1,000 women in France. The abortion rate in France remained pretty stable since the nineties, while the estimated abortion rate in Europe decreased significantly. Abortion in France France legalized abortion in 1975. If at that time the fight for legalization was intense, it appears that now the support for abortion right in France is widespread. In 2017, more than 80 percent of French people declared that abortion should be legal in all or most cases. France has a low rate of teenage pregnancy, but the abortion rate is not the same throughout the country. Overseas regions of France such as Guadeloupe or Mayotte have a higher abortion rate number of young women aged from 15 to 17 years, while in the rest of the country the majority of abortions concerned women aged between 20 and 29 years. The evolution of contraception in France Like in other European countries, French women seem to be more and more concerned about the consequences that may be related to their contraception method. In 2017, ** percent of women in France stated that they were rather worried about the cardiovascular risks of hormonal contraception like the pill. Consequently, the share of French women using contraceptive oral pills is decreasing and other methods like IUD or implant are becoming more common.

In 2017, the number of abortions for girls aged 11 to 14 years old in New Zealand amounted to **. While there has been a drop in the rate of teenage pregnancy in the country since 2012, the rate is still relatively high when compared to other OECD countries.

A survey of women who obtained an abortion in the United States between June 2021 and July 2022 found that ** percent were Hispanic, while ** percent were white. This statistic shows the distribution of women in the U.S. who obtained an abortion from June 2021 to July 2022, by race/ethnicity.

Hungary Vital Statistics: Induced Abortions data was reported at 1,929.000 Person in Sep 2018. This records a decrease from the previous number of 2,092.000 Person for Aug 2018. Hungary Vital Statistics: Induced Abortions data is updated monthly, averaging 3,367.000 Person from Jan 2002 (Median) to Sep 2018, with 201 observations. The data reached an all-time high of 5,510.000 Person in Jan 2002 and a record low of 1,929.000 Person in Sep 2018. Hungary Vital Statistics: Induced Abortions data remains active status in CEIC and is reported by Hungarian Central Statistical Office. The data is categorized under Global Database’s Hungary – Table HU.G003: Vital Statistics.

IntroductionDemographic and Health Surveys, widely used for estimation of fertility and reproductive health indicators in developing countries, remain underutilized for the study of pregnancy termination. This is partly due to most surveys not reporting the type of pregnancy termination, whether spontaneous or induced. Reproductive calendar data makes it possible to examine termination patterns according to contraceptive use at the time of pregnancy. Contraceptive failure is expected to increase the likelihood of induced abortion helping in the interpretation of reported termination patterns.Materials and methodsWe use individual-level calendar data regarding 623,966 pregnancies to analyze levels and differentials in reported patterns of pregnancy termination by age, union status, and contraceptive use in 107 DHS surveys from 50 countries. From the estimates of the probability of pregnancy termination, we compute derived reproductive health indicators providing an assessment of what is driving the differences by comparison to the few surveys reporting the type of pregnancy termination.ResultsFrom our estimates, 10.9% of pregnancies do not end in live-birth and 63.7% of them are spontaneous terminations. Reported pregnancy termination is higher among women using contraceptives, consistent with expectations. Very low levels of reported PT in some countries, particularly in sub-Saharan Africa, suggests possible underreporting. Differential patterns emerging from cluster analysis and regional rates indicate high rates of pregnancy termination driven by induced abortion in countries from the Former Soviet Union and Asian countries with liberal laws. Most countries with restrictive abortion laws have low levels of reported termination. While the probabilities of pregnancy termination are higher at older ages, termination rates generally peak at younger ages due to higher conception rates.DiscussionThis is the first large comparative study of the patterns of reported pregnancy termination in DHS surveys. While we have explored the extent to which differences arise from spontaneous terminations or induced abortion, more research is needed regarding the determinants of reported pregnancy termination.

More than ******* abortions were performed in Russia in 2023. Starting from over *** millio* abortions recorded in the country in 2000, the number of terminated pregnancies has continuously decreased over time. The figures include induced abortions as well as miscarriages. The abortion rate in Russia stood at *** procedures per 1,000 live births in 2022. How is abortion regulated in Russia? Abortions are legal in Russia up to the 12th week of pregnancy and up to the 22nd week in cases of rape. They are conducted in state as well as private medical facilities. In 2022, approximately ********* of all pregnancy terminations in the country were conducted in commercial clinics. However, over the past decade, the laws regarding abortion have been tightened, allowing for fewer reasons for pregnancy termination. Moreover, there are proposals to ban abortions in private clinics. In a ranking of European policies by progressiveness and openness to abortion, Russia listed below most Western European countries. Contraception use in Russia Russia was one of the lowest-ranking countries in Europe by access to modern contraception. Approximately ** percent of Russian women aged 15 to 49 years used hormonal contraceptives, while ***** percent used an intrauterine device (IUD). In 2023, the country’s health ministry increased control over the sale and storage of mifepristone and misoprostol, medicines for pregnancy termination.

