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：

---

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，并制定了一项成本高昂的国家计划来增加避孕药具的使用。估计此类投资可能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措施采用率的政策的效果和价值。我们利用个体层面的数据开发了一种新的避孕和怀孕模型，通过避孕方法捕获避孕开始、转换、终止和失败的复杂性，并考虑到个体特征的差异。我们通过人口运动（Pop）和产后计划生育干预（PPFP）来模拟避孕规模的扩大。我们在不对马拉维联合国 2019 年世界人口展望中出生率中值变异预测进行新干预的情况下校准了模型。如果不采取干预措施，马拉维人口到 2084 年将超过 6000 万；以及 Pop 和 PPFP 的干预。到 2100 年，这一数字将达到峰值，低于 3500 万。我们比较了 2023 年至 2050 年期间，按方法、有干预措施和无干预措施的避孕覆盖率和成本。我们估计，扩大避孕措施的投资仅占人均卫生总支出的 0.9%，尽管这可能会导致大幅减轻当前人口快速增长对卫生服务、学校、土地和社会造成的压力，帮助马拉维实现国家和全球卫生与发展目标。