World Population Awareness

Maternal, Infant, and Child Health Care

July 30, 2015

2005

Before, we didn't know how to control pregnancy, we didn't have the education, and people in the area were having nine or ten children. We have 18 families and no one has more than three children. The health of the children and mothers has improved, and so has the spacing of babies. Everyone understands the importance of family planning now. Vincente Jarrin and Maria Juana Jarrin Malca, Husband and Wife Family Planning Promoters in Pasquazo Zambrano, Ecuador doclink

Carl Haub - Population Reference Bureau

It took the US 200 years to go from 7 babies per family to two. "Bangladesh has done that in 20. Iran has more than halved its fertility rate in a decade." doclink

2005

Before, we didn't know how to control pregnancy, we didn't have the education, and people in the area were having nine or ten children. We have 18 families and no one has more than three children. The health of the children and mothers has improved, and so has the spacing of babies. Everyone understands the importance of family planning now. Vincente Jarrin and Maria Juana Jarrin Malca, Husband and Wife Family Planning Promoters in Pasquazo Zambrano, Ecuador doclink

The Two Parts of Sustainability Are Consumption and Population

The world could possibly reduce consumption down to a very basic level, but if population keeps growing, eventually that will not be enough. Even today many are living on a sub-sustainable level, due in part to an uneven distribution of resources, but also because, in many regions, population has outgrown essential resources for that region.

When people feel threatened by a hand-to-mouth existence, they are more likely to look towards less-than democratic ways to reduce population, especially if they have the foresight to realize that population growth is like a run-away train, very difficult to slow and stop.

However, more and more evidence is showing that the methods that work the best towards reducing population growth, are the methods established by the principles of the Cairo Conference in 1994 (United Nations International Conference on Population and Development (ICPD) September 1994, Cairo, Egypt), which include: a. Empowering women and girls in the economic, political, and social arenas; b. Removing gender disparities in education; c. Integrating family planning with related efforts to improve maternal and child health; and d. Removal of 'target' family sizes. doclink

Population Progress

October 6, 2004, Boston Globe

A United Nations report says poverty perpetuates and is exacerbated by poor maternal health, gender discrimination, and lack of access to birth control. This holistic view has helped slow the increase in world population. The average family has declined from six children in 1960 to around three today. The world's population is expected to grow by 39% over the next 45 years and births in the 50 poorest nations are estimated to rise by 228%. Education and improved health for women and access to contraception are vital. Smaller families are healthier families and improve the prospects of each generation. 201 million couples do not have access to contraception and if they could practice family planning, 22 million abortions, 142,000 pregnancy-related deaths, and 1.4 million infant deaths each year could be prevented. Since 1994 more women have access to education and other rights, and more early-marriage traditions are being opposed. Most countries have laws prohibiting violence against women, female genital mutilation, and other violations of human rights. doclink

End to Population Growth: Why Family Planning is Key to a Sustainable Future

April 13, 2011, The Solutions Journal

by Robert Engelman ... We are far from a world in which all births result from intended pregnancies. Surveys show that approximately 40% of pregnancies are unintended in developing countries, and 47% in developed ones.

Over 20% of births worldwide result from pregnancies women did not wish to occur.

It is estimated that 215 million women in developing countries are sexually active, but don't want to become pregnant; in other words, they have an unmet need for family planning. For various reasons they are not using contraception.

If all births resulted from women actively intending to conceive, fertility would immediately fall slightly below the replacement level; world population would peak within a few decades and subsequently decline.

It is not expensive to help all women to be in fully control of the timing and frequency of their childbearing. The key obstacles are religious, cultural, and political opposition to contraception or the possibility of population decline.

More research and a public better educated about sexuality and reproduction could engender a global social movement that would make possible a world of intended pregnancies and births. doclink

End of this section pg 1 ... Go to page 2 3
End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

10 Things America Does So Much Worse Than Europe

July 11, 2015, Salon   By: Alex Henderson

1. Lower Incarceration Rates

2. Less Violent Crime Than the U.S.

3. Better Sex Education Programs, Healthier Sexual Attitudes

For decades, the Christian Right has been trying to convince Americans that social conservatism and abstinence-only sex education programs will reduce the number of unplanned pregnancies and sexually transmitted diseases. The problem is that the exact opposite is true: European countries with comprehensive sex-ed programs and liberal sexual attitudes actually have lower rates of teen pregnancy and STDs. Looking at data provided by the Centers for Disease Control and Prevention (CDC), the Guttmacher Institute, Advocates for Youth and other sources, one finds a lot more teen pregnancies in the U.S. than in Europe. Comprehensive sex-ed programs are the norm in Europe, where in 2008, there were teen birth rates of 5.3 per 1000 in the Netherlands, 4.3 per 1000 in Switzerland and 9.8 per 1000 in Germany compared to 41.5 per 1000 in the United States. In 2009, Germany had one-sixth the HIV/AIDS rate of the United States (0.1% of Germany's adult population living with HIV or AIDS compared to 0.6% of the U.S. adult population), while the Netherlands had one-third the number of people living with HIV or AIDS that year (0.2% of the Netherlands' population compared to 0.6% of the U.S.' adult population).

4. Anti-GMO Movement Much More Widespread

5. Saner Approaches to Abortion

Logic never was the Christian Right's strong point. The same far-right Christian fundamentalists who favor outlawing abortion and overturning the U.S. Supreme Court's Roe v. Wade decision of 1973 cannot grasp the fact that two of the things they bitterly oppose -- contraception and comprehensive sex education programs -- reduce the number of unplanned pregnancies and therefore, reduce the need for abortions. But in many European countries, most politicians are smart enough to share Bill Clinton's view that abortion should be "safe, legal and rare." And the ironic thing is that European countries that tend to be sexually liberal also tend to have lower abortion rates. The Guttmacher Institute has reported that Western Europe, factoring in different countries, has an average of 12 abortions per 1000 women compared to 19 per 1000 women in North America (Eastern Europe, according to Guttmacher, has much higher abortion rates than Western Europe). Guttmacher's figures take into account Western Europe on the whole, although some countries in that part of the world have fallen below that 12 per 1000 average. For example, the UN has reported that in 2008, Switzerland (where abortion is legal during the first trimester) had an abortion rate of 6.4 per 1,000 women compared to 19.6 per 1000 women in the U.S. that year. And Guttmacher has reported that countries where abortion is illegal or greatly restricted tend to have higher abortion rates than countries where it is legal: back-alley abortions are common in Latin America and Africa.

Clearly, better sex education, easier access to birth control and universal healthcare are decreasing the number of abortions in Western Europe. So instead of harassing, threatening and terrorizing abortion providers, the Christian Right needs to examine the positive effects that sexually liberal attitudes are having in Switzerland and other European countries.

6. More Vacation Time

7. Universal Healthcare

The U.S. made a small step in the direction of universal healthcare when Congress passed the Affordable Care Act in 2010, but the U.S. is so backwards when it comes to health care that implementing even the modest reforms of the ACA (which doesn't go far enough) has been an epic battle. Meanwhile, every developed country in Western Europe has universal health care, which is implemented in different ways in different countries.

8.Greater Life Expectancy

9. Mass Transit Systems

10. Europeans More Likely to Speak Foreign Languages doclink

Aggressive Efforts Underway to Abolish Child Marriage in Niger by the Year 2050

October 2, 2014, AllAfrica.com   By: Priscilla Masilamani

The country of Niger has the highest incidence of child marriages in the world, with 77% of the underage girls currently married. One in three girls is married before the age of 15, according to UNICEF.

Religion, tradition and culture play a part while poverty, gender inequality and weak legislation add fuel to this violation of girl's rights.

The UNFPA in Niger has been, since 2012, aggressively carrying out ground work in raising awareness to put an end to this practice. "By carrying out strategic development and empowerment training, and by collectively engaging the community leaders and grassroots people, the UNFPA is foreseeing a future where child marriages would be completely abolished by the year 2050," says Monique Clesca, UNFPA Representative. The goal is to abolish the practice by 2050.

An eight-month educational training program for girls make them aware of the rights they have as children. "Training is provided about how their bodies work, hygiene, and also their reproductive and sexual health." said Clesca. For example, Amina, a 13 year old girl, learned that she, as a child, has her own rights. When she was forced by her parents to get married to a man three times older than her, she stood up for herself and refused to marry. She was beaten and ran away, but she did not bend to the demands of her family. Finally, she was able live in her uncle's house, where she now attends a special school, learning to read and write.

The UNFPA hopes to reduce domestic and sexual violence, maternal and infant health risks, incidence of STDs and fistula, which are all a few of the direct results of child marriage.

The UNFPA also targets the men in a program called 'The Husband School,' which brings together men from various communities to help them understand the health consequences of marrying a child.

"With the husbands being schooled, we are seeing a tremendous change in the attitude of men. Now, girls tell us that the husbands themselves willingly take them to healthcare centers. The men are waking up," Clesca said.

With success stories on the increase, Clesca hopes to see an enormous difference in the rate of child marriage in the next survey to be conducted by the UNFPA in 2017.

Clesca tells of the importance of a huge social movement to see a visible change. "We need different sectors of the community to come together at a local, national and international level to make a large, lasting difference." doclink

How Has the World Changed in the Last 20 Years?

April 7, 2014, UNFPA - United Nations Population Fund

Twenty years ago, the international community gathered in Cairo, Egypt, at the the International Conference on Population and Development (ICPD). There, 179 governments signed on to the ICPD Programme of Action, which recognizes that women, their rights and equality are global development priorities. The governments committed to: providing universal access to voluntary family planning, sexual and reproductive health services and rights; delivering gender equality and equal access to education; addressing the impacts of urbanization and migration; and supporting sustainable development.

Ways our world is different:

1. The world now has the largest generation of young people ever. Those between 10 and 24 years old accounted for 28% of the world population in 2010. The world must invest in the needs and rights of this group, supporting their access to quality health care and education, opportunities for safe paid work, and freedom from abuses such as early marriage and pregnancy.

2. The proportion of people living on less than $1.25 per day has fallen from 47% in 1990 to 22% in 2010. But growing inequality could undermine these gains. 8% of the world's population has 82% of the wealth, and over a billion people do not have access to social protections, meaningful work, or public health or education services.

3. In the last 20 years, the world's population grew by about a quarter, from 5.66 billion to 7.24 billion.

4. The population growth rate has slowed from 1.52% annually to 1.15%. We can now expect the global population to reach 9.55 billion by 2050.

5. Women are having fewer children. The average woman had about three children in 1994. Today, the fertility rate is around 2.5 children per woman. However, in 18 countries, fertility rates stand at five children or more per woman.

6. Adolescent childbearing has fallen by 50% or more in many countries. However, each day 20,000 girls under age 18 give birth and every year, there are 70,000 adolescent deaths from complications of pregnancy and childbirth.

7. Contraceptive use has increased. But between 2008 and 2012, the proportion of married women in the developing world using modern contraceptives only changed from 56% to 57%. There are about 222 million women without access to modern contraception.

8. Maternal deaths have dropped by 47% since 1994. Today, 800 maternal deaths occur every day, and the leading causes - postpartum haemorrhage, sepsis, obstructed labour, complications from unsafe abortion, and hypertensive disorders - are all preventable.1,3

9. Child deaths fell by nearly half. A major factor contributing to this decline is increased education for women and girls.

10. The number of births occurring under the care of a skilled attendant - a doctor, midwife or nurse - has grown from 56% in 1990 to 67% in 2011. Skilled birth attendance is one of the most critical ways to ensure safe delivery for both mother and child. That, along with increased access to antenatal care, emergency obstetric care and family planning services, accounts for much of the decline in maternal deaths.

11. Life expectancy has increased by 5.2 years.

12. Abortion rates have declined, from 35 per 1,000 women in 1995 to 29 per 1,000 women in 2008. Addressing unmet family planning needs would avert 54 million unintended pregnancies and result in 26 million fewer abortions.

13, 14, 15 - HIV/AIDS, SIDs, non-communicable diseases.

16. Primary school enrolment rates have jumped from 75% in 1990 to about 90% in 2010. But gender inequality still exists.

17. The global urban population rose by 1.6 billion between 1994 and 2014. More than half the world's people now live in towns or cities. But too much of this growth is taking place in slums.

18. More people are migrating than ever before.

19. The number of older persons increased from 490 million in 1990 to 765 million in 2010.

20. Record numbers of people are displaced within their countries by conflict or violence, taking a disproportionate toll on women and girls.

Much more work to be done

Female genital mutilation/cutting (FGM/C) and child marriage remain prevalent in much of the world, even in countries where these practices have been outlawed.

Gender-based violence continues to be a global epidemic. An estimated one in three women report experiencing physical or sexual abuse, most commonly by an intimate partner.

Discrimination against women continues in every society in the world, and belief in gender equality is not yet universal. doclink

Why it Takes Teens With Condoms to Encourage Family Planning in Africa

November 2013, Time magazine   By: Alexandra Sifferlin

This year, Addis Ababa, the capital of Ethiopia, will host the annual International Family Planning Conference. Ethiopia's public health facilities offer several contraceptive options. Usage has grown from 8% in 2000 to 29% in 2011. Combining family planning with immunizations, antibiotics and other health services has reduced Ethiopia's maternal and child mortality rates. Minister of Health, Catherine Gotani Hara, says that women have fewer children when they expect them all to survive.

The success of programs in Ethiopia, Rwanda, and Malawi show that even poor nations can make family planning work. Contraceptives are free at public health clinics in all three of these nations. Women tend to pick long-acting reversible and discreet contraceptives (like implants and IUDs) over condoms and pills. But clinics offer other options so users can decide for themselves which methods to choose.

Women often fear their husband's reaction, so health workers often offer birth control outside the clinic so husbands won't know that their wives have visited the program. Where men resist family planning, Ethiopia sends male mentors to their homes to help convince them. Officials in Rwanda encourage male family planning methods such as vasectomies. In Malawi, village campaigns headed by community chiefs promote family planning for couples. They include the voice and perspective of as many men as possible, including respected elders.

Some programs also focus on teens. Although many 18-year-old girls are already married with children, some national leaders fail to acknowledge that teens have sex. Ethiopian community health centers now include youth services and private offices to educate teens and offer them contraceptives. Boys even learn about family planning in primary school. Since teens may feel uncomfortable discussing sex with adults, some organizations use unconventional approaches to reach them. For example, Planned Parenthood partners with Mary Joy Aid Through Development to train Ethiopian teens as peer health promoters who can talk to other teens about sexual health issues and distribute pills and condoms.

Ethiopia's constitution makes access to family planning a woman's right, which highlights the critical role it has in that nation. Rwanda also introduced strong policies in support of family planning. It improved access to contraceptives by stocking up all public health clinics and training more family planning providers. This resulted in a 10-fold increase in contraceptive use (from 4% of married women of reproductive age in 2000 to 45% by 2010).

In Ethiopia and Malawi, health extension workers help get people to clinics. USAID helps these nations fund the Women's Development Army, which trains community mothers as extension workers. In addition to a hospital and small health center in every community, Ethiopia also staffs a health post with two extension workers. They go door to door and they host informal gatherings to promote family planning and answer questions. Before joining the Women's Development Army, Yenenesh Deresa had her first of five children at 15. Now she talks to women about family planning over coffee. She says this empowers women to make their own decisions and have safer pregnancies.

