Leontine Alkema
Datos Biográficos
| ID | 374020 |
|---|---|
| NOMBRE | Leontine Alkema |
| NOMBRES | Leontine |
| APELLIDO | Alkema |
| FIRMA | ALKEMA L |
| AFILIACIONES | University of Massachusetts Amherst |
| ORCID | 0000-0001-8806-5957 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAS | 67 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2011 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 5 |
Combining Bart and Principal Stratification to Estimate the Effect of Intermediate Variables on Primary Outcomes with Application to Estimating the Effect of Family Planning on Employment in Nigeria a…
There is interest in learning about the causal effects of modern contraceptive use on empowerment outcomes. Data on this question often come from family planning (FP) programs that increase access to FP and facilitate contraceptive use among some women, rather than directly assigning use. Women whose contraceptive behavior changes because of these programs (“compliers”) may differ from target populations in ways that alter the consequences of con…
New Measures for Family Planning and Exposure to Risk of Pregnancy Based on Sexual Activity and Contraceptive Use Data
Family planning measures for unmarried women are based on contraceptive demand and use among sexually active women. Sexual activity status is commonly defined based on comparing reported time‐since‐last‐sex to a cutoff time, with women defined to be sexually active if their most recent sex was within the last four weeks. While easy to understand and compute, this approach to constructing family planning measures results in a limited understanding…
Alignment between Desires and Outcomes among Women Wanting to Avoid Pregnancy
Since childbearing desires, and trends in these desires, differ across populations, the inclusion of women who want to become pregnant in the denominator for unintended pregnancy rates complicates interpretation of intercountry differences and trends over time. To address this limitation, we propose a rate that is the ratio of the number of unintended pregnancies to the number of women wanting to avoid pregnancy; we term these conditional rates. …
Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030
BACKGROUND: The Sustainable Development Goals (SDGs), set in 2015 by the UN General Assembly, call for all countries to reach an under-5 mortality rate (U5MR) of at least as low as 25 deaths per 1000 livebirths and a neonatal mortality rate (NMR) of at least as low as 12 deaths per 1000 livebirths by 2030. We estimated levels and trends in under-5 mortality for 195 countries from 1990 to 2019, and conducted scenario-based projections of the U5MR …
Country-specific estimates of unintended pregnancy and abortion incidence
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 …
A Bayesian Cohort Component Projection Model to Estimate Women of Reproductive Age at the Subnational Level in Data-Sparse Settings
Accurate estimates of subnational populations are important for policy formulation and monitoring population health indicators. For example, estimates of the number of women of reproductive age are important to understand the population at risk of maternal mortality and unmet need for contraception. However, in many low-income countries, data on population counts and components of population change are limited, and so subnational levels and trend…
Projecting sex imbalances at birth at global, regional and national levels from 2021 to 2100
INTRODUCTION: Skewed levels of the sex ratio at birth (SRB) due to sex-selective abortions have been observed in several countries since the 1970s. They will lead to long-term sex imbalances in more than one-third of the world's population with yet unknown social and economic impacts on affected countries. Understanding the potential evolution of sex imbalances at birth is therefore essential for anticipating and planning for changing sex structu…
Unintended pregnancy and abortion by income, region, and the legal status of abortion
BACKGROUND: Unintended pregnancy and abortion estimates document trends in sexual and reproductive health and autonomy. These estimates inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and abortion. We developed a new statistical model that jointly estimated unintended pregnancy and abortion …
National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030
BACKGROUND: Reducing neonatal mortality is an essential part of the third Sustainable Development Goal (SDG), to end preventable child deaths. To achieve this aim will require an understanding of the levels of and trends in neonatal mortality. We therefore aimed to estimate the levels of and trends in neonatal mortality by use of a statistical model that can be used to assess progress in the SDG era. With these estimates of neonatal mortality bet…
Systematic assessment of the sex ratio at birth for all countries and estimation of national imbalances and regional reference levels
