Sterilisations
The quality description of the statistics on Assisted Fertility Treatments assesses the reliability and suitability of the statistics for different purposes.
Relevance of statistical data
The statistics on sterilisations contain data on the annual number of sterilisations. Data on sterilisations are provided by gender and age group (per 1 000 persons aged 25–54) as well as by indication.
The report aims to provide up-to-date information on sterilisations to health care professionals, administrators, planning officials and researchers working in the area of reproductive health.
The report text describes the concepts and definitions used in the statistics.
The collection of data is based on the Act on the National Institute for Health and Welfare (668/2008), the Act on the Statistical Service of the National Research and Development Centre for Welfare and Health (409/2001), the Act (556/1989) and the Decree (774/1989) on National Personal Data Registers Kept under the Health Care, as well as the Act (283/1970) and the Decree on Sterilisations (427/1985) .
Description of methods
Data on sterilisations are collected from all health care units in Finland that perform sterilisations. The statistical population consists of all persons who have undergone sterilisation. According to current legislation, the health care unit performing the procedure is required to report the case to the National Institute for Health and Welfare (THL) within one month using a specific data collection form approved by the Ministry of Social Affairs and Health. Doctors who are self-employed practitioners are responsible for reporting the sterilisations they have performed.
The statistical data are based on notifications submitted to THL by 2nd May 2024.
Year 2023 most data were collected to THL by electronic means. The electronic data collection begun in 2015. Units performing procedures complete an electronic form and save it in a secure format for THLs use or information transfers to THL as a database acquisition. In 2023, only a few register notifications arrived in paper form.
Data check-ups are made regularly and any unclear cases and diagnoses are checked and ascertained by contacting the hospitals that have performed the procedure concerned.
Correctness and accuracy of data
Correctness of data depends on the quality of the data submitted by the data suppliers. In unclear cases, the data in the register of sterilisations are compared with those in other registers (Medical Birth Register, Care Register). If necessary, the health care unit that has performed the procedure is contacted in order to ascertain the data.
For the 2023 data there are some known data quality issues for some hospitals, but the total number of procedures is in line with the data in the Hospital Care Register. However, the register coverage should be treated with caution.
In 2006, the coverage of the register of sterilisations was studied with the help of the Care Register [1]. The study found that 95.5 per cent of all sterilisations carried out in Finland have been reported to the register of sterilisations. Data submitted to the register indicates that the total number of sterilisations in Finland have been falling since the mid-1990s. This trend is due in part to smaller age groups and improved contraceptives, but the study also found gaps in the reporting of sterilisations. The validation study with 2011 data showed that the coverage of the Register on Sterilisations is still good but declined to 90 per cent [2]. In recent years, increasing numbers of male sterilisations have been performed in private health care, and statistical coverage cannot be guaranteed.
[1] Hanna Eronen, Mika Gissler & Annukka Ritvanen (2006): Steriloimisten rekisteröiminen Suomessa. Steriloimisrekisterin ja hoitoilmoitusrekisterin steriloimistietojen vertailu ja aineiston laadun analysointi vuosilta 2000–2003 [Registering sterilisations in Finland. A comparison of sterilisation data recorded in the register of sterilisations and the care register for health care and an analysis of data quality in 2000–2003]. Discussion Papers 12/2006. Helsinki; Stakes.
[2] Heino A, Niinimäki M, Mentula M, Gissler M. How reliable are health registers? Registration of induced abortions and sterilizations in Finland. Inform Health Soc Care. 2017 Apr 7:1-10. doi: 10.1080/17538157.2017.1297306.
Timeliness and promptness of published data
The sterilisation statistics are published yearly with the final data for the previous year.
Availability and transparency/clarity of data
The reports are published on the THL website. The appendix tables to the statistical report are published as database tables which enable the reader to choose the data displayed.
Findata is authorised to disclose data in the Register of Sterilisations to researchers for scientific research purposes.
Findata
Comparability of statistical data
Since 1987, data on sterilisations have been kept in an electronic THL database. Official statistical publications by the National Board of Health (one of THL’s predecessors) have been used as a source of information for earlier years.
Data for earlier years have been checked, for instance, by removing data that had been entered twice and by adding missing cases, so some data may deviate from previously published statistics.
With regard to age-specific data, it should be noted that from 1994 onwards such data in the register refer to the age of the patient on the day of the procedure, whereas the data for the years 1987–1993 refer to the age at the end of the year.
The concepts and definitions related to sterilisation have remained unchanged throughout this time.
In the data collection form for the register, for some of the variables (e.g. contraceptive method, method of sterilisation, indication) it is possible to select more than one alternative. This should be taken into account when examining the tables.
The Sterilization Act was amended in 2023. The amendment came into effect on April 3, 2023, and after this, sterility is no longer a requirement for gender confirmation. An updated registration notification form (ST2) came into effect September 1st 2023.
Clarity and consistency
The data on sterilisations in the statistical report are nationwide.
Previous years' data are corrected, where necessary, retrospectively, but the changes have been fairly small. At the time of this report's publication, the 2022 data, for example, were corrected, and the total number of sterilisations increased by 13 cases.