Countries that lower their fertility rates often experience an economic boost known as the demographic dividend. Family planning allows more women to work and help grow the economy. Where girls can work and support themselves, the nation has fewer dependents, thus adding to its stability. The first step is to lower fertility rates, but for young people of both genders to join the workforce, they must be trained and jobs must exist. This is mainly a problem for girls in low-resource countries since about a quarter of them get pregnant and drop out of school. Roman Tesfaye, First Lady of Ethiopia, says to become a middle income nation, girls "need to be protected from unplanned pregnancies." Zewdtu Areda, who oversees health services in her area, sees significant progress. "You can see that things are changing now for women. I am a woman, and I am a leader here." doclink

Art says: According to 2013 CIA World Factbook estimates, these three nations still have a long way to go. Ethiopia has 5.31 children per woman. Malawi has 5.26 children per woman, and Rwanda has 4.71 children per woman

Why I Work on Family Planning and Reproductive Health: Reflections on World Population Day

July 11, 2013, MSH - Management Sciences for Health   By: Fabio Castaño

In the 1960s, during Columbia's demographic transition, Fabio's Castaño's father and mother came from large families and consequently never went to college, but instead had to work hard as teens to help their families. At that time Profamilia, a Columbian affiliate of International Planned Parenthood Federation (IPPF), was helping steer the country through successful demographic transition. Fabio's mother wanted an education for her children and convinced her husband that the best way out of poverty was hard work and having a small family.

Out of their large extended family of 70-plus, Fabio was the first one to graduate from college and medical school. Fabio's two sisters also received an education. Fabio's story exemplifies how access to reproductive health and family planning in a low-income country can have tremendous economic and life-transforming impact for young people and a whole generation -- beyond the reduction in fertility and improvements in health.

On July 11, World Population Day, we observed the one-year anniversary of the London Summit and the launch of the FP2020 initiative. The momentum for voluntary family planning and reproductive health is growing, However, globally more than 200 million females still have an unmet need. Many of them are adolescents.This unmet need leads to unintended pregnancies and unsafe abortions.

This unmet need can be met through quality family planning and reproductive health (FP/RH) services. innovative public/private partnerships and high impact, evidence-based interventions, such as through integrating FP/RH with adolescent health and maternal, newborn, and child health services and HIV services, implementing community-based FP, encouraging healthy timing and spacing of pregnancy, and by ensuring contraceptive security.

MSH - Management Sciences for Health - has over 40 years of experience in bolstering the capacity of local partners to dramatically expand community-based care, especially key maternal, neonatal, child health, adolescent, and family planning services. MSH has been actively engaged in helping end child marriage, such as through promoting equal access to health care for women and girls in more than 135 countries for over four decades.

Choosing to have a small family-and having access to quality family planning services and information-can lead to a multitude of positive effects for people's health, education, and economic safety. doclink

DKT International's Social Impact Entrepreneurs Are Transforming Family Planning

April 25, 2013, Business Wire

DKT uses social impact entrepreneurship as a tool to sell condoms and other contraceptives and provide reproductive health and family planning services, through innovative marketing and distribution channels, including the Internet, social media sites, midwives, clinics, drug and grocery stores. This approach differs greatly from traditional nonprofits by providing goods and services as normal commercial purchases that offer consumers a benefit at an affordable price.

In its most recent fiscal year DKT's $130 million in total revenue was balanced by an equal amount spent on programs, with approximately 70% of program costs recovered through sales. The balance of revenue comes from donors, and DKT's revenue generating models greatly leverage donor funds. It's an entrepreneurial model that works. In 2012 DKT programs prevented an estimated 8.2 million unwanted pregnancies, 1.7 million abortions, and more than 14,000 maternal deaths.

Christopher Purdy, Executive Vice President of DKT International says: "Our strategy depends on recruiting high performing people who are true social impact entrepreneurs. Many country directors have undergraduate or advanced business degrees, and some have served in corporate marketing or business capacities before joining us. They direct a field staff of 1,800 people and have wide autonomy to make decisions quickly."

DKT International's use of social marketing for reproductive health products and services builds contraception and family planning demand through mass media and non-traditional messaging that reduce social stigma and target all socio-economic groups. Each country director runs his or her custom-tailored, culturally appropriate program designed to reach the maximum number of people in each market segment.

"Our directors use new approaches in countries where tradition, religious restrictions, government censorship and politics complicate their task," Purdy added. "By providing people with an essential service that they value, and can afford, our country directors create real momentum for social change." doclink

According to Wikipedia, DKT International is Washington, D.C.-based; was founded in 1989 by Phil Harvey and operates in Africa, Asia, and Latin America. In 2012, DKT sold over 600 million condoms, 76 million cycles of oral contraceptives, 16 million injectable contraceptives and 1.5 million intrauterine devices (IUDs). This is equivalent to 25 million couple years of protection (CYPs), making DKT one of the largest private providers of contraceptives in the developing world. The average cost per CYP was less than US$3.00. Charity Navigator has given DKT a four-star financial rating, with 98.3% of its budget going towards programs and 1.6% towards administration and fund raising in 2010.

Thailand: Thai Restaurant Offers Family Planning Advice with Meals

December 20, 2012, Times of India

Cabbages and Condoms Restaurant Years ago former politician and activist Mechai Viravaidya popularised condoms, family planning and AIDS awareness in Thailand and helped establish a restaurant called Cabbages and Condoms where condoms are distributed along with the bill. Eventually six such restaurants were established across the south east Asian country.

Now the idea has been brought over to the UK with the new restaurant in Bicester, Oxfordshire, leading the way with all profits from merchandise sales donated to charitable causes in Thailand.

Diners are given leaflets on protective sex at the end of the meal and even encouraged to buy condom-themed merchandise. The new restaurant even has the slogan 'and remember our food is guaranteed not to cause pregnancy.'

The name of the eatery refers to the idea that people should buy condoms alongside everyday mundane items such as cabbages.

Diners at the new restaurant will get the chance to sample traditional Thai food 'in a cosy atmosphere.' Later they are urged to buy unusual condom-themed merchandise such as mugs, keyrings and books and even a mascot made out of the contraceptive. doclink

Karen Gaia says: I have eaten in the Bangkok Cabbages and Condoms. It is a very nice restaurant with a fun gift shop to browse. Thailand's fertility rate is 1.58 and it's population growth rate is 0.6% and still declining.

Niger: Traditional Chiefs Sign Landmark Commitment

November 26, 2012, Reproductive Health Supplies Coalition

In a forum organized by UNFPA Niger, 80 traditional chiefs have signed a statement of commitment to raise awareness of the crucial inter-relationship between literacy, education and reproductive health. The high turnout included three influential Emirs of Niger - the Sultan of Zinder, the Sultan of Dosso, and the Sultan of Matame.

The Declaration is committed to highlighting family planning, to all children receiving at least secondary school-level education, and to the need to end child marriage. It also recognizes the inter-relationship between demographic growth, development and poverty, and calls for boys and men to be involved in reproductive health issues, modelled on the "Husbands' School", a strategy to involve men in health promotion and foster change at community level. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

'One Key Question' to Revolutionize Reproductive, Public Health

August 26, 2015, Public Health Newswire

In Oregon there is a movement where doctors ask every woman of reproductive age "Would you like to become pregnant in the next year?" The movement is called One Key Question.

The Oregon Foundation for Reproductive Health (OFRH) believes this question "triggers a doctor-patient discussion that will keep women healthier, help eliminate health disparities and save taxpayer dollars."

The goal is to ensure that more pregnancies are wanted, planned and as healthy as possible.

This question brings pregnancy intention screening and preventive reproductive health directly in to primary care. It opens the door to providing either preconception, prenatal or contraceptive care in a novel fashion that goes beyond simply asking if she is pregnant or using contraception. One Key Question is a conversation starter, not a checklist. It can initiate a genuine conversation that empowers a woman to plan her health care needs in support of her goals for herself and her family.

OFRH tested many variations of asking about prenatal care and pregnancy prevention before determining this question to be the most effective. Clinicians implementing One Key Question have found that the majority of women have a clear opinion about whether or not they would like to become pregnant in the next year.

However, when a woman answers "maybe" or "I don't know," One Key Question often effectively leads to identifying urgent health needs that may otherwise go undetected - such as depression, violence in the home or substance abuse - and leads to negative pregnancy outcomes.

Women are relieved to be able to talk about their reproductive health needs in a primary care setting rather than through a separate appointment with a specialist. This more streamlined approach can be invaluable for low income women, women of color and those in rural communities, in particular, who have decreased access to reproductive health care.

OFRH is very aware of the need to establish reliable systems for measuring the impact of One Key Question as it is implemented in sites nationwide.

Ultimately, because One Key Question encourages women to obtain preconception care, we expect to see a drop-off in public health care costs as earlier identification and management of conditions such as diabetes and hypertension improve pregnancy, delivery and post-natal care and lower long-term costs for all women, but particularly for those with decreased access to specialized care. doclink

Karen Gaia says: After I gave birth to my first child 50 years ago, my doctor asked me if I wanted to get pregnant right away. Of course I said 'No'. That's when I was introduced to contraception. In Bangladesh, the health care worker tells the pregnant woman to come back after the birth and when she comes back, she is offered birth control to space her pregnancies. That is how Bangladesh lowered its fertility rate so quickly.

At Niger's School for Husbands, the Lesson is 'Space Your Children'

August 13, 2014, NPR National Public Radio   By: Marc Silver

Niger is a country that depends on agriculture, but since much of it is a desert, it has only a limited amount of land that can be farmed. This is a problem for a country that has the world's highest birthrate -- more than seven children per woman on average. It's current population will double in 20 years at that rate.

The United Nations Population Fund began the school for husbands program in 2011 to help bring down the birth rate. In different communities, men meet twice a month, under a tree or in an open-air classroom, to talk about maternal health and contraception.

In this society you have to convince the men that it's OK because that's how the decision is going to get made.

Contraception is fairly controversial in Niger so much of the time they talk about child spacing. In Niger, you're a big man if you have a big family, yet this is becoming a huge problem. Even the president talked about it being shameful this month for people to have 20 kids if they're not able to feed them.

The government is going to make contraception available in all the health clinics and get the word out that not only is it OK for women to use contraception but that they should be using contraception. Male condoms, female condoms, IUDs, injections, the pill will be available. In fact they are now available.

Younger men are expecting a smaller family than previous generations. So that change is happening.

There is also a push to have women get married later, not at 12 or 13 or 14 but in their late teens, early 20s. That shortens the period when they would be having children. In one case a girl went to court to stop her family from forcing her to marry her uncle in Nigeria. Ultimately, she was successful.

Infant mortality is going down, so kids are surviving longer. But people don't yet understand that they don't need to have as many kids because most of the kids are now going to survive to adulthood. doclink

How Bangladesh's Female Health Workers Boosted Family Planning

Contraception delivered through female community health workers has helped to reduce birthrates and infant mortality
June 6, 2014, Guardian   By: Kenneth R Weiss

This interesting article is somewhat long but worth reading in its entirety (by clicking on the link in the headline), so here is the gist of it:

Bangladesh established Matlab -- an experimental village -- in the 1960s and there trained a cadre of female community health workers who have been carefully maintaining one of the longest-running and most detailed health and population data sets in the developing world.

These health care workers make house calls to administer child and maternal health and are widely credited for demonstrating how poor Muslim women with little or no formal education can plan their families.

Ubaidur Rob, the non-profit Population Council's Bangladesh director said "Women were employed as field workers in the 1970s, when fertility was very high and female employment was virtually zero. This is where change began."

In the mid-70s researchers divided 149 villages into two groups. One half participated in the Matlab centre's maternal and child healthcare initiatives, including home delivery of modern contraceptives, while the other had access only to government services.

At that time, contraception was denounced by Islamic clerics. Dr Mohammad Yunus, who ran the Matlab centre for nearly 40 years said that what worked "was a comprehensive doorstep service with trained female health workers making regular follow-up visits to help mothers pick a method of contraception that was best for them, treat side-effects and provide basic maternal and child healthcare."

In the Matlab half, married women were more likely to use contraceptives and, over time, had an average of 1.5 fewer children than their counterparts in the comparison area. Their children were healthier, fewer women died of pregnancy-related causes, and child mortality fell. Parents accumulated more farmland, built more valuable homes and gained access to running water. Their children stayed in school longer, and women enjoyed higher incomes.

By the early 80s, when other areas using the Matlab approach had experienced a similar increase in contraceptive use, the government trained tens of thousands of female health workers using the Matlab model.

Since then, average birthrates have fallen from six children a woman to slightly more than two; projections for Bangladesh's population in 2050 (currently 160 million) have dropped from 265 million (forecast in 2000) to 200 million, and stabilizing soon after. Also Bangladesh has become one of the first impoverished countries to meet the UN millennium development goal of reducing child mortality by two-thirds. doclink

Karen Gaia says: one of the things that helped this program work was that new mothers were asked to come back after the baby was born, and during that visit, were asked if they wanted to have another baby soon. If the mother said 'No', the health care worker was prepared to give here one of an assortment of contraceptives.

Nigeria: Bundling Child Spacing and Immunization Into One Integrated Service

TSHIP Advancing Health in Bauchi and Sokoto Targeted States High Impact Project
October 9, 2013, Vietnam News Agency

Child spacing is a crucial aspect of improving the overall health of women in developing countries - helping to reduce unwanted pregnancies and the health risks associated with giving birth to many children. For children under-five years, a critical live saving measure is immunization.

Bundling these two services together as TSHIP is doing provides a continuum of care - from child spacing, antenatal and postnatal needs of women to the care of children under-5 years.

Raising awareness of child spacing is a tricky issue, especially in communities where conservative values are still strong. In an area of Sokoto such "cultural sensitivity" has been softened by making it a community-led exercise. The members of the WDC help start the needed dialogue at the community level, bringing health education and the issue of child spacing to locations as diverse as markets, gathering places and even places of worship.

Another approach is the practice of holding child spacing education at the same time as immunization or antenatal services in health facilities. This takes less time and money, with local people keen to make the most of the health services offered. Maryam Umar, a worker at the Shuni dispensary, said 'I provide immunization and child spacing services to women when they bring their children for immunization, because of fear that the women will not come back on the child spacing session day. Some will even report us to the WDC if we do not provide them with all necessary services'.

The changes in Shuni are just a small drop in the sea of change happening in Sokoto. The state has over 70% of its health facilities holding integrated child spacing and immunization sessions. As more women bring their children for immunization, the opportunity to reach these women with child spacing messages and services has equally increased.

TSHIP = Targeted States High Impact Project: increases the use of health services and strengthens health systems to be more responsive to the basic health needs of households in Northern Nigeria doclink

India: Family Planning After Childbirth Is Critical to Women's Health

April 15, 2013, Impatient Optimists

In India, Anita Devi had five children in nine years of marriage; three of her children were born within a year of each other. As part of India's postpartum family planning effort, the nurse-midwife encouraged Anita to choose contraception after the birth of her fifth child. Anita chose intrauterine contraception.