Significance This study provides information on sex ratio at birth (SRB) reference levels and SRB imbalance. Using a comprehensive database and a Bayesian estimation model, we estimate that SRB reference levels are significantly different from the commonly assumed historical norm of 1.05 for most regions. We identify 12 countries with strong statistical evidence of SRB imbalance: Albania, Armenia, Azerbaijan, China, Georgia, Hong Kong (SAR of Chi…
Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014
BACKGROUND: Estimates of pregnancy incidence by intention status and outcome indicate how effectively women and couples are able to fulfil their childbearing aspirations, and can be used to monitor the impact of family-planning programmes. We estimate global, regional, and subregional pregnancy rates by intention status and outcome for 1990-2014. METHODS: We developed a Bayesian hierarchical time series model whereby the unintended pregnancy rate…
Global estimation of neonatal mortality using a Bayesian hierarchical splines regression model
In recent years, much of the focus in monitoring child mortality has been on assessing changes in the under-5 mortality rate (U5MR). However, as the U5MR decreases, the share of neonatal deaths (within the ï¬ rst month) tends to increase, warranting increase
Global, regional, and subregional classification of abortions by safety, 2010–14
BACKGROUND: Global estimates of unsafe abortions have been produced for 1995, 2003, and 2008. However, reconceptualisation of the framework and methods for estimating abortion safety is needed owing to the increased availability of simple methods for safe abortion (eg, medical abortion), the increasingly widespread use of misoprostol outside formal health systems in contexts where abortion is legally restricted, and the need to account for the mu…
Setting Ambitious yet Achievable Targets Using Probabilistic Projections
In 2015, governments adopted 17 internationally agreed goals to ensure progress and well‐being in the economic, social, and environmental dimensions of sustainable development. These new goals present a challenge for countries to set empirical targets that are ambitious yet achievable and that can account for different starting points and rates of progress. We used probabilistic projections of family planning indicators, based on a global data se…
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030
Guidelines for Accurate and Transparent Health Estimates Reporting
Measurements of health indicators are rarely available for every population and period of interest, and available data may not be comparable. The Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) define best reporting practices for studies that calculate health estimates for multiple populations (in time or space) using multiple information sources. Health estimates that fall within the scope of GATHER include all quanti…
Abortion incidence between 1990 and 2014
Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030
Global causes of maternal death
BACKGROUND: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review. METHODS: We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data,…
World population stabilization unlikely this century
The United Nations (UN) recently released population projections based on data until 2012 and a Bayesian probabilistic methodology. Analysis of these data reveals that, contrary to previous literature, the world population is unlikely to stop growing this century. There is an 80% probability that world population, now 7.2 billion people, will increase to between 9.6 billion and 12.3 billion in 2100. This uncertainty is much smaller than the range…
National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015
Levels of urbanization in the world’s countries
Monitoring Progress Towards Millennium Development Goal 4
Background: Millennium Development Goal 4 calls for a reduction in the under-5 mortality rate (U5MR) by two-thirds between 1990 and 2015. Due to issues with data quality and quantity, there is uncertainty about how much progress has been made in many countries, and conflicting estimates of the overall levels and rate of decline have been reported. Consequently, there is a clear and urgent need to validate estimates, but consensus guidelines for m…
Estimating trends in the total fertility rate with uncertainty using imperfect data
BACKGROUND: Estimating the total fertility rate is challenging for many developing countries because of limited data and varying data quality. A standardized, reproducible approach to produce estimates that include an uncertainty assessment is desired. METHODS: We develop a method to estimate and assess uncertainty in the total fertility rate over time, based on multiple imperfect observations from different data sources, including surveys and ce…
Probabilistic Projections of the Total Fertility Rate for All Countries
