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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]

This commentary makes the case for increased investment in the development of improved contraceptive and multipurpose prevention technologies (MPTs) that better meet the needs and preferences of users, increase the methods' acceptability and use, and ultimately decrease unintended pregnancy. Methods that are inexpensive, user-controlled, and shelf-stable could help address challenges posed by weak supply chains and healthcare systems. New MPTs that protect against pregnancy and sexually transmitted infections (STIs), including HIV, could simultaneously address multiple sexual and reproductive health needs. Although promising scientific leads exist, the high costs and risks associated with contraceptive development has contributed to underinvestment. The public sector, philanthropies, and the pharmaceutical industry have decreased or eliminated investments in contraceptive research and development (R&D) in recent decades. Greater financial and policy support are required for the eventual introduction of new and improved contraceptives and MPTs. [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]

The authors comment on the importance of family planning to address global health, environmental and economic problems. They argue that family planning is essential to improve the rights, health and freedom of women and their families. According to them, one of the most efficient ways of decreasing abortion rates is the use of contraceptive methods.

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.

A letter to the editor in response to the article "Addressing Global Health, Economic and Environmental Problems Through Family Planning," by J. Joseph Speidel and Richard A. Grossman published in a 2011 issue and a reply by the authors to this are presented.

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.

Abstract: This synopsis of teens and OTC access is part of a series of briefs on emergency contraception, which address the following issues as they relate to EC: Is emergency contraception safe? Is emergency contraception effective at preventing pregnancy? Does emergency contraception promote sexual risk-taking? Is emergency contraception cost-effective? Does emergency contraception cause abortion? The full series can be found at http://crhrp.ucsf.edu. [Copyright &y& Elsevier]

Background Unintended pregnancy remains a serious public health challenge in the USA. We assessed the effects of an intervention to increase patients' access to long-acting reversible contraceptives (LARCs) on pregnancy rates. Methods We did a cluster randomised trial in 40 reproductive health clinics across the USA in 2011–13. 20 clinics were randomly assigned to receive evidence-based training on providing counselling and insertion of intrauterine devices (IUDs) or progestin implants and 20 to provide standard care. Usual costs for contraception were maintained at all sites. We recruited women aged 18–25 years attending family planning or abortion care visits and not desiring pregnancy in the next 12 months. The primary outcome was selection of an IUD or implant at the clinic visit and secondary outcome was pregnancy within 12 months. We used generalised estimating equations for clustered data to measure the intervention effect on contraceptive selection, and used survival analysis to assess pregnancy rates. Findings Of 1500 women enrolled, more at intervention than control sites reported receiving counselling on IUDs or implants (565 [71%] of 797 vs 271 [39%] of 693, odds ratio 3·8, 95% CI 2·8–5·2) and more selected LARCs during the clinic visit (224 [28%] vs 117 [17%], 1·9, 1·3–2·8). The pregnancy rate was lower in intervention group than in the control group after family planning visits (7·9 vs 15·4 per 100 person-years), but not after abortion visits (26·5 vs 22·3 per 100 person-years). We found a significant intervention effect on pregnancy rates in women attending family planning visits (hazard ratio 0·54, 95% CI 0·34–0·85). Interpretation The pregnancy rate can be reduced by provision of counselling on long-term reversible contraception and access to devices during family planning counselling visits. INSET: Panel: Research in context.. [ABSTRACT FROM AUTHOR]