Manual Vacuum Aspiration (MVA) Market Outlook

The global Manual Vacuum Aspiration (MVA) market size was valued at approximately USD 1.5 billion in 2023 and is projected to reach USD 2.8 billion by 2032, growing at a compound annual growth rate (CAGR) of 6.8% during the forecast period. The market is driven by factors such as increasing incidence of pregnancy-related complications, rising awareness about safe abortion techniques, and the growing focus on minimally invasive procedures.

One of the primary growth factors of the MVA market is the increasing incidence of unintended pregnancies and the subsequent demand for safe and effective abortion methods. According to the World Health Organization, approximately 73 million induced abortions occur worldwide each year. This high incidence rate underscores the urgent need for safe and accessible abortion services, thereby driving the demand for MVA procedures, which are known for being safer and less invasive than alternative methods. Additionally, growing awareness campaigns by health organizations are playing a crucial role in spreading information about the benefits of MVA, further fueling market growth.

Technological advancements in medical devices have also significantly contributed to the growth of the MVA market. Innovations such as the development of more efficient, user-friendly, and portable MVA kits have made the procedure more accessible and manageable, even in resource-limited settings. These advancements have also increased the reliability and safety of the procedure, making it a preferred choice for both healthcare providers and patients. Furthermore, the rise in government and non-governmental initiatives to ensure safer abortion practices, particularly in developing countries, is expected to provide a substantial boost to the market.

Another contributing factor to the growth of the MVA market is the cost-effectiveness of the procedure. In comparison to surgical abortion, MVA is significantly less expensive, which makes it an attractive option for both healthcare providers and patients. The reduced need for anesthesia, lower risk of complications, and shorter recovery time associated with MVA further enhance its cost-effectiveness. This economic advantage is particularly pertinent in low-income regions where healthcare budgets are limited, making MVA a feasible solution to meet the healthcare needs of the population.

Regionally, North America and Europe are expected to dominate the MVA market during the forecast period, owing to well-established healthcare infrastructures, high awareness levels, and favorable regulatory frameworks. However, the Asia Pacific region is anticipated to exhibit the highest growth rate due to increasing healthcare investments, growing awareness about safe abortion methods, and supportive government policies. The rising population and improving access to healthcare services in countries like India and China further contribute to the region's robust market growth.

Product Type Analysis

The MVA market is segmented into Reusable MVA Kits and Disposable MVA Kits. Reusable MVA Kits have long been a staple in healthcare facilities due to their cost-effectiveness and sustainability. These kits are designed for multiple uses, provided they undergo proper sterilization and maintenance, which can significantly reduce the long-term costs for healthcare providers. Reusable kits are particularly favored in low-resource settings where budget constraints are a significant challenge. The durability and reliability of these kits make them a preferred choice, especially in high-volume settings like public hospitals.

However, Disposable MVA Kits are gaining traction due to their convenience and reduced risk of cross-contamination. These kits are designed for single-use, thereby eliminating the need for sterilization and reducing the risk of infection transmission. The growing focus on patient safety and infection control, particularly in the wake of the COVID-19 pandemic, has accelerated the adoption of disposable kits. Moreover, advancements in manufacturing processes have made disposable kits more affordable, thereby increasing their accessibility across various healthcare settings.

