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Driven by increasing consumption and population numbers, human demands are depleting natural resources essential to support human life, causing damage to crop lands, fresh water supplies, fisheries, and forests, and driving climate change. Within this century, world population could increase by as little as 15% or by more than 50%, depending largely on how we respond. We must face the challenge of accommodating these additional people at the same time as virtually eliminating the use of fossil fuels and other activities that generate greenhouse gases, reversing environmental degradation and supporting improved living standards for billions of impoverished people. The response to this challenge is handicapped by a lack of common understanding and an integrated agenda among those contributing to the response. This report offers a strategy to protect natural systems and improve welfare through expansion of reproductive justice, a concept that includes family planning, reproductive health, and gender equity, and preservation of the environment and climate. [ABSTRACT FROM AUTHOR]

Objectives. We determined whether public funding for contraception was associated with long-acting reversible contraceptive (LARC) use when providers received training on these methods. Methods. We evaluated the impact of a clinic training intervention and public funding on LARC use in a cluster randomized trial at 40 randomly assigned clinics across the United States (2011-2013).Twenty intervention clinics received a 4-hour training. Women aged 18 to 25 were enrolled and followed for 1 year (n = 1500:802 intervention, 698 control). We estimated the effects of the intervention and funding sources on LARC initiation with Cox proportional hazards models with shared frailty. Results. Women at intervention sites had higher LARC initiation than those at control (22 vs 18 per 100 person-years; adjusted hazard ratio [AHR] = 1.43; 95% confidence interval [CI] = 1.04, 1.98). Participants receiving care at clinics with Medicaid family planning expansion programs had almost twice the initiation rate as those at clinics without (25 vs 13 per 100 person-years; AHR = 2.26; 95% CI = 1.59, 3.19). LARC initiation also increased among participants with public (AHR= 1.56; 95% CI = 1.09, 2.22) but not private health insurance. Conclusions. Public funding and provider training substantially improve LARC access. [ABSTRACT FROM AUTHOR]

CONTEXT: Long-acting reversible contraceptive (LARC) methods (IUDs and implants) are the most effective and cost-effective methods for women. Although they are safe to place immediately following an abortion, most clinics do not offer this service, in part because of the increased cost. METHODS: In 2009, telephone interviews were conducted with 20 clinicians and 24 health educators at 25 abortion care practices across the country. A structured topic guide was used to explore general practice characteristics; training, knowledge and attitudes about LARC; and postabortion LARC counseling and provision. Transcripts of the digitally recorded interviews were coded and analyzed using inductive and deductive processes. RESULTS: Respondents were generally positive about the safety and effectiveness of LARC methods; those working in clinics that offered LARC methods immediately postabortion tended to have greater knowledge about LARC than others, and to perceive fewer risks and employ more evidence-based practices. LARC methods often were not included in contraceptive counseling for women at high risk of repeat unintended pregnancy, including young and nulliparous women. Barriers to provision were usually expressed in terms of financial cost-to patients and clinics-and concerns about impact on the smooth flow of clinic procedures. Education and encouragement from professional colleagues regarding LARC, as well as training and adequate reimbursement for devices, were considered critical to changing clinical practice to include immediate postabortion LARC provision. CONCLUSION: Despite evidence about the safety and cost-effectiveness of postabortion LARC provision, many clinics are not offering it because of financial and logistical concerns, resulting in missed opportunities for preventing repeat unintended pregnancies. [ABSTRACT FROM AUTHOR]

Human consumption is depleting the Earth's natural resources and impairing the capacity of life-supporting ecosystems. Humans have changed ecosystems more rapidly and extensively over the past 50 years than during any other period, primarily to meet increasing demands for food, fresh water, timber, fibre and fuel. Such consumption, together with world population increasing from 2.6 billion in 1950 to 6.8 billion in 2009, are major contributors to environmental damage. Strengthening family-planning services is crucial to slowing population growth, now 78 million annually, and limiting population size to 9.2 billion by 2050. Otherwise, birth rates could remain unchanged, and world population would grow to 11 billion. Of particular concern are the 80 million annual pregnancies (38% of all pregnancies) that are unintended. More than 200 million women in developing countries prefer to delay their pregnancy, or stop bearing children altogether, but rely on traditional, less-effective methods of contraception or use no method because they lack access or face other barriers to using contraception. Family-planning programmes have a successful track record of reducing unintended pregnancies, thereby slowing population growth. An estimated $15 billion per year is needed for family-planning programmes in developing countries and donors should provide at least $5 billion of the total, however, current donor assistance is less than a quarter of this funding target. [ABSTRACT FROM AUTHOR]

Discusses evidence that the growth of the world population is threatening to public health, socioeconomic development, and the environment. Details of reports indicating that without stabilization of population and consumption, human health will worsen, developing countries will not be able to escape poverty, and the environment will be degraded by waste and pollution; Suggestion that better reproductive health care, and efficient economic systems and technology are needed.

The article cites a study which evaluates the knowledge of technique of birth control among an urban hospital and clinic population of low socio-economic status. The study tried to examine the extant to which birth control techniques are known, whether the knowledge be adequate to allow its effective use, whether the knowledge is related to ethnicity and what are the sources of knowledge about birth control. The study found a high level of knowledge among users of birth control devices, such as condoms, diaphragm and pills, against nonusers.

The article discusses the highlights of the conference "The World in 2050" held at the University of California in Berkeley, on January 23 and 24, 2009. The conference was attended by an international group of scientists. They discussed various issues related to global population growth, including its impact on fossil fuel and natural resources consumption, the future of family planning and the need for contraception in low-income countries.

Focuses on the impact of deficient family planning services on women's health. Association between poverty and health; Percentage of maternal mortality caused by unsafe abortion; Amount of health care cost generated by chlamydial infections.

Context Low knowledge of long-acting reversible contraceptives ( LARC) and restrictive counseling practices have been documented among contraceptive care clinicians. However, little is known about health educators' counseling on LARC, how their practices compare with clinicians' and their specific training needs. Methods A survey conducted in 2011-2012 assessed knowledge and practices related to LARC counseling and provision among 410 staff at 40 Planned Parenthood clinics. Clinicians' and health educators' knowledge and practices were compared via chi-square tests; use of evidence-based criteria was assessed in multivariable logistic regression analyses. Results At least half of both types of staff routinely discussed LARC with clients, and nearly all considered the methods safe. Health educators considered a smaller proportion of clients candidates for LARC than did clinicians (57% vs. 77%), and they were less likely to consider IUDs for teenagers (79% vs. 96%), nulliparous women (82% vs. 98%) and unmarried clients (90% vs. 99%). In a multivariable model, health educators were less likely than clinicians to counsel clients using the least restrictive evidence-based criteria (odds ratio, 0.1). Sixty-four percent of health educators and 40% of clinicians desired additional LARC training. Conclusion Even in clinics that specialize in reproductive health care, health educators are less likely than clinicians to apply current evidence-based criteria in counseling about LARC. To provide evidence-based contraceptive counseling, health educators need training on LARC eligibility and indications. [ABSTRACT FROM AUTHOR]

A list of participants of the conference "The World in 2050" held at the University of California in Berkeley, on January 23 and 24, 2009 is presented.