"My mother-in-law was against any form of contraception," Mrs. Devi explained when asked about her previous births. "Though my second child was a son, she said that I should try for more sons. But my next children were girls. I was tired and felt I had nothing left in my body."

In Bihar province, families have on average 3.7 children, and only 32.4 percent of women use any family planning method.

With the support and technical expertise of Jhpiego (affiliate of Johns Hopkins University) and under the PPFP (Post Partum Family Planning) initiative supported by the Bill and Melinda Gates Foundation, India's nurse-midwives are educating and counseling women about their family planning options during antenatal visits and introducing them to the intrauterine contraceptive device (IUCD). This long-acting method lasts for 10 years and can be inserted within 48 hours after giving birth. 16 states are participating in the program.

She has seen firsthand the challenges women and their families face when burdened with too many children, often struggling to provide them with food and clothing. "Only if we have smaller families will we be able to have healthier families where the children will get better nutrition and opportunities to educate themselves. Only then can we ultimately have a better and healthier society." doclink

South Sudan Women Choose Family Planning, Longer Lives

November 8, 2012, Voice of America News   By: Hannah Mcneish

South Sudan has been cut off for nearly 50 years by Africa's longest running civil war, and, due to a lack of basic health and education, early marriage, and a culture that values big families have led to alarming child mortality rates, has seen the highest maternal mortality rate in the world. The average woman has seven children and at 1.7%, South Sudan has one of the lowest contraceptive availability rates in the world, plus early pregnancy has increased from one-fifth to one-third of teenagers in recent years.

Now newly-independent South Sudan has been building a health service from scratch with the help of international aid agencies and South Sudanese women are getting the chance to improve their chances for a long life. South Sudan hopes to increase the contraceptive availability rate to 20% by 2015, as the new nation's population grows at three percent a year and it struggles to get a grip on providing basic services. Family planning charity Marie Stopes International (MSI) started programs in South Sudan's three southern states.

One woman is getting a hormone implant that will space her children and give her a five-year break. Another woman has a husband earning a paltry and irregular salary, and she is determined to educate her children in a hope that one may someday lift the family out of poverty.

Over 80% of South Sudan women have no education and 16% are married off by the age of 15.

A clinical officer Jude Omal at one of the clinics said, "When we were beginning, we had a lot of resistance as people think when you provide family planning to a mother, or a lady of reproductive age, she may most likely turn into a prostitute. You say 'no, these services helps her to have children at a time when she thinks she's ready,' so this family planning is like an empowerment to women and girls of reproductive age."

He said both men and women are increasingly aware about the links between a quick succession of pregnancies and lack of health care to high instances of maternal mortality. doclink

Solutions to Poverty, Population Growth, Global Warming

September 19, 2012, Los Angeles Times

Experts from three continents convened last week at UC Berkeley to discuss rapid population growth, climate change and other intractable problems. Before the conference, the Los Angeles Times held an online video discussion with some of the conference attendees.

The article in the Los Angeles Times newspaper explored such issues around the world in its recent five-part series on population growth in the developing world. Among other topics, the "Beyond 7 Billion" series examined chronic hunger and mass migration in East Africa -- trends that Dr. Malcolm Potts believes will soon extend across the Sahel, an arid region of Africa just below the Sahara desert.

Malcom Potts, a UC Berkeley professor of public health who co-organized the conference said, "What you've been seeing from Somalia is going to happen in all those countries, all the way across from the Red Sea to the Atlantic Ocean." .. "You've just seen a fraction of what's going to happen in the next 10 or 20 years." The goal of the online broadcast before the conference was to discuss solutions to the problems facing this part of Africa and other impoverished nations with soaring populations. He was joined by Dr. Ndola Prata of UC Berkeley, William Ryerson of the Population Media Center and Fatima Adamu from Usmanu Danfodiyo University in Sokoto, Nigeria. Kenneth R. Weiss was the moderator.

Dr. Potts: The Sahel is dry dusty region in Africa which is affected by climate change and has rapid population growth, and the status of women is low. It is where there are many cases of drought and famine. Other areas are also in trouble: Afghanistan will double by 2050; people there are growing poppies instead of food. Child brides are a problem in both areas.

Dr. Prata: Women need control over number and timing of their births; Over 200 million women don't want to have a child in the next two years or don't want to have children at all. They need access to family planning. Family planning is very cost effective and has a beneficial impact on maternal and child mortality. Women want to be able to send their children to school, and family planning helps this.

Ryerson - Only 1% of people who don't use contraception cite lack of availability as the reason. 40% of non-users cite religion, husband, or personal, 17% want as many children as possible, a sizable number cite fear of side effects, and another large number are fatalistic - 'God will determine how many children I have'. We must be very careful to avoid cultural imperialism. What is important is people's perception of what is normal. This can be changed. Population Media Center uses serialized entertainment mass media featuring role modes of various types of people. PMC models behavior such as delaying marriage and childbearing until adulthood, prevention of HIV, spacing births, and communication between husbands and wives concerning health and number of children. Of those who were interviewed, 67% of clients of a family planning clinic gave the PMC radio show as the reason for patronizing the clinic.

Dr. Adamu - Agrees with the need to give women information and the culturally sensitive way that is needed to introduce these issues. There must be no coercion of any kind. Every woman wants to improve her life. It is important for the woman to have information of where to get services. The majority of our women lack basic information. We must invest in the woman and empower her. Many times religion allows women to space their births.

Dr Potts: The best contraception is 'what the woman wants'. Even illiterate women can get family planning. A woman in the poorest countries have a 1 in 12 chance of dying in childbirth compared 1 in 5,000 for a developed country. Family planning could prevent most of these deaths. The current cost to Americans for international family planning funding is the cost of one hamburger. To provide adequate family planning and reproductive health for all the women who have an unmet need, it would take the cost of two hamburgers. It is shameful that we let so many women die for the cost of a hamburger. And what we avoid by family planning is the great cost of war and the cost of feeding so many people.

Dr. Potts: Education has been considered one of the best contraceptives, but in the Sahel the population is growing so rapidly that schools cannot keep up. But education is not absolutely necessary. The women in Bangladesh were illiterate when they reduced their fertility rate so quickly.

Dr Prada worked in Angola where the birth rate was 5 children per woman. Women want to improve their lives; they want to send their children to school; they want to feed their children. A family planning program will educate to allow women to make the best use of contraception. It is difficult to get contraception on a regular basis. Many want a long-acting injection but all they can get are condoms and pills. Dr. Prada suggests couple counselling before marriage.

Dr. Adamu: Too many girls get married early. We must delay those marriages. The government must be working on poverty reduction and saving the woman's life. Let us not approach it in terms of 'population control' but more for saving lives. No husband wants his wife to die. Dr. Adamu works with adolescent mothers - some are age 12. They work in peer groups and involve the husbands and mother-in-laws. Giving them information on how to control their reproduction and get health care - and that there is a choice - empowers them and gives them the self-esteem to choose the number and the spacing of their children.

Dr Potts: If you respect women and give them a choice, they will tend to have fewer children.

Ryerson: Coercion is a terrible idea. However we must still realize that population is a key threat posing a real threat to human survival. Yet the U.S. Congress tried this year to stop all funding for international family planning.

Dr Adamu: We have to understand the woman in the village where her respect lies in the number of children she has. There is still the question of how many children will survive, and so she values having many.

Ryerson: People need to know that children will survive. Infant mortality rates are continuing to come down, but knowledge of that lags. Part of education must include the health of infants and ways they can survive.

Dr Prada: The desired number of children does come down. Often the number of children a woman has is below the number she said she desired.

Ryerson: The U.S. is not immune to population problems. It has the third largest population in the world and the highest per capita energy consumption. It promotes endless growth which is not possible. We need a whole new paradime for our economy. doclink

U.S.: Early, Adequate Prenatal Care Linked to Healthy Birthspacing

March 1, 2012, Guttmacher Institute

The findings of a study called "Prenatal Care and Subsequent Birth Intervals," by Julien O. Teitler, "provide strong evidence that earlier and more intensive exposure to prenatal care during a first pregnancy is associated with more optimal spacing and thus, most likely, better fertility control."

The authors used birth records from New Jersey women who had a first birth between 1996 and 2000, and examined the relationship between the timing and adequacy of prenatal care prior to a woman's first birth and the timing of her second birth. Most women (85%) had initiated prenatal care during the first trimester. However, 12% of women had initiated prenatal care in the second trimester, and 3% in the third; fewer than 1% had had no care. The later prenatal care was initiated, the more likely women were to have had a second birth within 18 months. Additionally, the likelihood of having a second birth soon after the first was greater if women had had inadequate rather than adequate prenatal care.

The authors suggest that providers should take advantage of their encounters with women who initiate prenatal care later in pregnancy in particular, to ensure that these women receive family planning information and services during their prenatal visits. By doing so, providers could bridge the gap left by funding and service cuts to the family planning program; the potential impact on public health is large. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Infant Mortality and Birth Rates

It has been shown that providing reproductive health care, lowering the infant mortality rate and the maternal death rate have had a positive correlation to reducing birth rates. In the case of infant mortality, when a women thinks that many of her children will not survive childhood, she wants to have extra children as insurance that she will have enough children. When death rates are high, as in the case of HIV/AIDS, families try to have more children to replace family members who will die, even if the result is a growing population. Women who are given attention in basic health matters begin to see themselves as more than just baby machines, and they gain more respect for their own lives. Then they can look beyond birthing babies and see themselves in other ways: as income-earners, as community workers, as valuable human beings who do not have to produce babies to show their worth. doclink

Bill Gates - Saving the Lives of Children Reduces Population Growth

November 2010, Bill Gates at a TED (Technology, Entertainment, Design) conference

While most of us assume that saving the lives of children will contribute to overpopulation, Gates said the contrary is true. "The key thing, the most important fact that people should know and make sure other people know: As you save children under 5, that is the thing that reduces population growth. That sounds paradoxal. The fact is that within a decade of improving health outcomes, parents decide to have less children."

"As the world grows from 6 billion to 9 billion, all of that population growth is in urban slums," he said. "Slums is a growing business. It's a very interesting problem."

He said no matter what we care about-the environment, schools, nutrition, conflict-the issues are insoluble at 3 percent population growth per year. "Nobody can handle that type of situation, so the best thing you can do is avoid those deaths." doclink

Karen Gaia says: There are people who twist this very concept into accusations that Bill Gates is practicing eugenics with his vaccine. See http://www.voltairenet.org/article164347.html In fact, it has been long known that reducing infant deaths by any means (treating diarrhea, and pneumonia, for example), have made mothers more confident about, and desirous of, having fewer children.

August 28, 1999, Werner Fornos

It is well-known that high infant and child mortality in poor countries, where 97% of world population growth occurs, is a principal reason that women in less developed regions give birth to two and three times as many children as do women in industrialized regions.

Women in poor countries tend to believe that the more children they have, the greater their chances that the number they actually want will survive. It is a tragic commentary on the health risks to infants and children in developing regions, among them: births too closely spaced, air and water pollution, lack of nutritious food and a shortage of medical supplies and personnel. doclink

Impact of Child Mortality and Fertility Preferences on Fertility Status in Rural Ethiopia

July 9, 2005, East African Medical Journal

Child mortality is an overwhelming factor in determining fertility among rural Ethiopian women. According to a study conducted by physicians among over 1100 Ethiopian women, those who were older when they married and had their first child tended to have fewer children.

Moreover, women who did not lose children in infancy had far lower fertility rates than those who lost one or more children. doclink

Report Ranks U.S. Last Among Developed Countries for Maternal Health

May 7, 2015

An annual report by Save the Children provides a global ranking of the best and worst countries for maternal health and other motherhood-related measures, Time magazine reports. In addition to maternal health, the report considers economics, education, children's well-being, and women's political status.

Averaging all measures, the U.S. ranked as the 33rd best country for mothers out of 179 surveyed countries, down from 31st the previous year (2014). But on maternal health the U.S. ranked 61st. One per 1,800 U.S. women experience a pregnancy-related death, 10 times the rates for Austria, Belarus and Poland. What's more, U.S. infant mortality (death of baby within the first year) is 6.1 per 1,000 live births. (compare to 2.13 in Japan). Washington, D.C. had the highest infant mortality rate among the 25 surveyed capitals of high-income nations, and some U.S. cities -- including Cleveland and Detroit -- had even higher rates. Time magazine correlated high infant mortality with premature births, inadequate prenatal care, low incomes, education, race, age and marital status. doclink

Recognize Effective Ways to Save the World's Children

November 23, 2013, Durango Herald

Two of my recent columns dealt with child deaths. The sad fact is that, worldwide, 19,000 children die every day - mostly in poor regions, and mostly related to inadequate nutrition.

The first column (Herald, Aug. 25) told the story of two boys I took care of in Nicaragua when I was in medical school. Miguel hadn't been fed enough protein and recovered with good food. Van was just skin and bones, and died from starvation.

The second article (Herald, Oct. 27) mentioned that there is hunger in the United States. Our country doesn't have a universal safety net to catch people in need.

Sending food to poor countries does not help in the long run because it increases people's dependence. Indeed, well-meaning people may do more harm than good. This is made clear (in a religious context) in the book When Helping Hurts. It points out that many actions that might seem helpful have the opposite effect.

Unfortunately, despite the best of intentions, transferring technology from rich to poor countries can have bad effects. Supplanting breast-feeding with artificial formula is a good example. Contaminated water may be used to mix the formula, and poor parents cannot afford to buy the formula after breast milk has dried up.

Nepal, where villages had an epidemic of deaths, provides another example of unintended consequences. Metal cookware appeared to be a boon to the Nepalese because food cooked more rapidly than in old-fashioned earthenware pots. This meant less denuding forests for firewood and less smoke from cooking fires. But it also meant that pork wasn't uniformly well-cooked. Pork tapeworms lodged in people's brains and killed them. Fortunately, cooking pork adequately can prevent this disease, cysticercosis. Sanitary toilets are also important in separating human waste from pigs. We must try to foresee and prevent unintended consequences when trying to help others.

There are many examples of programs that are very effective in reducing child deaths. Brazil, which has experienced a remarkable transformation, is one.

Nancy Scheper-Hughes first went to a favela (Brazilian shanty town) in 1964 as a Peace Corps volunteer. She is now a professor of medical anthropology. Her article "No More Angel-Babies on the Alto" is available at: http://clas.berkeley.edu/research/brazil-no-more-angel-babies-alto.

Nancy found that many babies in the favela died, and she was shocked that their mothers didn't grieve their deaths. The average woman gave birth to eight children, of whom almost half died. One woman put it this way: "Why grieve the death of infants who barely landed in this world, who were not even conscious of their existence?"

When Nancy returned to Brazil recently she was surprised to find that the under-5 death rate in that same city had decreased from 110 to 25 per 1,000. How had this radical drop been achieved? She cites several factors. Brazil's president's wife was a strong advocate for women's rights. They started a system of care for all, including "barefoot doctors" to identify children at risk. The "zero hunger" campaign provides food for the most vulnerable. Safe water supplies and prenatal clinics improved the health of pregnant women. Women's literacy is a universal theme in social change, especially for improving child survival.