The choice between reusable and disposable kits often depends on the specific needs and capabilities of the healthcare provider. While reusable kits offer the advantage of long-term cost savings, disposable kits provide unparalleled convenience and safety. The ongoing advancements in material science and manufacturing techniques are expected to further enhance the effi

General Indicators; 2. Attitude to the EC; 3. Attitude to abortion; 4. Smoking habits; 5. Product safety. Topics: 1. General Indicators: citizenship and eligibility to vote at place of residence; contentment with life; satisfaction with democracy; opinion leadership and frequency of political discussions; postmaterialism; frequency of obtaining news from television, radio and newspapers. 2. Attitude to the EC: knowledge about the EC and its institutions; hopes and fears for the future of the European Community; judgment on personal level of information about the EC; attitude to European unification and membership of one´s own country in the EC; advantages or disadvantages for the country from EC membership; regret of a possible failure of the EC; general assessment of the significance of the EC; attitude to a European Government and European Parliament; judgment on the possibilities for citizens to democratically influence EC decisions; preferred new EC member countries until the year 2000; significance of European unification for national or European identity of the individual; judgment on the EC Commission by means of a semantic differential; preference for national or European decision-making authority in selected political areas; knowledge about the start of the European domestic market; expectations of the European domestic market and reasons for hopes and fears; general attitude to the domestic market and to a European social policy; general significance of the European Parliament in selected political areas; attitude to an increasing significance of the parliament; agreement with an expanded transfer of authority to the EC in an economic and currency union as well as in a political unification; knowledge about the Maastricht conference, its resolutions and their contents; agreement or rejection of the Maastricht Treaty as well as selected components of the treaty; expected effects of the Maastricht Treaty for the EC, for one´s own country and for personal life; exchange of national identity for a European identity; chances of individual EC countries to join the economic and currency union; expected advantages or disadvantages for one´s own country from the economic and currency union; preference for European or national precedents in conflicts of laws; sense of justice and attitude to selected aspects of the legal system (scale); attitude to the European Court of Justice and the highest national court of law; judgment on the work of the highest European Court of Justice. 3. Attitude to abortion: attitude to the right to abortion and a European regulation regarding abortion. 4. Smoking habits: number of cigarettes smoked daily; desire to quit smoking or reduce use of cigarettes (split: in the second case the question was not about desire but intent); frequency of not smoking in order not to bother others present; reasonableness for a smoker to travel in the no-smoking compartment or vice versa for a non-smoker to travel in the smoking compartment; time of quitting smoking (for former smokers); presence of smokers at home, in one´s circle of friends, at work and at other places; frequency of requests to smokers not to smoke; perceived bother from smokers; frequency of personal passive smoking; assessment of jeopardy to health from passive smoking; attitude to a smoking ban in public institutions; extent of such a smoking prohibition in one´s own vicinity; perceived observance of the smoking ban; preference for smoking zones or no-smoking zones at work; preference for an independent solution among work colleagues or for a management decision; smoking regulations at one´s place of work and perceived observance of these rules; attitude to a prohibition of cigarette advertising; knowledge about prohibitions of advertising for cigarettes in one´s country; evaluation of the effectiveness of these prohibitions; knowledge about the European program to combat cancer. 5. Product safety: most important criteria in purchase of products; interest in the safety of products and services; significance of thesecurity aspect of products in the media, in school and in leisure time; assessment of the salience of consumer protection (scale); consumer areas in which one should place particular value on safety; consumer areas to which one attributes the greatest potential for jeopardy; those primarily responsible for product safety and the safety of services in selected product areas; expected comparability of security standard of products in Europe and desire for generally understandable safety codes; the same security standards in Europe; desire for cross-border signs and symbols for dangers at the beach, in the mountains and with fire; adequate extent to which citizens are informed about dangers to the environment; assessment of the usefulness of selected types of insurance; greatest sources of danger for older people and children in different age-groups; last accident at home in one´s family; person who had an accident; product or object which lead to the accident; one responsible for the accident. Demography: self-classification on a left-right continuum; party allegiance; party preference (Sunday question); behavior at the polls in the last election; union membership; marital status; age at end of education; resumption of school training after an interruption and length of school training; length of further education; sex; age; size of household; number of children in household; possession of durable economic goods; occupational position; weekly number of working hours; supervisor status; employment in the civil service or private enterprise (company sector); person managing household; position in household; age of head of household at end of education; occupation of head of household; supervisor status of head of household; self-assessment of social class; residential status; degree of urbanization; religious denomination; frequency of church attendance; religiousness; monthly household income; city size; region; possession of a telephone. Indices: opinion leadership (cognitive mobility); postmaterialism; attitude to Europe; status in profession; party preference on European level; EC support; support for the EC domestic market; media usage; ESOMAR Social Grade; life cycle. In the Federal Republic the following questions were also posed: use of selected sources of information about the EC; perceived EC topics; preferred sources of information about the European Community; assessment of the EC role in achieving equivalent standard of living between Eastern and Western Germany. In Great Britain and Northern Ireland the following question was also posed: knowledge and significance of the British EC presidency. In France, West Germany, United Kingdom, Spain and Italy the following questions were also posed: self-classification of knowledge about selected EC countries; naming the most pleasant, most conscientious, most efficient and most trustworthy EC countries; assessment of the achievability of conditions for joining the economic and currency union by one´s own country. Only in Italy the following questions were posed: assumed interest of new applicant countries in EC membership; attitude to a subordinate role of one´s own country in an economic and currency union; most important obstacles to participation in the economic and currency union; perceived readiness of the population for economic and social sacrifices for the benefit of an economic and currency union; judgment on selected economic and social disadvantages for Italy from the economic and currency union; willingness to sacrifice income for the benefit of European unification. In Denmark the following questions were also posed: knowledge about the monthly magazine ´ES-AVISSEN´ and its content; origin of the issues read; evaluation of information content in selected areas; preference for more frequent publication of this magazine. The following questions were posed only in Norway: highest school degree; further education and college attendance. Also encoded was: date of interview; length of interview; willingness of respondent to cooperate; number of contact attempts; ZIP (postal)code; identification of interviewer.

