English summary: STERILISATION ON THE DECLINE IN FINLAND

The number of sterilisations has decreased in Finland: among women from 12 651 in 1996 to 5 102 in 2005; among men from 2 202 in 1997 to below 1 700 in 2003-2005. We studied if poorer registration has caused this decreasing trend by analysing sterilisation statistics from 1987 to 2005 and by combining the Register on Sterilisations with the Hospital Discharge Register for 2000 to 2003. Between 1996-2005, female sterilisations declined in all age groups and all central hospital districts. In 1997-2005, male sterilisations declined more among men aged less than 40 years (-17%) compared to men aged 40 years or older (-8%). The number of sterilised men increased in five central hospital districts, but decreased elsewhere. The Hospital Discharge Register included 1 662 sterilisations (4.5%) that were not found in the Register on Sterilisations. This percentage was higher among men (5.9%) than women (4.2%). The coverage of sterilisation data is good, but it can be further improved by routinely linking this data to hospitalisations. It is unlikely that poorer registration explains the declining sterilisation trend. Other reasons, such as changed attitudes towards sterilisation or increased use of other contraceptives, need to be explored using questionnaire or interview surveys.