Along with the decrease in child mortality has come an amazing decrease in family size. The average number of children a Brazilian woman will bear is 1.8 - fewer than in the U.S., and less than replacement. Each child born can be expected to live to adulthood and is therefore valued from birth. This favela has gone through the demographic transition in less than 40 years!

What is the difference between good aid programs and not so good? The best programs tune in to what the local people want rather than imposing agendas that are not culturally sensitive. They are sustainable - meaning that the aid recipients will be motivated to maintain the work with little or no help from donors.

Back to Nicaragua. People there are still impoverished; it is the second poorest country in the Western Hemisphere, with 80 percent living on less than $2 per day. Less than 40 percent of people in rural areas have improved sanitation. Fortunately, the country is receiving sustainable assistance. El Porvenir (a nonprofit organization) partners with rural Nicaraguans to build sanitation and pure water infrastructure and protects the water supply through reforestation. Their school hand-washing facilities make kids healthier and increase school attendance by 20 to 30 percent!

These improvements have raised the standards of living and health. Better-educated women have healthier and fewer children. Development has helped Nicaraguans in many ways, including reducing the average number of children a woman has from seven when we visited in 1968 to just 2.6 now.

Note: this article was first published in the Durango Herald doclink

Kenya's Maternal Death Rate May Fall Thanks to Free Services for Women

July 15, 2013, Vietnam News Agency   By: Katy Migiro

Last month Kenya began offering free maternity services for women, and some hospitals report a 50% increase in deliveries. A 10% increase was estimated around the country. However Kenya will not meet the MDG of a 75% drop in deaths between 1990 and 2015. Giving birth with the help of a trained professional is critical for reducing maternal mortality, but 56% of Kenyan women give birth at home. 42% reported that services were too far away or there was no transport, 20% said it was unnecessary, 19% said that their labour was too quick to have time to get there, and 17% said services were too expensive.

Wambui Waithaka, a doctor at Nairobi's Pumwani maternity hospital said the government is giving the hospital extra money each week to buy the things they need to treat patients. However, in Pumwani, there is a shortage of incubators.

The next step is to educate women about their care. "The most critical thing in improving maternal health is educating the woman herself and the community around her," said Waithaka. "If she doesn't know that her labour is going a dangerous way, we are not going anywhere."

Almost 28% of women give birth at home with the assistance of traditional birth attendants, the same percentage as are helped by a nurse or midwife. The region where the use of traditional birth attendants is highest - at 64% also has the highest maternal mortality rate, twice the national average.

In Kenya, 43% of pregnancies are unwanted due to limited access to contraceptives, poverty and high rates of sexual violence. Unsafe abortions account for 35% of maternal deaths compared to the global average of 13%. Rich women easily access safe abortion in private facilities. But the poor and uneducated risk their lives using backstreet doctors as government hospitals are reluctant to treat them.

A high proportion of maternal deaths are among adolescents. Shahnaz Sharif, the government's director of public health and sanitation said. "They tend to hide their pregnancies. They don't come to the clinic," ... "Or they'll go for abortion." Teenagers also tend to have more complications because their bodies and minds are not ready to give birth. doclink

3 Unexpected Ways to Improve Food Security in Sub-Saharan Africa

July 31, 2013, World Resources Institute - WRI   By: Tim Searchinger and Craig Hanson

Sub-Saharan Africa would need to increase crop production by 260% by 2050 in order to feed its projected population.

The UNs' new population growth projections say that the world will reach nearly 9.6 billion by 2050. Unless we control dietary shifts to more meat and reduce food loss and waste, the world will need to produce about 70% more food by 2050 to meet global demands. Plus we would need to do this without converting millions more hectares of forests into farmland if we don't wish to contribute to more climate change.

The population of Sub Saharan Africa is expected to more than double by 2050 and quadruple to 3.9 billion people by 2100. Even today FAO says that over 25% of Sub-Saharan Africa's people are undernourished, and the region already imports roughly 20%of its staple calories. Yet Sub-Saharan Africa has the world's lowest grain yields and extensive areas of degraded soils.

One way to help meet the food challenge would be to hold down population growth.

Most of the world's regions have already achieved or are close to replacement level fertility, but Sub-Saharan Africa has a total fertility rate was 5.4 children per woman - double the fertility rate of any other region. While the regions fertility rate is projected to decline to 3.2 by 2050, this is not enough to avoid the large projections of population growth.

Go to the link in the headline to see the interactive maps.

What can be done?

*Increase educational opportunities for girls. In general, the longer girls stay in school, the later they start bearing children, and the fewer children they ultimately have. In countries where 80-100% of the women have attained at least a lower secondary education level, total fertility rates are around 2.1

*Increase access to reproductive health services, including family planning. Millions of women want to space and limit their births, but do not have adequate access to reproductive health services. The World Health Organization (WHO) found that 53% of women in Africa who wish to control their fertility lack access to birth control, compared with 21-22 percent in Asia and Latin America.

*Reduce infant and child mortality. Reducing infant and child mortality assures parents that they do not need to conceive a high number of children in order to assure survival of a desired number. Better health care, sanitation, and food will accomplish this.

Botswana has a country-wide, free system of health facilities that integrates maternal and child healthcare, family planning, and HIV/AIDS services. Mortality rates for children under five declined from 81 per 1,000 in 2000 to 26 per 1,000 in 2011. Contraceptive use increased from 28% in 1984 to 53% in 2007. Botswana has long provided free education to all, and still exempts the poorest from school fees, resulting in an 85% literacy rate and a rate of 88% of girls enrolled in lower secondary education. Botswana's fertility rate has fallen from 6.1 in 1981 to 2.8 by 2010.

Advantages to achieving replacement level fertility in Sub Saharan Africa:

*Gender equity will be advanced, giving people more control over life decisions, and save millions of lives.

*About 9% of the gap between food available in 2006 and the amount needed in 2050 would be closed and and the projected growth in food demand in Sub-Saharan Africa would be reduced by 25% in the same period.

*A "demographic dividend" could be achieved. During and after a rapid decline in fertility, a country simultaneously has fewer children to care for and a greater share of its population in the most economically productive age bracket. Researchers estimate that this type of demographic shift was responsible for up to one third of the economic growth of the East Asian "Tigers" between 1965 and 1990.

*Agriculture's impact on the environment would be reduced since, according to FAO projections for yield gains in the region, Sub-Saharan Africa will need to add more than 125 million hectares of cropland from 2006 levels to meet the region's projected food needs in 2050. Achieving replacement level fertility would cut that needed cropland expansion in half, sparing from conversion an area of forest and savannah equivalent to the size of Germany. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

U.S.: Calif. Assembly Passes Bill Making Pregnancy a Qualifying Event for Insurance Enrollment

June 8, 2015, National Partnership for Women and Families

The California Assembly approved a bill (AB 1102) that would make pregnancy a qualifying event to purchase health coverage through California's insurance marketplace (under the Affordable Care Act) outside of the exchange's open enrollment period. The bill would require insurers to allow individuals who do not have minimum essential coverage to enroll or change their health plan when they become pregnant.

The proposal now proceeds to the state Senate for consideration (AP/Sacramento Bee, 6/4).

The measure would take effect in 2017 doclink

Karen Gaia says: Health care for pregnant women is a good way to ensure the health of mother and infant, and a time to introduce effective and affordable methods for birth spacing needed for the health of future babies as well as the health and well-being of the mother and family. When these birth methods are started, it is likely they will be used throughout a woman's child-bearing years so that she can have children when she is ready, emotionally, financially, and for the good of her family.

Publicly Funded Family Planning Yields Numerous Positive Health Outcomes While Saving Taxpayer Dollars

Three New Resources Make the Case for Investing in These Services
January 16, 2015, Guttmacher Institute

In "Beyond Preventing Unplanned Pregnancy: The Broader Benefits of Publicly Funded Family Planning Services," the Guttmacher Institute's Senior Public Policy Associate Adam Sonfield provides research findings which prove that, by reducing unintended pregnancies, abortions, disease, and pre-term or low-birth-weight births, public investment in family planning can save taxpayers billions of dollars. In October, the Institute reported on the following benefits of services provided by publicly funded family planning centers in 2010 -- the most recent year for which comprehensive data are available:

• Contraceptive care helped women avert 2.2 million unintended pregnancies, 1.1 million unplanned births, 761,000 abortions and 164,000 preterm or low-birth-weight births.

• STI testing averted 99,000 chlamydia infections, 16,000 gonorrhea infections, 410 HIV infections, 1,100 ectopic pregnancies and 2,200 cases of infertility.

• Pap and HPV testing and HPV vaccination prevented 3,700 cases of cervical cancer and 2,100 cervical cancer deaths.

Congress and the President should not ignore these benefits when they set their priorities for the next two years. All told, the net public savings was $13.6 billion, or $7.09 saved for every public dollar spent. Congress must protect the Title X national family planning program and the national network of safety-net family planning centers while protecting and expanding Medicaid coverage of family planning; and breaking down barriers that deny people services

A series of fact sheets titled Facts on Publicly Funded Family Planning Services covers each state and the District of Columbia. They provide state-level policymakers, advocates, and providers with data and graphics showing the need for publicly funded family planning; the services provided by safety-net family planning centers, including those funded by Title X; the range of health benefits accrued from these services; and the costs and public savings associated with their provision.

The Institute also offers Health Benefits and Cost Savings of Publicly Funded Family Planning. This tool enables family planning centers and other end users to estimate the impact of and cost-savings resulting from publicly funded family planning services in their state or service area. It estimates by state the number of contraceptive clients served and the number of STI and cervical cancer screening tests. This data can help family planning providers looking to contract with Medicaid and private health plans, and advocates and policymakers looking to defend and expand public investment in family planning services.

The full analysis, "Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program," by Jennifer J. Frost, Adam Sonfield, Mia R. Zolna and Lawrence B. Finer, is currently available online and appears in the December 2014 issue of The Milbank Quarterly. doclink

U.S.: Is Inequality Killing US Mothers?

January 16, 2015, Truthout.org   By: Andrea Flynn

It is no surprise that maternal mortality rates (MMRs) have risen in tandem with poverty rates. Women living in the lowest-income areas in the United States are twice as likely to suffer maternal death, and states with high rates of poverty have MMRs 77% higher than states with fewer residents living below the federal poverty level. Black women are three to four times as likely to die from pregnancy-related causes as white women, and in some U.S. cities the MMR among Black women is higher than in some sub-Saharan African countries.

In terms of economic inequality it might as well be 1929, the last time the United States experienced such an extraordinary gulf between the rich and everyone else. Today 30% of Blacks, 25% of Hispanics (compared to only 10% of whites) live in poverty, and in certain states those percentages are even higher. Since 2008, the net worth of the poorest Americans has decreased and stagnant wages and increased debt has driven more middle class families into poverty. Meanwhile, the wealthiest Americans have enjoyed remarkable gains in wealth and income.

The Affordable Care Act is providing much-needed health coverage to many poor women for whom it was previously out of reach and if fully implemented could certainly help stem maternal deaths. But nearly 60% of uninsured Black Americans who should qualify for Medicaid live in states that are not participating in Medicaid expansion. doclink

U.S.: Where Immigration and Healthcare Meet

November 19, 2014, Hill   By: Shivana Jorawar

Open enrollment for the Affordable Care began for a second time last week. The number of people who take advantage of the ACA this time around is projected to be low. 9.1 million people are expected to enroll by the end of the enrollment period in February, just 1.8 million more than the number enrolled in August.

But unfortunately there has been little talk among government officials and healthcare advocates about the people locked out of healthcare because of their immigration status.

More than 10 million people have gained access to health insurance since it Obamacare began. Insurance companies can no longer discriminate against people based on a preexisting condition or charge more because of gender, and they are now required to cover prevention and wellness benefits at no charge.

112,000 people lost their ACA coverage this year because they did not verify their eligibility based on citizenship and immigration status. More than 11 million people living in the United States are ineligible for the ACA at the national level due to their immigration status.

550,000 of them are young people, often called "Dreamers," who came to the United States as children and are, at present, lawfully residing here. These Deferred Action for Childhood Arrivals (DACA) program recipients, who have been given reprieve from deportation, were explicitly carved out of the ACA through announcements made by CMS and HHS on Aug. 28, 2012, issued as federal regulations and guidance. The announcement altered federal rules for DACA-eligible people by excluding them from health insurance options available to others with deferred action status.

Immigrants work, pay taxes, and contribute to our communities and our economy. They should have the same responsibilities and opportunity to participate in health care as their friends and neighbors. Further, it's better and more affordable for all of us when immigrants can participate in the health care system their tax dollars support. Affordable health coverage improves access to preventive care, protects public health, prevents suffering, and puts less strain on under-resourced and costly emergency services. The impact of the large number of uninsured on our economy is huge. It results in a loss of $65 billion to $130 billion annually, consisting of lost wages, absenteeism, and family leave. doclink

Karen Gaia says: and the failure to cover contraception for everyone of reproductive age results in more unintended pregnancies, a higher fertility rate, and a high population growth rate.

The Case for Advancing Access to Health Coverage and Care for Immigrant Women and Families

November 19, 2014, Health Affairs Blog   By: Kinsey Hasstedt

Many lawfully present immigrants are ineligible for coverage through Medicaid and the Children's Health Insurance Program during their first five years of legal residency. Undocumented immigrants are largely barred from public coverage, and the Affordable Care Act (ACA) prohibits them from purchasing any coverage, subsidized or not, through its health insurance marketplaces.

In 2012, the administration created the Deferred Action for Childhood Arrivals (DACA) Program, enabling many so-called DREAMers to lawfully remain in the United States. Unfortunately those with DACA status are essentially treated as if they were undocumented and expressly carved out of nearly all public and private health coverage and affordability programs. Also, the immigration reform bill passed by the Senate in 2013 failed for the most part to address the legitimate health insurance and health care needs of immigrants, denying those eligible for provisional status access to public coverage and the ACA's subsidies.

Among women of reproductive age (15-44), 40% of the 6.6 million noncitizen immigrants are uninsured, compared with 18% of naturalized citizens and 15% of U.S.-born women.

Of reproductive-age women living below the poverty level (a group in which immigrant women are overrepresented), 53% percent of noncitizen immigrant women lack health insurance -- about double the percentage of U.S.-born women. Further, only 28% of poor noncitizen women of reproductive age have Medicaid coverage, compared with 46% of those born in the United States.

Only half (52%) of immigrant women at risk for unintended pregnancy received contraceptive care, compared with two-thirds (65%) of U.S.-born women.

Consistent contraceptive use is critical to helping women prevent unintended pregnancies, plan and space wanted pregnancies, and achieve their own educational, employment, and financial goals. Without coverage, immigrant women and couples may well be unable to afford the method of contraception that will work best for them, which is critical to realizing these benefits.

In addition, preventive sexual and reproductive health services are effective in helping women and couples avoid cervical cancer, HIV and other STIs, infertility, and preterm and low-birth-weight births -- all while saving substantial public dollars. Notably, cervical cancer disproportionately afflicts and causes deaths among immigrant women, particularly Latinas and women in certain Asian communities, likely because many go without timely screenings. doclink

A Closer Look: Myanmar

November 5, 2014, Family Planning 2020

The Myanmar Family Planning Best Practices Conference met this summer in the new capital of Myanmar: Nay Pyi Taw.