Abstract

The Turkmenistan Demographic and Health Survey (TDHS 2000) is the first national survey of maternal and child health in Turkmenistan. It is a nationally representative survey of 7,919 women of reproductive age (15-49). Survey fieldwork was conducted from June to September 2000.

The TDHS was sponsored by the Ministry of Health and Medical Industry (MOHMI) of the Republic of Turkmenistan. The Gurbansoltan Eje Clinical Research Center for Maternal and Child Health implemented the survey with technical assistance from the Demographic and Health Surveys Program. The National Institute of State Statistics and Information (Turkmenmelihasabat) conducted sampling activities for the survey. The U.S. Agency for InternationalDevelopment (USAID) provided funding for the survey. UNFPA/Turkmenistan assisted with survey coordination and logistic support.

The purpose of the survey was to develop a single integrated set of data for the government of Turkmenistan to use in planning effective policies and programs in the areas of health and nutrition. TDHS 2000 collected data on women's reproductive history, knowledge and use of contraceptive methods, breastfeeding practices and nutrition, vaccination coverage, and episodes of diseases among children under the age of five. Information on the knowledge of and attitudes toward HIV/AIDS, other sexually transmitted infections, and tuberculosis were also collected. The survey also included the measurement of the hemoglobin level in the blood to assess the prevalence of anemia and measurements of height and weight to assess nutrition status.

The TDHS 2000 also contributes to the growing international database on demographic and health-related variables.

MAIN RESULTS

The TDHS was designed to provide policymakers and program managers at MOHMI with detailed information on the health status of women and children. Some of the health indicators provided by the TDHS-such as fertility and infant mortality rates-are available from other sources. However, other survey indicators are not available from other sources-for example anemia status and nutritional indices for women and children. Thus, when taken together, the TDHS and existing data provide a more complete picture of health conditions in Turkmenistan than was previously available.

• Fertility rates. For the three years preceding the survey (mid-1997 to mid-2000), the estimated crude birth rate was 24.6 births per 1,000 population. This is higher than the MOHMI rate of 20.3 (the average of the annual rates for calendar years 1997 to 1999).

• Knowledge of contraceptive methods is widespread in Turkmenistan. Among currently married women, knowledge of at least one method is universal (99 percent). Married women have knowledge of, on average, six methods of contraception. Married women of all ages, all educational levels, all ethnic groups, and all regions of the country have a high level of knowledge of contraceptive methods.

• Abortion rates. For the three-year period preceding the survey (mid-1977 to mid2000), the total abortion rate for Turkmenistan was 0.9. The total abortion rate was higher in urban areas (1.0 abortions per woman) than in rural areas (0.7 abortions per woman). The highest levels of induced abortion were in Ashgabad City and the Lebap Region (1.1 and 1.2 abortions per woman, respectively).

• Antenatal care. Almost all respondents who gave birth in the last five years (98 percent) received antenatal care from either a doctor (81 percent) or a nurse/midwife (17 percent). In general, in Turkmenistan women seek antenatal care early and continue to receive care throughout their pregnancy. The median number of antenatal care visits is ten.

• Infant Mortality Rates In the TDHS, infant mortality data were collected based on the international definition of a live birth, i.e., a birth that shows any sign of life, irrespective of the gestational age at the time of delivery (United Nations, 1999). Because of the difference between the government data collection system and that of the TDHS in the definition of a live birth, the TDHS estimate of the infant mortality rate (IMR) would be expected to exceed the official government estimates.

