Modeling Contraception and Pregnancy in Malawi: A Thanzi La Onse Mathematical Modeling Study

Area of Science:

• Demography
• Public Health
• Reproductive Health

Background:

• Malawi faces a significant unmet need for contraception.
• A national plan exists to increase contraception use.
• Understanding the demographic impact of increased contraception is crucial for policy.

Purpose of the Study:

• To estimate the impact of increased contraception uptake on Malawi's future population size.
• To model the effects of specific interventions: a population campaign (Pop) and postpartum family planning (PPFP).

Main Methods:

• Developed a novel, individual-level model of contraception and pregnancy.
• The model captures initiation, switching, discontinuation, and failure rates by method and individual characteristics.
• Calibrated the model to UN World Population Prospects 2019 data and simulated intervention scenarios.

Main Results:

• Without interventions, Malawi's population exceeds 60 million by 2084.
• With Pop and PPFP interventions, the population peaks below 35 million by 2100.
• Contraception scale-up costs are estimated at 0.9% of per capita health expenditure.

Conclusions:

• Investments in contraception scale-up can dramatically reduce population growth pressures.
• These interventions support Malawi's national and global health and development goals.
• Increased access to family planning offers substantial societal benefits.