We describe a Bayesian projection model to produce country-specific projections of the total fertility rate (TFR) for all countries. The model decomposes the evolution of TFR into three phases: pre-transition high fertility, the fertility transition, and post-transition low fertility. The model for the fertility decline builds on the United Nations Population Division’s current deterministic projection methodology, which assumes that fertility wi…
Probabilistic Projections of the Total Fertility Rate for All Countries
We describe a Bayesian projection model to produce country-specific projections of the total fertility rate (TFR) for all countries. The model decomposes the evolution of TFR into three phases: pre-transition high fertility, the fertility transition, and post-transition low fertility. The model for the fertility decline builds on the United Nations Population Division’s current deterministic projection methodology, which assumes that fertility wi…
Estimating trends in the total fertility rate with uncertainty using imperfect data
BACKGROUND: Estimating the total fertility rate is challenging for many developing countries because of limited data and varying data quality. A standardized, reproducible approach to produce estimates that include an uncertainty assessment is desired. METHODS: We develop a method to estimate and assess uncertainty in the total fertility rate over time, based on multiple imperfect observations from different data sources, including surveys and ce…
Levels of urbanization in the world’s countries
Alignment between Desires and Outcomes among Women Wanting to Avoid Pregnancy
Since childbearing desires, and trends in these desires, differ across populations, the inclusion of women who want to become pregnant in the denominator for unintended pregnancy rates complicates interpretation of intercountry differences and trends over time. To address this limitation, we propose a rate that is the ratio of the number of unintended pregnancies to the number of women wanting to avoid pregnancy; we term these conditional rates. …
Global estimation of neonatal mortality using a Bayesian hierarchical splines regression model
In recent years, much of the focus in monitoring child mortality has been on assessing changes in the under-5 mortality rate (U5MR). However, as the U5MR decreases, the share of neonatal deaths (within the ï¬ rst month) tends to increase, warranting increase
Monitoring Progress Towards Millennium Development Goal 4
Background: Millennium Development Goal 4 calls for a reduction in the under-5 mortality rate (U5MR) by two-thirds between 1990 and 2015. Due to issues with data quality and quantity, there is uncertainty about how much progress has been made in many countries, and conflicting estimates of the overall levels and rate of decline have been reported. Consequently, there is a clear and urgent need to validate estimates, but consensus guidelines for m…
New Measures for Family Planning and Exposure to Risk of Pregnancy Based on Sexual Activity and Contraceptive Use Data
Family planning measures for unmarried women are based on contraceptive demand and use among sexually active women. Sexual activity status is commonly defined based on comparing reported time‐since‐last‐sex to a cutoff time, with women defined to be sexually active if their most recent sex was within the last four weeks. While easy to understand and compute, this approach to constructing family planning measures results in a limited understanding…
A Bayesian Cohort Component Projection Model to Estimate Women of Reproductive Age at the Subnational Level in Data-Sparse Settings
Accurate estimates of subnational populations are important for policy formulation and monitoring population health indicators. For example, estimates of the number of women of reproductive age are important to understand the population at risk of maternal mortality and unmet need for contraception. However, in many low-income countries, data on population counts and components of population change are limited, and so subnational levels and trend…
Setting Ambitious yet Achievable Targets Using Probabilistic Projections
In 2015, governments adopted 17 internationally agreed goals to ensure progress and well‐being in the economic, social, and environmental dimensions of sustainable development. These new goals present a challenge for countries to set empirical targets that are ambitious yet achievable and that can account for different starting points and rates of progress. We used probabilistic projections of family planning indicators, based on a global data se…
Probabilistic Projections of the Total Fertility Rate for All Countries
We describe a Bayesian projection model to produce country-specific projections of the total fertility rate (TFR) for all countries. The model decomposes the evolution of TFR into three phases: pre-transition high fertility, the fertility transition, and post-transition low fertility. The model for the fertility decline builds on the United Nations Population Division’s current deterministic projection methodology, which assumes that fertility wi…