Everything from condom cue cards for teenagers to the finer points of IUD insertion and removal was discussed. Local OB/GYNs compared notes with technical advisors from global NGOs.

After decades of international isolation, Myanmar is rejoining the world community and embarking on modern development goals. Myanmar made a bold commitment to family planning at the 2013 International Conference on Family Planning in Addis Ababa, where country representatives vowed to halve unmet need for contraception by 2020 and to raise the contraceptive prevalence rate to 60%.

Myanmar's budget for contraceptive commodities was increased from US$1.29 million in 2012/2013 to US $3.27 million in 2013/2014. The government has begun efforts to strengthen supply chains and improve service delivery. Health providers are being trained in a greater range of contraceptive methods: state obstetricians and gynecologists are being trained in IUDs, and doctors in private networks are learning about contraceptive implants.

The Ministry of Health hosted the event, welcoming representatives from the World Health Organization (WHO), UNFPA, the Gates Institute, Stanford University, the Government of Indonesia, and Pathfinder.

The announcement of our commitment to FP2020 was an occasion of great hope for Myanmar. Access to contraception is the fundamental right of every woman and community, and we aim to expand family planning services to reach all who need and want them. This journey will not be easy, but thanks to FP2020, we have many partners around the world to help us on our way. doclink

Karen Gaia says: I repeat: I don't understand the recent emphasis on family planning in Myanmar. Their fertility rate is only 2.18. The country already has a health plan. See https://www.cia.gov/library/publications/the-world-factbook/geos/bm.html

States with More Abortion Laws Have Less Support for Women and Children's Health

October 1, 2014, Huffington Post   By: Laura Bassett

A study by Ibis Reproductive Health and the Center for Reproductive Rights found that a state's performance on indicators for women and children's health and well-being is inversely proportional to the amount of anti-abortion laws in that state. States with mandatory ultrasound laws, mandatory waiting periods and shorter gestational limits on abortion, for example, generally have higher rates of obesity, child and maternal mortality, teen births and women and children without health insurance.

States enacted more abortion restrictions between 2011 and 2013 than they had in the entire previous decade, and more than 250 anti-abortion bills have been introduced in state legislatures this year alone. These include mandatory waiting periods, counseling and ultrasounds before abortions, harsh building standards for abortion clinics, insurance coverage restrictions, gestational limits and restrictions on non-surgical medication abortions.

Most states with more than 10 abortion restrictions in effect, including Mississippi, Oklahoma, Arizona, Indiana, Florida, Arkansas, Alabama, Louisiana, Missouri and Texas, scored near the bottom.

The report considered a wide variety of indicators of well-being for women and children, such as asthma prevalence, the percentage of adult women who had received a pap smear in the past three years, drug abuse, HIV and domestic violence incidence, maternal and infant mortality rates, children receiving dental and mental health care, high school graduation rates and the number of suicide deaths among women. The report also considered policies that support women and children's health, such as whether a state had moved forward with Medicaid expansion, requires reasonable accommodations for pregnant workers and implements strong family and medical leave policies.

"This report exposes the flimsy claims of politicians who have been shutting down women's health care providers under the patently false pretext of protecting women's health," said Nancy Northup, president and CEO at the Center for Reproductive Rights. "It clearly demonstrates how women and families have suffered as politicians put their ideological agenda before the real needs of their constituents." doclink

Michael Brune, Executive Director of the Sierra Club, Makes the Connection Between Women's Reproductive Rights, Access to Health Care, and Protecting Our Environment

April 21, 2014, Why We Care Champions for Reproductive Health

Michael Brune, Executive Director of the Sierra Club, Makes the Connection Between Women's Reproductive Rights, Access to Health Care, and Protecting Our Environment

Michael Brune "saw the power of community activists who organized their neighbors into a movement, demanded meetings, wrote letters, and pressured local decision makers".

"Any relationship -- including the one we have with the natural world -- is more complicated than a child can comprehend. But as we grow to understand and accept these complications, our relationships become much richer". It requires acquiring the knowledge about the factors affecting them. "That big-picture environmental thinking is what eventually led me to appreciate the central and crucial role that family planning and women's reproductive health care play in environmental conservation".

The two things that Michael Brune learned were: "Human population is still growing at unsustainable rates in the developing world, and 222 million women who want access to voluntary family planning and contraceptives still cannot get them". He also learned this compelling correlation: "The places where environmental degradation is the worst are also the places where women's rights and opportunities are most compromised".

Societies where women are valued enables them to stay in school and have access to basic and reproductive health care. They will learn how to "responsibly manage crops, heat the home, and use water and also how to care for their own changing bodies and make choices about their reproductive destiny. Each additional year of education means they will earn more, take more interest in public life, and become more engaged in solving the problems facing their communities -- including water pollution, toxic industrial waste, and the degradation of their land".

"We cannot achieve the environmental goals we have for the planet unless millions more families have the tools they need to plan their lives so that they have better, healthier, more productive lives."

"As executive director of the Sierra Club, I am proud of our work to connect women's health and rights to the environment and sustainable development." Our Global Population and Environment Program has been working for more than 40 years to ensure that women have access to voluntary family planning, and the benefits for individuals, communities, and the planet have been far-reaching." doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

The Faces Behind the Numbers

July 11, 2015, Sierra Club   By: Michael Brune, Executive Director, Sierra Club

On World Population Day it's easy to focus on the numbers -- over 7 billion humans now sharing our planet, and 10 billion later. But it is about much more than the numbers -- it's about the needs of the people behind those statistics.

Even though it has been 20 years since the United Nations defined voluntary family planning as a basic human right, 225 million women around the world today want to plan, space, or delay childbirth but have no access to modern contraceptive methods. That means these women have little power to control their own lives or escape the cycle of poverty.

If women and families are going to gain ground economically, politically, or environmentally, we need to address not only access to voluntary family planning but clean energy access, clean water access, and the right to an education.

Helping those in need will help all of us. For instance, if we simply filled the unmet demand for family planning, the resulting reduction in CO2 emissions would be equivalent to eliminating deforestation worldwide, doubling the fuel economy of every car on the planet, or replacing every coal-fired power plant with solar energy.

We can't have a healthy planet without healthy families.

To mark World Population Day, the Sierra Club's Global Population and Environment Program has released its second POP Quiz -- https://secure.sierraclub.org/site/SPageNavigator/PRG_GP_PopQuiz_JE.html . Test your own knowledge of the connection between the health of women and families and our environment. doclink

Birth Control Isn't a 'Women's Issue' - It's An Economic Issue

July 8, 2015, Yahoo! News   By: Julia Sonenshein

Birth control is not only the biggest asset to female autonomy in modern history, it is also an economic issue that is in all of our best interests. Almost half of pregnancies in the U.S. are unplanned. Significantly reducing unintended pregnancies would save taxpayers an estimated average of $5.6 billion per year.

Giving women early access to birth control pills accounted for 10% of the narrowing in the gender gap during the 1980s and 31% during the 1990s, allowing for women to have higher lifetime incomes and education. 51% of women surveyed reported that contraception allowed them to complete their education, and 50% said contraception enabled them to work.

Women have saved a staggering $1.4 billion on birth control pills since the Affordable Care Act required insurance companies to cover birth control at no cost to the consumer, while spending on IUDs has fallen 68%.

Until recently, if your workplace chooses not to cover your birth control because of ethical or religious reasons, you were stuck paying for your contraception out of pocket, which for many could be prohibitive, even if an unintended pregnancy could be especially financially devastating.

Access to birth control is an economic necessity, and it's an issue our country can't afford to sleep on. doclink

Karen Gaia says: 1) There is hope that new rules coming from the Obama administration will provide an alternative coverage for birth control methods. 2) No sources were quoted for the statistics in this article. They could very likely be from the Guttmacher Institute

Improving Nutrition and Food Security Through Family Planning

June 2015

The goal of "Improving Nutrition and Food Security Through Family Planning" is to raise awareness and understanding among decision makers about how family planning can help improve key measures of nutrition for mothers, infants, and children, as well as improve food security on a broader scale. Ultimately, the aim is to start a critical policy dialogue to encourage integration of family planning into nutrition and food security policies, strategies, action plans, and programs throughout the world, particularly in Asia and Africa. As such, this presentation can be used as a tool to not only raise awareness, but also to mobilize political commitment and resources.

Developed under the USAID-funded Informing DEcisionmakers to Act (IDEA) project, this presentation is part of a series of ENGAGE presentations that examine the relationship between family planning and the Millennium Development Goals in developing country contexts. doclink

A Woman in Guediawaye: Family Planning for Health and Development in Senegal

April 29, 2015

The CSIS Global Health Policy Center produced a new video, A Woman in Guédiawaye: Family Planning for Health and Development in Senegal. The video follows a young woman, Anta Ba, from Guédiawaye, a poor urban area of Dakar, who explains why she decided to access family planning, despite her husband's opposition, and why these services matter for her own life and for women's health and empowerment in Senegal. Through her story, and through the voices of other champions of family planning in Senegal-government and NGO health workers, an imam, and the Minister of Health-the video illustrates new approaches to expanding access to family planning as well as the challenges ahead. doclink

U.S.: Unintended Pregnancies Cost Federal and State Governments $21 Billion in 2010

February 27, 2015, Guttmacher Institute   By: Adam Sonfield and Kathryn Kost.

A study "Public Costs from Unintended Pregnancies and the Role of Public Insurance Programs in Paying for Pregnancy-Related Care: National and State Estimates for 2010," showed that U.S. government expenditures on births, abortions and miscarriages resulting from unintended pregnancies nationwide totaled $21 billion in 2010. In 19 states, public expenditures related to unintended pregnancies exceeded $400 million in 2010. Texas spent the most ($2.9 billion), followed by California ($1.8 billion), New York ($1.5 billion) and Florida ($1.3 billion); those four states are also the nation's most populous.

51% of the four million births in the United States in 2010 were publicly funded, including 68% of unplanned births and 38% of planned births.

Prior research has shown that investing in publicly funded family planning services enables women to avoid unwanted pregnancies and space wanted ones, which is good not only for women and families, but also for society as a whole. In the absence of the current U.S. publicly funded family planning effort, the public costs of unintended pregnancies in 2010 would have been 75% higher.

Adam Sonfield, one of the authors, said. "Reducing public expenditures related to unintended pregnancies requires substantial new public investments in family planning services." ... "That would mean strengthening existing programs, such as the Title X family planning program, as well as working to ensure that the Affordable Care Act achieves its full potential to bolster Medicaid and other safety-net programs. We know we can prevent unintended pregnancies and the related costs. There are public programs in place that do it already, but as these data show, there is significantly more progress to be made." doclink

Provide Family Planning in Congo

February 21, 2015   By: Richard Grossman Md

The London Summit on Family Planning was the start of something big. If kept, an array of promises made at the groundbreaking July 11 2012 event could have a major impact on the lives of women and girls for years to come ... Susan A. Cohen, Guttmacher Institute

In a prior article I wrote about how it was possible for one doctor to perform hundreds of tubal ligations in one day-but probably not honor the rights of the patients. The next column was about putting human and reproductive rights first and foremost. Today's column focuses on one country where FP2020 is making amazing improvements in the lives of women and children.

FP2020 is the nickname of the ambitious program started in 2012 at the London Summit on Family Planning. Its goal is to reach 120 million women of the 225 million who are unable to access modern contraception, but wish to regulate their fertility. These are women in developing countries who currently have little or no access to reproductive health care. Typically they have high fertility rates and high rates of child deaths, illegal abortion and maternal mortality. Often these women are the poorest of the poor, have little schooling and are subservient to men. Many of these women live grim lives.

A very high percentage of people in wealthy countries already use family planning (FP); indeed, that is part of how we became wealthy. It is time to share that knowledge and technology with our less fortunate brothers and sisters. Unfortunately where access to FP is limited, infrastructure is also challenging-transportation, sanitation and communication are often poor. Reaching these people will be difficult.

Providing full reproductive health care for every woman in the world who does not currently have access to those services would cost a whopping 40 billion dollars annually-about the same amount as the US military spends in a month. The lives saved by such an investment would make that money very well spent, however. Reaching all people in developing countries with FP and with maternal and newborn care would prevent 79,000 maternal deaths, 26 million abortions and 21 million unplanned births each year.

The cost of providing just FP services for these people would be about nine billion dollars a year. Because moms will be healthier, improved birth spacing alone would prevent over a million infant deaths globally each year!

Funding is a major challenge for FP2020. The programs are jointly supported by developing countries and by donor (wealthy) countries. In addition, generous funding has come from foundations; the Bill and Melinda Gates Foundation is a major source of financial support as well as being a prime mover. Assistance also comes from the UN and the US Agency for International Development, among many other organizations.

One of the FP2020 programs is in the Democratic Republic of the Congo. This beleaguered country has had a miserable history of colonialism, dictators and civil war. Average income there is less than two dollars per day. Only 53 % women are literate, and only one in twenty married women uses a modern method of contraception. Indeed, a 1933 law makes contraception illegal! The average woman bears over 6 children in her lifetime and the country will double in population every 23 years-exacerbating many of its economic and political problems.

Despite these challenges, FP2020 is seeing successes in DRCongo. One project was to map existing FP resources, using a sophisticated system of data collection with cell phones. They now know where there are trained FP personnel and which pharmacies have pills or injectable birth control. Fortunately, all sites offer condoms.

Women in DRCongo have been relying on traditional methods of FP for years, with too many unintended pregnancies-more than a million in 2013. Contraceptive implants (such as Nexplanon©) were introduced in 2014 with great success. So far, the program has recruited almost 200,000 new users of modern contraception.

What FP2020 has meant to women in DRCongo is telling. More than 300,000 unintended pregnancies were averted in 2013. Calculations suggest that 1481 women's lives were saved, and 76,000 unsafe abortions were prevented by the use of modern contraception.

FP2020 offers hope for the future, especially for people in countries such as DRCongo. I am optimistic that FP2020 can help women and families lead healthier and happier lives and will be a model for the future of family planning. And I expect it and future programs will be built on respect for the people that they serve. doclink

Social Justice Requires Family Planning

February 13, 2015, Population Connection Action Fund   By: Elspeth Dehnert

Evidence from around the world shows that investments in reproductive health are critical to reducing poverty and increasing educational levels.

While most women in the United States have access to contraception, some 225 million women in the developing do not, even though they wish that they did.

Having the ability to prevent pregnancy, survive childbirth, and enjoy equal opportunities is a basic human right. And it is up to all of us to call on our prospective governments to make a real investment in international family planning - otherwise, the world may never achieve true social justice.

Only $25 per year buys a woman living in the developing world lifesaving family planning services, and a new outlook on life.

Making voluntary family planning available to everyone in the developing world would reduce costs for newborn and maternal health care by more than 11 billion dollars.

Poverty elimination, gender equality, and educational and health equity cannot be fully realized until everyone around the world has the ability to plan their pregnancies. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Paving the Way: Ethiopia's Youth on the Road to Sustainability

July 2015, NewSecurityBeat

Tesema Merga was part of a vanguard of young Ethiopians who brought the first roads to the Gurage in the 1960s. He and others went on to form the Gurage People's Self-help Development Organization (GPSDO).