• The TDHS was the first study of anemia in Turkmenistan based on a nationally representative sample of women and children. The survey measured the hemoglobin level of capillary blood.

• Acquired Immune deficiency Syndrome(Aids) Compared with other parts of the world, Turkmenistan has been relatively untouched by the AIDS epidemic. Currently, there is only one known case of AIDS and one other person known to be HIV positive in Turkmenistan. Almost no respondents reported that they knew an HIV-infected person or anyone who had died of AIDS.

• Knowledge. Awareness and knowledge ofHIV/AIDSislimited. Seventy-threepercentof respondents reported having heard of HIV/ AIDS, but only 50 percent believe that they could adoptbehavior patterns thatwould reduce their risk of contracting the disease. Further evidence of limited knowledge of HIV/AIDS was the fact that only 31 percent of respondents recognized that condom use is a risk-reducing behavior.

Geographic coverage

The Turkmenistan Demographic and Health Survey (TDHS) is a nationally representative survey. The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).

Analysis unit

• Household
• Women age 15-49

Universe

The population covered by the 2000 TKMDHS is defined as the universe of all women in the reproductive ages (i.e., women 15-49).

Kind of data

Sample survey data

Sampling procedure

SAMPLE DESIGN

The sample for the 2000 TDHS was designed to allow statistical analysis at the national level, for urban and rural areas, and for the six regions of the country (Ashgabad City, Akhal, Balkan, Dashoguz, Lebap, and Mary).

The sample design was specified in terms of a target number of households in the six regions of Turkmenistan. The overall target number of households was set at 6,800. This number was allocated to the regions as follows: 800 to Ashgabad City, 1,000 to each of 4 regions (Akhal, Balkan, Lebap and Mary) and 2,000 to the remaining region (Dashoguz), for which more intensive analysis was desired.

The six regions of the country were further stratified into urban areas (cities, towns and small settlements) and rural areas (villages). The sampling frame consisted of the list of standard segments. Each standard segment was created on the basis of contiguous blocks that have clear boundaries-coinciding to the extent possible with census supervisor areas-and have between 200 and 500 households according to measures of size estimated by projection from to the 1995 Census data.

SAMPLE SELECTION

The sample was designed as a two-stage probability sample. Within regions the sample was to be self-weighting. The first stage involved the selection of standard segments (PSUs) by systematic sampling with probability proportional to size. This resulted in the selection of 231 standard segments:118 in urban areas and 113 in rural areas. A household listing operation was conducted in each selected standard segment. In the second stage, households were selected with probability proportional to the inverse of the first stage selection probability. On average, the number of households selected per standard segment was 28.

Since the sample for each of the six survey regions was self-weighting, the sampling fraction for each region was an important design parameter. The sampling fractions were estimated with projected census figures. The weighting factors for the six survey regions are inversely proportional to the sampling fractions.

SAMPLE IMPLEMENTATION

Implementation of the sample design resulted in the selection of 6,850 households. The data on household membership and age collected in the Household Questionnaire identified 8,250 women eligible for the Women's Questionnaire (i.e., women age 15-49 who were usual household members or who stayed in the household the night before the interviewer's visit).

From the 6,850 selected households, 6,391 were identified as current households and household interviews were completed in 6,302. This yields a household response rate of 98.6 percent. Of the 8,250 women who were eligible respondents, a total of 7,919 were interviewed. This yields an eligible woman response rate of 96.0 percent.

The overall response rate (94.7 percent) is the product of the household response rate and the eligible woman response rate. The overall response rate varies by region from 85.6 percent in Ashgabad City to 97.4 percent in the Balkan Region.

Mode of data collection

Face-to-face

Research instrument

Two questionnaires were used for TDHS 2000: a) the Household Questionnaire and b) Women's Questionnaire. These questionnaires were based on the model survey instruments developed for the MEASURE DHS+ project and were adapted to the data needs of Turkmenistan during consultations with specialists in the area of reproductive health and child health and nutrition. The questionnaires were developed at first in English and then translated into Russian and Turkmen. A pretest was conducted in April 2000. Based on the pretest, the questionnaires were revised and finalized.

a) The Household Questionnaire was used to enumerate all usual members and visitors in a sample household and to collect information related to the socioeconomic status of the household. In the first part of the Household Questionnaire, information was