Monitoring Progress Towards Millennium Development Goal 4
Background: Millennium Development Goal 4 calls for a reduction in the under-5 mortality rate (U5MR) by two-thirds between 1990 and 2015. Due to issues with data quality and quantity, there is uncertainty about how much progress has been made in many countries, and conflicting estimates of the overall levels and rate of decline have been reported. Consequently, there is a clear and urgent need to validate estimates, but consensus guidelines for m…
Estimating trends in the total fertility rate with uncertainty using imperfect data
BACKGROUND: Estimating the total fertility rate is challenging for many developing countries because of limited data and varying data quality. A standardized, reproducible approach to produce estimates that include an uncertainty assessment is desired. METHODS: We develop a method to estimate and assess uncertainty in the total fertility rate over time, based on multiple imperfect observations from different data sources, including surveys and ce…
National, regional, and global rates and trends in contraceptive prevalence and unmet need for family planning between 1990 and 2015
Levels of urbanization in the world’s countries
Global causes of maternal death
BACKGROUND: Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review. METHODS: We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data,…
World population stabilization unlikely this century
The United Nations (UN) recently released population projections based on data until 2012 and a Bayesian probabilistic methodology. Analysis of these data reveals that, contrary to previous literature, the world population is unlikely to stop growing this century. There is an 80% probability that world population, now 7.2 billion people, will increase to between 9.6 billion and 12.3 billion in 2100. This uncertainty is much smaller than the range…
Global, regional, and national levels and trends in under-5 mortality between 1990 and 2015, with scenario-based projections to 2030
Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030
Guidelines for Accurate and Transparent Health Estimates Reporting
Measurements of health indicators are rarely available for every population and period of interest, and available data may not be comparable. The Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) define best reporting practices for studies that calculate health estimates for multiple populations (in time or space) using multiple information sources. Health estimates that fall within the scope of GATHER include all quanti…
Abortion incidence between 1990 and 2014
Global, regional, and subregional classification of abortions by safety, 2010–14
BACKGROUND: Global estimates of unsafe abortions have been produced for 1995, 2003, and 2008. However, reconceptualisation of the framework and methods for estimating abortion safety is needed owing to the increased availability of simple methods for safe abortion (eg, medical abortion), the increasingly widespread use of misoprostol outside formal health systems in contexts where abortion is legally restricted, and the need to account for the mu…
Setting Ambitious yet Achievable Targets Using Probabilistic Projections
In 2015, governments adopted 17 internationally agreed goals to ensure progress and well‐being in the economic, social, and environmental dimensions of sustainable development. These new goals present a challenge for countries to set empirical targets that are ambitious yet achievable and that can account for different starting points and rates of progress. We used probabilistic projections of family planning indicators, based on a global data se…
Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014
BACKGROUND: Estimates of pregnancy incidence by intention status and outcome indicate how effectively women and couples are able to fulfil their childbearing aspirations, and can be used to monitor the impact of family-planning programmes. We estimate global, regional, and subregional pregnancy rates by intention status and outcome for 1990-2014. METHODS: We developed a Bayesian hierarchical time series model whereby the unintended pregnancy rate…
Global estimation of neonatal mortality using a Bayesian hierarchical splines regression model
In recent years, much of the focus in monitoring child mortality has been on assessing changes in the under-5 mortality rate (U5MR). However, as the U5MR decreases, the share of neonatal deaths (within the ï¬ rst month) tends to increase, warranting increase
National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030
BACKGROUND: Reducing neonatal mortality is an essential part of the third Sustainable Development Goal (SDG), to end preventable child deaths. To achieve this aim will require an understanding of the levels of and trends in neonatal mortality. We therefore aimed to estimate the levels of and trends in neonatal mortality by use of a statistical model that can be used to assess progress in the SDG era. With these estimates of neonatal mortality bet…