Today, Tesema and GPSDO are working with the next generation of local leaders to establish PHE clubs at local schools and encourage girls education and empowerment. doclink

The Endangered Wildlife Trust Breaks the Population Taboo

November 12, 2014, AG Africa Geographic   By: David Johnson

The Endangered Wildlife Trust (EWT) recently became the newest member of the Population and Sustainability Network (PSN), an independent body which also coordinates an international network of organisations recognising the importance of population and consumption impacts as significant factors in sustainable development. PSN raises support for, and investment in, sexual and reproductive health services which respect and protect rights. PSN membership includes the United Nations Population Fund, the UK government's Department for International Development, the International Planned Parenthood Federation and several smaller conservation organisations promoting the integrated approach to development known as "Population, Health and Environment".

Poor rural communities rely on healthy ecosystems for their food, water and livelihoods. When population growth threatens those ecosystems, the local communities suffer too. Population, Health and Environment (PHE) programs integrate improved sexual and reproductive health services with conservation actions and the creation of alternative and sustainable livelihoods. This approach has led to greater conservation and health outcomes than single sector actions but continental southern Africa has no PHE programs.

The women's rights NGO Thohoyandou Victim Empowerment Programme (TVEP), based in Limpopo, South Africa, also has become a member of EWT. TVEP passionately advocates for increasing women's capacity to act. Male partners must allow female partners to use the contraceptives of their choice and this is not always the case. TVEP's programs seek to ensure women can exercise their rights to make their own contraceptive and other decisions.

Africa's population is anticipated to double by 2050, a reality which successful conservation cannot ignore. When women are empowered to choose the number and timing of their pregnancies, they are likely to have fewer, healthier children, which means that fewer natural resources need be harvested, benefiting food security and the environment.

The EWT and TVEP are hoping to get funding for a pilot project for a site in KwaZulu-Natal where human settlements are encroaching on remaining habitats and where an absence of alternative livelihoods means some locals have little choice but to turn to bush meat to support their families. Sometimes the bush meat animal is endangered.

To help them get their funding, click here to vote for this project as a candidate for the Hivos Social Innovation Award.

Although some people feel uncomfortable talking about population growth, there should be no need if the conversation is rooted in empowerment, women's rights and education. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

A Seattle High School is Taking Birth Control Access to the Next Level

May 27, 2015, Grist   By: Eve Andrews

Chief Sealth International is a Seattle public school is in a diverse neighborhood on the southwest end of the Seattle. In the school-based health center students can get treatment for sore throats bandages for sprained ankles, and IUDs, as well as other forms of birth control .

The American College of Obstretricians and Gynecologists formally recommended LARC's -- Long Acting Reversible Contraceptives -- as the best ways for teen girls to avoid unwanted pregnancies. And Seattle's public health department decided these should be available in school based medical clinics.

LARC's are the most costly of birth control. These are made possible by a state medicaid program to be available to minors.

In-school LARC placement was made possible in part by Take Charge, a Washington State Medicaid program that's specifically targeted toward minors seeking contraceptive services. Because of Take Charge, girls under 19 who don't want to use their parents' private insurance to get birth control have a way to get contraception in school at no cost.

The clinic as a very supportive, confidential environment where students can come in on their own terms and get counseling for birth control methods based on efficacy and what makes sense for their own bodies.

One of the greatest benefits of the clinic is the degree to which it's opened up the conversation around birth control in the school. Girls will openly trade stories about what kind of contraception they're using. doclink

Invest in Adolescents and Young People

August 2014, Women Deliver

doclink

Malawi: FPAM Engages Ku Youths to Fight Overpopulation

May 2, 2014, AllAfrica.com   By: Davie Munkhondya

The Family Planning Association of Malawi (FPAM) manager said there is a great need for the young population of the country to get to know their sexual reproductive rights which will assist them to the claim family planning methods.

She, however, bemoaned cultural attitudes towards sexual reproductive issues as one of the hardships fuelling overpopulation as most parents do not want to talk about such issues to their children because they feel it is not normal to do so.

FPAM is working in four T/A's in Kasungu namely: Mwase, Kaomba, Lukwa and Santhe where, with funding from the University of North Carolina (UNC), the young generation is being drilled in issues concerning their sexual reproductive health rights so that they make right decisions. doclink

Karen Gaia says: this is extremely important because half the world's population is age 25 or younger and thus there is a high potential for birth rates to rise.

How to Empower Youth to Change the World (video)

September 20, 2013, Impatient Optimists   By: Elena Sonnino

During UN Week world leaders, entrepreneurs and innovators gathered in New York City for events like the Social Good Summit, the Clinton Global Initiative and of course, the meetings of the UN General Assembly. Discussions were held on the Millenium Development Goals (or MDGs) with a heavy emphasis on addressing issues to achieve the goals we want to see in place by 2030, as a global community. The answer for reaching our goals by 2030 is easy: we need to empower youth to be change agents.

What is a change agent you ask?


BAVC Map Your World
from Grainger-Monsen Newnham on Vimeo.

The "how" of how to empower youth to be change agents is to let them be kids and develop their own ideas- wherever they are in the range of potential social good actions.

The answer is simple- we simply let them "do." We let them dream and think. We give our youth the tools to collaborate and problem solve, brainstorm and reflect. We empower them to believe that their voice matters without judging or criticizing their ideas.

A new study conducted by the Women's Philanthropy Institute at Indiana University Lilly Family School of Philanthropy and the United Nations Foundation found that 9 out of 10 American youth between the ages eight and 19 give money to organizations dedicated to charitable causes. Tweens and teens want to give, participate and have an impact- it is up to us to support and empower them.

Our children need to know that we believe in their ideas and potential as change agents. doclink

Considering that half the world's population is under 25, there is much to be done in involving young people.

Islamabad Survey Finds Low Reproductive Rights Awareness Among Adolescents

September 8, 2013, Express Tribune (Pakistan)   By: Sehrish Wasif

According to the Express Tribune, a survey conducted in eight districts of the Islamabad Capital Territory by Hayat Life Line, found that, out of 5,670 adolescent respondents, only 23.4% of girls and 27.1% of boys understood their sexual and reproductive health rights. Results varied by district. Only 42% could identify some forms of gender-based violence in society. Of those, 73% identified forced marriages as the most common form. 42% could identify physical changes related to puberty, but only 8% could identify emotional changes linked with puberty.

The author attributes this knowledge gap to parents not knowing or not discussing sexual rights information with their children. The report recommended parent counseling combined with gender separated peer programs in the schools, and additional support from the media. The objective is to raise awareness concerning the emotional aspects of puberty, the legal rights of adolescents, the social protections available to them, complications and other consequences of pregnancy during adolescence, and misconceptions about HIV/AIDS and other sexually transmitted diseases.

The report also called for advocating that government policy include the addition of a culturally sensitive sexual and reproductive health and rights components in the school and college curricula, complete with teacher training, as needed. doclink

Make Women Matter

September 8, 2013

A unique website aimed at educating young people about sex education and reproductive health. Lots of 'vodcasts' by young radio journalists. doclink

Thanks to Better Sex Ed, California's Teen Birth Rate Has Plummeted by 60 Percent

July 19, 2013, Think Progress   By: Tara Culp-ressler

California's teen birth rate has dropped 60% since 1991, according to new data from the state's health department.

Public health experts attribute this to the requirement that California's public schools to offer comprehensive sex ed classes with scientifically accurate information about birth control. Family planning programs that provide community-based resources to teens were also credited with lowering rates.

Overall, the United States' teen pregnancy rate has been plummeting due to teens gaining better access to contraceptive methods and opting to use birth control as soon as they become sexually active. Community-based youth programs are one of the most effective strategies of instilling teens with healthy attitudes and safe approaches toward sexuality.

Teen pregnancy rates remain high in the South where adolescents there tend to receive ineffective abstinence education, and are more likely to lack access to birth control resources. doclink

'i Have Seen My Friends Die': Why We Need to Talk Frankly About Girls' Reproductive Health

July 9, 2013, Huffington Post

Last year at the London Family Planning Summit a global movement was catalyzed to ensure that 120 million more women and girls have access to contraception by 2020. World Population Day 2013 focuses on adolescent pregnancy. Complications in pregnancy and childbirth are the leading causes of death among adolescent girls ages 15-19 in low- and middle-income countries.

One in three of girls under 18 in the developing world are married; many without their consent. 15% of all unsafe abortions in low- and middle-income countries are among adolescent girls aged 15-19 years.

Because of these alarming numbers, we need to talk frankly and openly; we cannot shy away from tough conversations when girls are at risk.

Young women face barriers when they seek contraception or access to information and commodities to practice safer sex. This must stop.

A young woman in Ethiopia, Haregnesh, says girls she knows who were very young when they got married and starting having children and she has see some of them die. "I have seen educated people and I saw the difference in their lives. ... I watched as they had no food to eat or feed their children and they just kept getting pregnant and having babies. I could see that they were suffering and I wanted to go to school." A Pathfinder International program in Amhara, Ethiopia supports girls to continue their studies. Haregnesh's strength and resolve to stay in school, as well as talk openly about girls' education, early marriage, and childbirth, has shifted the approach to girls' education in her family and in her community.

Haregnesh's father, who had not wanted her to attend school said. "Haregnesh is our third child and she made all the change happen in our family. My three younger children now attend school as well."

We must commit to ensuring adolescent girls have the support and resources they need to delay marriage and childbirth, stay in school, and start their adult lives the way each of them want to. doclink

Karen Gaia Pitts says: it is important to note that patriarchal attitudes can be changed. That is why I am such a fan of programs like PAI's or the Population Media Center soap operas.

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

1998,

Micro Credit is small loans for low-income people to borrow to start income-generating projects. Part of a comprehensive approach to empowering women and ensuring a stable population level, it is channeled to the poorest citizens in a country. According to the 1997 United Nations Development Report, women comprise 2/3 of the poorest citizens in each country. Supporting women's efforts to achieve economic self-sufficiency also helps to slow population growth. Women who are earning an income often choose to have smaller families, have more ability to pay for their own family-planning needs, and choose to send their sons and daughters to school, which often leads to greater spacing between generations an important component of slowing population growth globally. doclink

U.S.: Microfinance: How it Lost Its Way and Betrayed the Poor

October 9, 2012, New York Times

Microfinance was supposed to bring upward mobility to millions of people. Kiva and other organizations have let millions of people lend money to struggling entrepreneurs. But a new blockbuster book by a former industry insider is exposing the dark side of the micro-lending world. In a special co-production with KALW radio, Hugh Sinclair, the author of Confessions of a Microfinance Heretic, tells the story of how he learned the dirty truths behind the banking sector that's creeping across the developing world.

Follow the link in the headline to hear this provocative audio broadcast. I don't know whether to believe it or not, but the speaker, Hugh Sinclair, seems knowledgeable and sincere.

A Response from CFI at ACCION to Hugh Sinclair's blog post http://www.microdinero.com/index.php/english/nota/5271/a-response-from-cfi-at-accion-to-hugh-sinclairs-blog-post

More, from the New York Times, at http://www.nytimes.com/2010/04/14/world/14microfinance.html?pagewanted=1&_r=0 doclink

Bangladesh: Women Hurting Women

September 29, 2012, New York Times   By: Nicholas D. Kristof

It would be nice to think that women who achieve power would want to help women at the bottom. But the acts of one female leader show that women in power can be every bit as contemptible as men.

Sheikh Hasina, prime minister of Bangladesh driven Muhammad Yunus from his job as managing director of Grameen Bank. Yunus, is the founder of Grameen Bank and champion of the economic empowerment of women around the world. He won a Nobel Peace Prize for his pioneering work in microfinance, focused on helping women lift their families out of poverty.

Since last month, her government has tried to seize control of the bank from its 5.5 million small-time shareholders, almost all of them women, who collectively own more than 95% of the bank. The government has also started various investigations of Yunus and his finances and taxes

We see a woman who has benefited from evolving gender norms using her government powers to destroy the life's work of a man who has done as much for the world's most vulnerable women as anybody on earth.

Bangladesh is a prime example of the returns from investing in women. It invested in girls' education, and today more than half of its high school students are female -- an astonishing achievement for an impoverished Muslim country.

The average Bangladeshi woman now has 2.2 children, down from 6 in 1980. Bringing women into the mainstream also seems to have soothed extremism, which is much less of a concern than in Pakistan (where female literacy in the tribal areas is only 3%).

Secretary of State Hillary Clinton commented: "I highly respect Muhammad Yunus, and I highly respect the work that he has done, and I am hoping to see it continue without being in any way undermined or affected by any government action." Former secretaries of state, George Shultz and Madeleine Albright, have asked Sheikh Hasina to back off.

Sheikh Hasina has been disappointing in other ways, turning a blind eye to murders widely attributed to the security services, for example.

Despite this bad example, we need more women in leadership posts at home and around the world, from presidential palaces to corporate boards. The evidence suggests that diverse leadership leads to better decision making, and I think future generations of female leaders may be more attentive to women's issues than the first. doclink

Kenya: Microfinance: Women Pull Together Against Poverty

April 14, 2011, InterPress Service

39 women in the Kiambu District of Central Kenya joined together to form the Consolata Self Help Group, which was linked with a microfinance institution known as the Pamoja Women Development Program (PAWDEP).

Each member of the Consolata group was to put the equivalent of $2.50 into a common kitty each month. Members presenting a workable business idea can then borrow money from the combined savings at an interest rate of 5%; the loan is repayable at the end of three months.

Members' loans are limited to two and a half times the capital they have accumulated in savings with the group; for example, a member who has accumulated $100 in savings can take out a loan of $250. In this way 40% of the loan is guaranteed against money the borrower herself has put into the scheme if she defaults.

Esther, a participant in the program, is the proprietor of a dairy project with 15 cows, delivering 100 litres of milk daily to the nearby milk collection centre in her home village.

After starting with one cow, she repaid the first loan from the proceeds of selling milk and then borrowed 625 dollars to buy a second cow. Milk sales again covered repayment, and a series of larger loans from the Consolata group steadily built her operations.

The other members of the Consolata group have experienced similar rapid growth, establishing small businesses or farming.

PAWDEP currently works with savings schemes whose combined membership totals 48,000 women in the Central, Eastern, Rift Valley and Nairobi provinces of Kenya. There are several similar institutions in Kenya, helping women and youth with enhanced access to credit.

A 2010 report published by international development charity ActionAid - "Fertile Ground: How Governments and Donors Can Halve Hunger" - based on data gathered in Kenya, Uganda and Malawi - suggests that this kind of support for women small-scale farmers could halve hunger on the African continent by 2015.

While many African women would find the benefits of enhanced access to credit limited by legal and traditional patterns of land tenure, domestic power relations; rural men and women alike also struggle to overcome weak infrastructure that denies them water, access to markets, or even sound advice and agricultural technologies -- microfinance still contributes powerfully to making the most of resources available to rural people. doclink

Microfinance Institutions Prefer Lending to Women

April 8, 2011, The New Times

Microfinance Institutions (MFIs) prefer to give loans to women and their cooperatives because they are trustworthy in loan repayments compared to men, enabling them to do business better.

