Abstract

BackgroundSexual and Reproductive Health (SRH) targets have been included as part of the United Nations Sustainable Development Goals and indictors are important to monitor progress towards these targets. SRH indicators are recommended for setting norms and measuring progress globally. However, given the diverse political, socioeconomic and cultural contexts in different countries, and lack of global agreement on broad indicators, it is important to select appropriate indicators for specific countries. Based on internationally recommended indicators and data availability in China, this paper selected four indictors to reflect SRH in China and interpreted these indictors by analyzing the underlying factors.MethodsWe employed secondary data analysis and key informant interviews. Secondary data were obtained from the China Health Statistical Yearbook (2005–2017), China Statistical Yearbook (2005–2017), and the sub-national estimates of the Global Burden Diseases Study 2016. We interviewed 36 key informants at national and sub-national levels.ResultsThe four selected SRH indicators are contraceptive prevalence rate (CPR), adolescent birth rate, abortion rate, and availability of school sex education. CPR of married women has remained above 75% over the last three decades, indicating a high level of access to family planning (FP) services; however, unmarried but sexually active women have significant unmet needs for FP services. Although adolescent birth rates in China remain low, the abortion rate, abortion numbers, and the ratio of abortions to births increased from 2014 to 2016 while FP policy was relaxed. This suggests that abortion among unmarried women is a significant contributor to overall figures. Qualitative analysis of the availability of school sex education, reveals an absence of policy due to conservative attitudes of key stakeholders.ConclusionSince SRH challenges vary significantly between contexts, indicators for measuring progress towards SRH targets should be selected based on country context. The CPR and abortion rate are currently available and important indicators to monitor the most basic part of SRH in China, but require modification to ensure they reflect universal access to quality reproductive healthcare by all reproductive age women, regardless of their marriage status. Policy and indicators on sex education need to be carefully developed to fit the context in China.

Highlights

  • In 2015, the United Nations Sustainable Development Goals (SDGs) succeeded the Millennium Development Goals (MDGs) as the new development agenda until 2030

  • Plain English summary Sexual and Reproductive Health (SRH) targets have been included as part of the United Nations Sustainable Development Goals and indictors are important to monitor the progress towards these targets

  • Contraceptive prevalence rate: what do the data say and how should we interpret them? One of SRH indicators suggested by the Inter-Agency and Expert Group on SDG Indicators for target 3.7 is 3.7.1 Proportion of women of reproductive age who have their need for family planning satisfied with modern methods

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Summary

Introduction

In 2015, the United Nations Sustainable Development Goals (SDGs) succeeded the Millennium Development Goals (MDGs) as the new development agenda until 2030. The 1994 International Conference on Population and Development (ICPD) Programme of Action adopted the first internationally recognized, normative definition of reproductive health, which incorporates aspects of physical, mental, and social well-being [3]. Sexual and Reproductive Health (SRH) targets have been included as part of the United Nations Sustainable Development Goals and indictors are important to monitor progress towards these targets. Based on internationally recommended indicators and data availability in China, this paper selected four indictors to reflect SRH in China and interpreted these indictors by analyzing the underlying factors

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