Systematic assessment of the sex ratio at birth for all countries and estimation of national imbalances and regional reference levels
Significance This study provides information on sex ratio at birth (SRB) reference levels and SRB imbalance. Using a comprehensive database and a Bayesian estimation model, we estimate that SRB reference levels are significantly different from the commonly assumed historical norm of 1.05 for most regions. We identify 12 countries with strong statistical evidence of SRB imbalance: Albania, Armenia, Azerbaijan, China, Georgia, Hong Kong (SAR of Chi…
Unintended pregnancy and abortion by income, region, and the legal status of abortion
BACKGROUND: Unintended pregnancy and abortion estimates document trends in sexual and reproductive health and autonomy. These estimates inform and motivate investment in global health programmes and policies. Variability in the availability and reliability of data poses challenges for measuring and monitoring trends in unintended pregnancy and abortion. We developed a new statistical model that jointly estimated unintended pregnancy and abortion …
Projecting sex imbalances at birth at global, regional and national levels from 2021 to 2100
INTRODUCTION: Skewed levels of the sex ratio at birth (SRB) due to sex-selective abortions have been observed in several countries since the 1970s. They will lead to long-term sex imbalances in more than one-third of the world's population with yet unknown social and economic impacts on affected countries. Understanding the potential evolution of sex imbalances at birth is therefore essential for anticipating and planning for changing sex structu…
Global, regional, and national trends in under-5 mortality between 1990 and 2019 with scenario-based projections until 2030
BACKGROUND: The Sustainable Development Goals (SDGs), set in 2015 by the UN General Assembly, call for all countries to reach an under-5 mortality rate (U5MR) of at least as low as 25 deaths per 1000 livebirths and a neonatal mortality rate (NMR) of at least as low as 12 deaths per 1000 livebirths by 2030. We estimated levels and trends in under-5 mortality for 195 countries from 1990 to 2019, and conducted scenario-based projections of the U5MR …
Country-specific estimates of unintended pregnancy and abortion incidence
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 …
A Bayesian Cohort Component Projection Model to Estimate Women of Reproductive Age at the Subnational Level in Data-Sparse Settings
Accurate estimates of subnational populations are important for policy formulation and monitoring population health indicators. For example, estimates of the number of women of reproductive age are important to understand the population at risk of maternal mortality and unmet need for contraception. However, in many low-income countries, data on population counts and components of population change are limited, and so subnational levels and trend…
New Measures for Family Planning and Exposure to Risk of Pregnancy Based on Sexual Activity and Contraceptive Use Data
Family planning measures for unmarried women are based on contraceptive demand and use among sexually active women. Sexual activity status is commonly defined based on comparing reported time‐since‐last‐sex to a cutoff time, with women defined to be sexually active if their most recent sex was within the last four weeks. While easy to understand and compute, this approach to constructing family planning measures results in a limited understanding…
Alignment between Desires and Outcomes among Women Wanting to Avoid Pregnancy
Since childbearing desires, and trends in these desires, differ across populations, the inclusion of women who want to become pregnant in the denominator for unintended pregnancy rates complicates interpretation of intercountry differences and trends over time. To address this limitation, we propose a rate that is the ratio of the number of unintended pregnancies to the number of women wanting to avoid pregnancy; we term these conditional rates. …
Combining Bart and Principal Stratification to Estimate the Effect of Intermediate Variables on Primary Outcomes with Application to Estimating the Effect of Family Planning on Employment in Nigeria a…
There is interest in learning about the causal effects of modern contraceptive use on empowerment outcomes. Data on this question often come from family planning (FP) programs that increase access to FP and facilitate contraceptive use among some women, rather than directly assigning use. Women whose contraceptive behavior changes because of these programs (“compliers”) may differ from target populations in ways that alter the consequences of con…
Population (22 obras) · Demography (21 obras) · Global Maternal and Child Health (18 obras) · Family planning (13 obras) · Medicine (13 obras) · Economics (12 obras) · Environmental health (11 obras) · Estimation (11 obras) · Research methodology (11 obras) · Sociology (11 obras)