With their increasing responsibilities in their families, women have exhibited a culture of trustworthy and diversification of doing multi businesses to raise enough income, says the MFI Vision Finance Company, which provides financial and non-financial services to the economically productive poor Rwandans especially women.

"Women are trustworthy clients; they know how to use the loans effectively by investing in many businesses. When they are in cooperatives the trust is much stronger that you don't get worried of defaulters." doclink

Kudos to Muhammad Yunus, Instigator of Micro Credit

August 16, 2009, Times of Trenton

Muhammad Yunus worked for over thirty years giving micro-credit loans that bring a better quality of life to the poorest of the poor in Bangladesh. He founded the Grameen Bank which loans as makes loans for as little as $9, without collateral, to start small businesses such as selling candy or toys, buying cellular phones and charging for calls, or purchasing weaving materials.

He has recently received the Medal of Freedom. In 2006 the Nobel Peace Prize Committee awarded him and Grameen Bank its 2006 prize and said: "Lasting peace cannot be achieved unless large population groups find ways in which to break out of poverty." The Grameen Bank model has been duplicated in more than 100 countries, from Uganda to Malaysia to Chicago's South Side.

Women make up 97% of the 6.83 million borrowers because they were found to be the best risk. In a Muslim-dominated country where rural women are often not allowed to touch money or work outside the home, this was a ground-breaking movement. Guidelines for borrowers to follow include discipline, unity, courage and hard work; repair houses; grow vegetables; educate children; and keep families small.

The link between lower fertility and reduced poverty has long been recognized. The Independent UK news, citing a report from Parliament, noted, "The earth's population will approach an unsustainable total of 10.5 billion unless contraception is put back at the top of the agenda for international efforts to alleviate global poverty...and even help to avert global warming."

from an LTE by Bonnie Tillery, volunteer population issues coordinator for the New Jersey Chapter of the Sierra Club doclink

Karen Gaia says: it has been shown that, when women are able to raise money themselves, they feel they have more control over their destiny and find ways to have smaller, healthier families.

Banking on Women

January 16, 2009, AllAfrica.com

We are not waiting. We are moving," says Pilda Modjadji, a founding member of the Pankop Women Farmers Forum. "We mean business."

The Pankop group, in Mpumalanga, South Africa started with the goal of growing fruit collectively and using the proceeds to supplement family diets, raise incomes and pay school tuition fees. But the village offered few job prospects and their children were going off to the cities.

Determined to create an alternative source of employment, the women, with the support of traditional chiefs and municipal authorities, set up a fruit and vegetable dehydration plant. The Pankop group needed the equivalent of $100,000 and got the funds from local commercial banks because a South African organization created in 1996 by the US non-profit Shared Interest and the Swiss-based Recherches et Applications de Financements Alternatifs au Developpement (RAFAD), put up $70,000 in loan guarantees.

With the first loan, the women converted an old school dormitory into a functioning plant and hired 65 young people .

With a second loan of $120,000, they increased the number of employees to 200, working in shifts.

Their latest loan is worth about $1 mn, and with those funds, the women plan to meet European Union health and safety standards and start exporting their produce.

Increasingly, private equity funds and philanthropic groups and individuals are making it possible to leverage significantly larger loans.

Donna Katzin, president of Thembani's parent organization, Shared Interest, told Africa Renewal that her group does more than create access to financing but identifies projects and partners, helps develop business proposals and hooks them up with banks to provide the credit.

We are helping to change the way the banks operate. We are introducing them to a new set of people who need their capital."

Women own about 48% of all enterprises in Africa.

Non-governmental organizations like Shared Interest are not the only ones using guarantees to improve women's access to credit. The International Labour Organization and the African Development Bank (ADB) have jointly created a $10 million guarantee scheme called Growth-Oriented Women Entrepreneurs (GOWE), with the ADB and IFC managing the operation.

GOWE is intended to help about 400 women entrepreneurs across Africa to secure access to financing by 2011.

To qualify, their businesses must be at least two years old and show potential for growth. Those who are approved can borrow between $20,000 and $400,000, but are expected to raise 20% of the expansion costs on their own.

In Kenya, the UN Development Programme (UNDP) has partnered with Equity Bank to provide $81 million in loans exclusively to women.

In Nigeria, until recently, enterprising women with solid businesses could not get loans because they lacked collateral requirements or credit histories.

But Access Bank, approached the IFC, which provided it with a $15 million line of credit for lending to businesses owned by women.

The loans were accompanied by business development advice and training. In Kenya, 61% of household entrepreneurs are women, and in 1981, a group formed the Kenya Women Finance Trust (KWFT), a microfinance lender dedicated to women.

But as commercial banks have realized that lending to women can be profitable, loans to organizations like KWFT have become cheaper, enabling it to expand its reach.

Today it is the largest microfinance institution for women in East and Central Africa.

KWFT realized that emergency health costs often forced women to raid their business capital to pay for health care. In response, the trust launched a medical insurance programme for its clients and their families.

For a yearly payment of about $60, KWFT clients get policies to cover expenses and also draw weekly allowances during hospital admissions. If they become disabled, they receive a lump-sum payout.

Once Equity Bank took on that administrative cost and collected the tiny amounts, the sums totalled over $20 million annually. Equity Bank not only saved the insurance companies the costs of collecting small premiums and earned a commission in the process, but also ensured that its clients got the insurance they needed. doclink

Zimbabwe;: State Embarks on Women Empowerment Programme

September 25, 2007, Africa News Service

Minister of Women Affairs, said Government had embarked on a project to empower and promote women for sustainable development.

Speaking in Harare, Cde Muchinguri said this was being done through community development and poverty alleviation initiatives. Government, she said, had established a fund for women's clubs aimed at empowering women to alleviate poverty.

She urged women to access the funds. There are over 5 000 women's clubs which provide opportunities for women to develop their potential through the acquisition of life skills. Nestle Zimbabwe was launching the Maggi cooking competition, which complements Government's efforts to uplift the living standards of women. The competition seeks to promote hygiene, creativity and cooking skills among women. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

November 2010

Ethiopia poster advocating that girls should be allowed to go to school

Ethiopian poster showing a little girl who is sad that she cannot go to school while some of her friends are allowed. She is taking care of her brother or sister, while others must gather firewood or tend the sheep. doclink

The Afghan Institute of Learning's Mobile Literacy Program Uses Texting to Teach and Expands Communities

May 15, 2015, Global Fund For Women

At the Afghan Institute of Learning, women and girls are taught to read and write using mobile phones and text messaging (SMS). SMS not only increases literacy levels, it allows program participants to develop self-confidence and to connect with their communities.

The Afghan Institute of Learning program is a four-month curriculum that involves classroom instruction, interactive teaching methods, and hands-on practice. The classes, which typically consist of two teachers and 30-35 students, combine AIL's proven literacy curriculum with text messaging to accelerate the pace of learning.

At the beginning of the program, about 80% of the women and girls participating cannot read or can only recognize the basic alphabet. By the end of the four-month program, 80% are able to read at the fourth grade reading level or higher. In a traditional classroom setting this kind of progress typically takes 18 months. The difference is attributed to the use of technology! So far, almost 1,000 women and girls have completed the program.

Most of the girls who participate in the program have limited social circles and live very far away from each other. Text messaging allows them to be in touch with one another. AIL believes this helps support an accelerated learning process. doclink

Karen Gaia says: As long as the girls continue to be allowed to use text messaging, this is the path to education, which is one of the main ways that fertility rates are lowered. Still, Afghani women need more empowerment than this.

Displaced Children in South Sudan Continue to Learn

Mobile technology lets young readers continue with lessons
February 15, 2015, USAID

Since the conflict began in South Sudan in December 2013, nearly 1,200 schools in the most conflict-affected states have closed. An additional 400,000 children and adolescents have dropped out due to the crisis, and some 90 schools are occupied by fighting forces or internally displaced persons.

The children of Matok have been able to continue learning with a simple and mobile USAID literacy program called All Children Reading.

Before the conflict began, the children were introduced to reading in their mother tongue, Dinka Cham, using digital audio players provided by ACROSS, a South Sudanese NGO that implements the literacy program.

When ACROSS staff member John Chol visited them in May 2014, the children welcomed him with songs they had learned from the lessons. ACROSS conducted a simple survey that indicated the children could read their mother-tongue alphabet, short words and simple sentences.

USAID launched the All Children Reading program in 2011 as part of a Grand Challenge for Development to improve literacy rates among children in developing countries. doclink

Karen Gaia says: Education is one of the contributors to a lower fertility rate.

Global Population and Environment 101

January 7, 2015, Sierra Club Global Population and Environment Program

See http://www.sierraclub.org/population doclink

Mobile Devices Improve Literacy

April 23, 2014, Tech Crunch   By: Catherine Shu

A survey of 5,000 people in Ethiopia, Ghana, India, Kenya, Nigeria, Pakistan, and Zimbabwe cites data from the United Nations that says more than 6 billion people have access to a working phone, which it claims means that 6.8 billion people, or most of the world's population, can potentially have access to reading material. "In places where physical books are scarce, mobile phones are plentiful. And while mobile phones are still used primarily for basic communication, even the simplest phones are a gateway to long-form text," says the report.

The phone project was created in partnership with Nokia, which uses featurephones, and Worldreader, a free mobile reading platform that targets markets in Asia and Africa.

The Worldreader Mobile can compress data and reduce cost of reading to just two to three cents for every 1,000 pages read. Only 18% of the people surveyed said the cost of data was a concern, while 50% said they never worry about the price

Though 77% of mobile readers are male, girls and women read up to six times more than boys and men. One-third of parents surveyed said they read regularly to their children from their mobile phones.

Worldreader was founded in 2010 by David Risher, a former executive at Microsoft and Amazon, and Colin McElwee, a former marketing director at Barcelona's ESADE Business School. doclink

Training Teachers to Empower Girls in Nepal

April 21, 2014, Women Deliver   By: Rehema Namukose

Developing nations like Nepal have the lowest levels of quality education systems, and that is why the Global Fund for Women, Nepal Training of Teachers Program (NTTP), and Her Turn -The Girls Education and Empowerment Program have raised funds through Catapult to address this issue and also extend education to remote villages of Nepal, where girls between the ages of 10 and 14 are extremely susceptible to child marriage or sex slavery. The program aims to train teachers and empower girls through workshops in rural areas of Sindupolchowk and North Gorkha with little access to education. Despite challenges like political instability, the program has played an important role in empowering girls.

With funding support from the Catapult community and the Global Fund for Women, the program has trained 150 village teachers, and has conducted 400 Girl Empowerment Workshops since April 2013. doclink

Iran's Birth Control Policy Sent Birthrate Tumbling

Plunging birthrates helped usher in changes concerning the role of women
July 22, 2012   By: Kenneth R. Weiss

Since the 1980s, Iran has experienced the largest and one of the fastest drops in fertility ever recorded - from about seven births per woman to fewer than two (or, by year, from a high of 3.2% in 1986 to just 1.2% at its lowest point). It confounded all conventional wisdom that this could happen in an Islamic republic, said Jalal Abbasi-Shavazi, a demographer at the University of Tehran. But it happened largely because of Ayatollah Ruhollah Khomeini, Iran's supreme leader. Khomeini had earlier encouraged large families, but after the war with Iraq he decided the economy could no longer support a rapidly growing population. In the late 1980s he issued fatwas making birth control available and encouraged conservative Muslims to use them.

With his backing, Iran's Health Ministry launched a nationwide campaign introducing contraceptives - pills, condoms, IUDs, implants, tubal ligations, and vasectomies and providing them free at government clinics, including thousands of new rural health centers. An Iranian factory produced more than 70 million condoms a year. Throughout the country clinics supported the changes. Dozens of mobile teams offered free vasectomies and tubal ligations in remote parts of the country, promoting contraception as a way to leave more time between births and help reduce maternal and child mortality. At a center in Tehran, brides-to-be, some covered head to toe in black chadors, filed into a room with their bearded bridegrooms where they confronted packaged samples of condoms, birth control pills and intrauterine devices pinned to a bulletin board.

In 1993, Parliament passed further legislation withdrawing food coupons, paid maternity leave, and social welfare subsidies after the third child. Hour-long birth control classes and counseling in family planning were required before a couple could marry. "Our aim is to help you know how to avoid an unwanted child," said a government-trained midwife. "The trend among "modern Iranians," she said, "is to have one child, two at most." Her no-nonsense PowerPoint presentation covered male and female anatomy, menstrual cycles, fertility and birth control.

Plunging birthrates led to social changes. With smaller families, parents could invest more in their children's education. Khomeini had resegregated schools by gender, so that even the most conservative families could send girls to school without worrying that having their daughters mix with males would place family honor at risk. Female students soon outnumber males 65% to 35% in public universities, leading to calls in parliament for affirmative action for men. As women became better educated, their influence within the family grew. Djavad Salehi-Isfahani, an Iran expert at Virginia Tech. said, "Without intending to, Iran's clerical leadership helped to foster "the empowerment of Iranian women." Woman still have fewer legal rights than men and are limited in the jobs they can hold and what they can wear, but more of them now attend universities and delay childbirth.

Later, President Mahmoud Ahmadinejad sought to reverse the trend toward smaller families through speeches and economic sanctions, but he was widely ignored. "Iranian women are not going back," said Sussan Tahmasebi, an Iranian women's rights leader now living in the United States. doclink

Art says: By demonstrating how a population problem can be reversed so quickly, Iran now serves as a model for other nations. But not all Islamic nations would start from such a supportive baseline. The reversal occurred because: 1) the idea came from nation's most powerful cleric, and 2) advanced systems of public schools and public health services already existed, allowing for millions of Iranian women to complete high school or college and quickly obtain family planning advice. This empowerment allowed them to continue practicing birth control even after support for the policy waned. Turkey, another advanced Islamic nation with a similar baseline, had similar success. Since many Islamic clerics distrust western influences, it would be difficult for the UN or any NGO to get them to support family planning as fervently as Khomeini did. Also, few girls attend school at all in several Muslim nations, so female empowerment remains unlikely in the near future. None-the-less, this article makes clear that winning genuine clerical and government support can be key to success.

Karen Gaia says: there is also the example of Bangladesh, another Muslim country, whose government had the help of USAID to develop its family planning program. But it had to start almost 'from scratch' in order to educate girls, and also 'from scratch' to employ women as health care workers, which turned out to be another way to empower women.

Pakistan: We Need to Apply the Brakes

February 8, 2014, Pakistan Today

Pakistan, the world's sixth-most populous country, plans to ensure sustainable economic expansion by slowing its birth rate through enhanced education for women.

According to Planning Commission Deputy Chairman Ahsan Iqbal, Pakistan will try to reduce its population growth rate to 1.2% a year (1.6 children per woman) by 2025 from its current rate of about 2.96 per woman. Each year this nation of about 196 million people adds some 4.4 million more people, the equivalent of New Zealand's population, he said. Pakistan's birth rate is exceeded in South Asia only by Afghanistan's rate of 5.54 children per woman.

