The ICEH presented a series of rigorous studies at the World Congress of Epidemiology, held from September 24–27, 2024, in Cape Town, South Africa. The four ICEH presentations tackled pressing health inequities facing vulnerable communities worldwide, providing policymakers with data-driven insights.

Exploring Disparities in Adolescent Fertility Rates in Brazil

ICEH’s Aluisio J. D. Barros led a comprehensive study on adolescent fertility rates across Brazil's 5,493 municipalities, uncovering stark regional differences. The research highlights the North region, home to many Indigenous communities, as experiencing the highest adolescent fertility rates—some reaching 101 births per 1,000 adolescents—compared with the wealthier South, where the lowest rates prevail. Barros notes, "Adolescent fertility disrupts education and perpetuates economic and gender inequalities." The study attributes these high fertility rates to social vulnerability factors, with the Social Vulnerability Index accounting for 59% of the variation across municipalities. In the North, the most vulnerable municipalities report fertility rates nearly three times that of the least vulnerable areas.

The Critical Role of Education in Family Planning

Fernando C. Wehrmeister's investigation across 570 subnational regions in 46 countries found a clear link between women's education and improved access to family planning services. "Each additional year of schooling can significantly enhance women's health services, demonstrating the transformative power of education," Wehrmeister stated. The study calls for tailored interventions that focus on empowering women through education to help ensure equitable access to family planning services.

Trends in Family Planning in Low- and Middle-Income Countries

Further expanding on family planning trends, Aluisio J. D. Barros presented findings indicating an annual average increase of 0.5% in the demand for family planning satisfied by modern methods (DFPSm) in low- and middle-income countries (LMICs). West and Central Africa notably showed a rise from 0.5% to 1.8% per year during the Sustainable Development Goal (SDG) era. Despite reductions in wealth-related inequalities—marked by a decrease in the slope index of inequality from 27 in 2000 to 7 in 2022—DFPSm levels remain below the 70% target. 

New Indicator Developed to Enhance Maternal and Newborn Health Metrics

Luisa Arroyave and colleagues presented a new composite indicator for maternal and newborn health (MNH) interventions, derived from national health surveys in 97 LMICs. The Maternal and Newborn Health Composite Indicator (MNHci) quantifies the coverage of essential services—such as antenatal care, institutional delivery, and postnatal checks—scoring from zero to three, with striking disparities observed between wealth deciles. The authors identified a strong inverse correlation between the MNHci and neonatal mortality rates, highlighting the critical role of comprehensive MNH service access in improving infant health outcomes. This innovative tool aims to facilitate effective monitoring to bridge the health equity gap for vulnerable populations.