Iqbal said that the current growth rate will strain natural resources, hinder growth, and make it very difficult to sustain development. "If we can give our young population the right education and right skills, it is a big demographic dividend for the next 10 to 15 years. If it doesn't happen it becomes a demographic disaster. . . . The government will focus on making planning programs available to married couples and prioritizing education for women."

According to a finance ministry economic survey published last year, only about 30% of married Pakistanis use contraceptives, compared with 55% in India and 73% in Iran. Pakistan's population grows about 4.4 million (2.21% - adjusted by editor) per year, compared with 1.3 % in India and 1% in Iran.

A middle class of 55 million to 70 million people is helping to drive the $225 billion economy, according to Sakib Sherani, a former finance ministry adviser and now chief executive officer at Macroeconomic Insights, an Islamabad-based research firm. But Sakib calls Pakistan's population growth rate "out of control." doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

When Sex Ed Discusses Gender Inequality, Sex Gets Safer

A new study shows a 'striking' difference in effectiveness between programs that address gender and power, and those that don't
April 27, 2015, Atlantic Monthly   By: Julie Beck

"Comprehensive sex education" is often used in opposition to "abstinence-only," but that only means that, at a baseline, it includes information about contraception and sexually transmitted diseases. What would it mean to be truly "comprehensive?"

A new study published in International Perspectives on Sexual and Reproductive Health, reviewed 22 sex-education programs for adolescents and young adults and compares how effective they were in reducing pregnancy and STIs. Ten of the programs had at least one lesson on gender and power, and 80% of them saw significant decreases in pregnancy or STIs compared with a control group. Of the 12 programs that did not address these issues, 17% led to those positive outcomes.

Other research shows that women who report having less power in their relationships than their male partners have higher rates of HIV infection and other STIs,

Some of the curriculums in study author Nicole Haberland's study asked questions such as, "What is this ad saying to you about what a woman is supposed to look like and act like?" Haberland says. "What are guys supposed to feel and act like?"

Jane does not use a condom because she doesn't want to. It's because she's afraid her boyfriend is going to leave her. "Helping kids identify the inequality in those power dynamics and how it affects all of us in our relationships," is important, cites Haberland.

According to the Guttmacher Institute, only 13 states have laws requiring that sex education be medically accurate, while 19 require that instruction on the importance of engaging in sexual activity only within marriage be provided.

There are emotions and social pressures at play, and it seems that when teachers address them, sex ed gets a little closer to being truly comprehensive. doclink

It's Not Enough to Just Mention Condoms -- Sex Education Should Be Sex-Positive

April 22, 2015, RH Reality Check   By: Amanda Marcotte

Early in his administration, Obama stopped the requirement that sex education programs teach that abstinence is the only legitimate way to prevent pregnancy and STI transmission. Some states have resisted, but at least the Federal government no longer requires abstinence only. Still, although "abstinence-only" is fading, most sex education programs still imply that sex is evil and could even kill you.

After reviewing some of the content in her son's sex education class at East Lansing High School, Medical historian Alice Dreger joined friends who wanted her to get involved in school board debates over what exactly would be taught in sex ed classes. Administrators emphasized that they do not teach abstinence-only and that "the curriculum (which was developed by a crisis pregnancy center) also reviews contraception choices." Most parents would settle for that. But Dreger concluded that the sex education she observed was more terror-based than abstinence-based." Abstinence-only educators basically hold to the "don't even think about it" line where contraception is concerned. The victory over that approach had not been as big as she and others had hoped. Based on her account, the current class teaches that sex is a shameful activity, premarital sex is evil, people who do it are dirty, and men and women should adhere to traditional gender roles. The new program was not "abstinence-only," but conservatives were still using "sex ed" to brand kids as failures if they chose to have sex without marriage.

The rebranding effort is not all locally based. Congress is allocating $25 million annually to "risk-avoidance education" based on many real and imagined consequences that are likely to follow premarital sex. This amounts to new packaging for abstinence-only. Amanda Marcotte compares this to schools trying to convince kids that owning a pet is evil by displaying pictures of ugly dog bites, telling sob stories about cat allergies, and playing games where everyone who gets a pet ends up with a serious problem. Even those who survive pet ownership end up sad because their pets will eventually die. Teaching responsible pet ownership should not make kids see pets as evil. The same applies to non-marital or pre-marital sex. Only 62% of Americans own pets, but 95% have premarital sex, and most of them find in it a positive experience. Some people may view that as bad, but most of us do not. Kids need education in responsible sexuality, but overall they should not be given negative attitudes about sex. Sex education should offer a non-slanted fact-based education that allows parents and/or religious leaders to express opinions outside the classroom if they wish.

Most of us don't buy the implication that kids should wait a decade or more until marriage before having sex. We want our young people to grow up looking forward to a future of fun, fulfilling sex, not to teach them that it's a thing that they will probably do but should feel bad about. doclink

Proof That Comprehensive Sex Ed Classes Actually Help Kids Put Off Having Sex

October 21, 2014, Think Progress   By: Tara Culp-ressler

A three-year study by a research team at the Wellesley Centers for Women compared Get Real, Planned Parenthood's (PP's) comprehensive sex ed program, with existing programs at 24 racially and economically diverse Boston area schools (some of which already offered sex ed). The results, published in the Journal of School Health, show that classes emphasizing healthy relationships and family involvement encourage middle school students (grades 6 - 8) to delay trying sex.

Get Real's "social-emotional learning approach" teaches kids how to navigate relationships. Researchers say that Get Real's key feature is that kids get to practice communication skills both in the classroom and at home with their parents. Study leader, Sumru Erkut, said the program teaches relationship skills and provides a very strong follow-up of family involvement.

Using test and control groups of equal size, the study found that 16% fewer boys and 15% fewer girls became sexually active by the end of eighth grade after completing Get Real. Previous research into standard Boston-area sex ed programs did not show such clear results for both genders. "It's certainly a very important and positive contribution," Erkut, told Think Progress. "People clap their hands over a program that can reduce HIV infections by 4%, so these numbers can be put in that context."

"Parents tend to talk about sex earlier and more frequently with their daughters than their sons," said the paper's lead author, Jennifer Grossman. Get Real's take-home assignments got parents involved in discussions that few parents knew how to handle the on their own. Sixth grade boys who completed the family assignments were more likely to delay sex until after eighth grade.

PP is the nation's largest sex ed provider, but is also a flashpoint in the abortion rights fight. Jen Slonaker, Vice President of Education and Training at the PP League of Mass. said. "This is exactly what we want our middle schoolers to be doing... delaying sex." But that is not the way conservatives typically view PP programs. Those who favor abstinence education believe (against contrary evidence) that teaching students about sex encourages them to become sexually active at an earlier age, and they pressure schools administrations to remove certain sex ed materials from the classroom. Most states don't require sex ed, and some prohibit any form of comprehensive sex ed. Republicans in Texas and Louisiana have even suggested that PP wants teens to get pregnant so it can give them abortions. But PP officials say the resisters are a small minority. Educators, administrators, and parents should remember that 95% of parents in high school and 93% of parents in middle school support sex education.

PP partners with ETR to distribute its Get Real materials. Thanks to these study results, ETR's website can offer this pitch: "Research Shows It Works! Students who receive Get Real are less likely to have sex." doclink

Art says: A small minority has prevented millions of kids from learning information that can be vital to their lives. That is one reason why the U.S. has the highest rate of teen pregnancy in the developed world.

Judging a comprehensive sex ed program on abstinence objectives seems ironical. The U.S. has the highest rate of teen pregnancy in the developed world, but a small minority prevents millions of kids from learning skills and information that can be vital to their decision making.

Karen Gaia says: When I was a teen girl I actually thought my parents thought it was OK to have sex. They said so little about it.

U.S.: MTV Public Policy: How 16 and Pregnant Reduced Teen Motherhood

August 14, 2014, Business Week   By: John Tozzi

In 2008 the rate of unwed births was the highest ever recorded. After 2008 births to unmarried women declined each year, according to new data from the CDC.

The steepest declines in childbearing have been recorded among unmarried black and Hispanic women, narrowing the gap with whites. And children born out of wedlock are increasingly born to partners who share a home.

While most of the declines from 1990 to 2008 could be attributed to better access to effective contraceptives, said Melissa Kearney, an economics professor at the University of Maryland, she credits MTV's reality show 16 and Pregnant and its spinoffs for the sharp drop in births in the years after 2008.

Kearney's and Phillip Levine's research showed how the narratives of hard lives of young mothers prompted Google searches and tweets about birth control or abortion and accounted for as much as one-third of the overall drop in teen births in the year and a half after its debut. High unemployment also contributed to the decline.

According to Kearney's research, a hit TV show dwarfs the influence of pretty much all the public policy that could affect teen birth rates. Changes to welfare, Medicaid coverage for contraception, sex ed or abstinence curriculums, access to abortion -- all play "a very, very small role in affecting aggregate rates" of unmarried births".

The CDC's data also shows decreases in unmarried births since 2007 for women of every age group younger than 35.

Since the 1990s, women have been delaying childbirth as they see greater economic opportunity -- better access to education and higher-paying jobs, Kearney says.

Teens, in particular, are staying childless by using contraception and having less sex. "The reductions in teen birth rates in particular are not driven by an increased reliance on abortion," Kearney says.

However, in populations with the least economic opportunities, "The proportion of births .. that are outside of marriage remains staggeringly high," Kearney says. doclink

Population Media Center Capacity Building with South-to-South Training

April 14, 2014, GlobeNewsWire

Population Media Center (PMC) works around the world to improve the health and well-being of people through storytelling. PMC employs writers and staff from the countries where the stories are being told so that the stories are authentic, and powerful. As PMC's work has expanded, country offices have become so proficient that PMC has begun using local staffs to provide south-to-south (one developing country to another) training.

Gabin Kifukiau is Population Media Center's Country Representative in the Democratic Republic of Congo. In March Kifukiau and his DRC colleague traveled to Burundi, with a stop-over in Rwanda, to see how Burundians and Rwandans were operating country offices of PMC.

"Such meetings allow mutual enrichment and have many advantages," says Kifukiau. "The most important is undoubtedly a valuable time saver in the approach used to solve potential operations management problems and implementation of program activities."

These country teams produce long-running radio serial dramas that engage people and effect behavior change. South-to-south trainings allow the details of best practices to be transferred.

PMC's President Bill Ryerson said "We produce long-running dramas for radio and TV which require our country teams to handle numerous tasks at once. Plus, they have to work within the framework of their country and establish partnerships for research, broadcast, distribution, and promotion. South-to-south training allows our country teams to help each other anticipate and overcome stumbling blocks."

PMC is helping the DRC launch five radio serial dramas later this year, in the languages of Lingala, Swahili, French, Tshiluba, and Kikongo.

Burundi launched 208-episode radio serial drama in January of 2014 and Rwanda produced a 312-episode radio serial drama from 2007 to 2009 and is currently preparing for a new program that will launch in May of 2014.

PMC's Vice President for International Programs Kriss Barker said "The south-to-south trainings are fabulous because we get to see the country teams' excitement to share our framework and methodology with other country teams so that they can effect change within their community and create a real impact." doclink

Celebrate Solutions: Family Planning Messages Provided in Barber Shops and Beauty Salons in Liberia

April 14, 2014, Women Deliver   By: Sara Pellegrom

Jhpiego and USAID's Maternal and Child Health Integrated Program (MCHIP) have been working in collaboration with Liberia's Ministry of Health and Social Welfare to increase access to family planning information and services since 2009. Adolescent pregnancy continues to be a major problem, with approximately one-third of Liberian girls having begun childbearing between the ages of 15 and 19. The program distributes condoms in the community, engages religious leaders to promote family planning, and integrates family planning with immunization services.

In Monrovia, the country's capital, Gbeni Taylor, a 21-year old hairstylist told of how, after becoming pregnant at 16 and seeing her friends become mothers before they were ready, she decided to partake in a community-based initiative to educate young people about family planning through barber shop and beauty salon employees. She thinks that if young people are aware of their family planning options early enough, it will allow them to stay in school and postpone having children.

Barber shop and beauty salon employees are trained to deliver important family planning messages, hand out condoms, and refer people interested in obtaining family planning services to local hospitals. So far, since 2012, 16 employees in four barber shops and beauty salons have reached 1,100 clients and distributed 16,550 condoms.

To broach the topic of family planning, a taboo subject in Liberia, Gbeni tries to make her clients feel comfortable and welcome by first talking to them about local politics and gossip.

Once the customer has relaxed, Gbeni brings up family planning and asks them if they are using any method. If her client is not using family planning and is interested in learning more, Gbeni is able to counsel the woman, supply her with condoms, and offer a referral card for the closest family planning clinic. When the woman shows the referral card at the clinic, it guarantees that she will be seen quickly and provided with family planning services.

Gbeni tells Jhpiego that family planning "will reduce the poverty rate. It will help families to be happy together, because if you have too many children, there will be no time to care for them all." doclink

TV Lowers Birthrate

March 19, 2014   By: Nicholas Kristof

A remarkably effective tool has emerged in the search to lower America's teen birthrates. The MTV reality show called "16 and Pregnant" is a huge hit, spawning spinoffs like the "Teen Mom" franchise. These shows remind kids that babies cry and vomit, scream during the night and poop with abandon.

Economists Melissa Kearney and Phillip Levine have studied why we have the highest teen pregnancy rate of any developed country ̶ almost 10 times that of Switzerland and more than twice that of Canada. Kearney and Levine found that teen births reflect poverty and carry it on to the next generation, but they also found that teen births dropped in regions with large audiences for "16 and Pregnant" and the "Teen Mom" franchise. Tweets containing the words "birth control" increased by 23% the day after each episode of "16 and Pregnant," and there were more Google searches concerning how to get birth control pills. (To ensure the success of these searches, we need clinics that offer free, long-acting contraception to teenage girls.) The study concluded that the shows reduced teenage births by 5.7% (20,000 fewer births per year or one less birth each half-hour). Since abortion rates also fell, the reduced birthrate appears to mostly result from more contraception use.

Even as inequality and family breakdown grew worse, teen birthrates plunged by 52% since 1991. One factor Kearney and Levine credit for this decline is women having better job opportunities. For example, girls who were randomly assigned to attend Promise Academy, a middle school in Harlem Children's Zone, became pregnant less often if they had a good shot at college. But the decline greatly accelerated when MTV began airing "16 and Pregnant in 2009. "It's another reminder that great storytelling can be a powerful catalyst for change," says MTV President Stephen Friedman. These shows worked because they focused on compelling stories, not on lecturing or wagging fingers. "If the government tried this, it would have a good message, but three people would watch it," Levine said. The shows portray a better life for girls who delay childbearing.

Another study found that before television arrived in Indian villages, 62% of women said wife beating was acceptable and men had to grant women permission to leave the house. These norms changed after women began watching soap operas showing middle-class urban families in which women weren't beaten and could leave home at will. The studies estimated that these shows nurtured as many egalitarian attitudes as five years of female education.

The master of injecting causes into storytelling is Neal Baer, the television producer behind "ER" and "Law and Order: Special Victims Unit." Baer, a doctor who helps lead the Global Media Center for Social Impact at U.C.L.A.'s School of Public Health, wove issues like vaccination and rape-kit testing into his shows, raising awareness in ways that no news program could. Polling showed that one "ER" episode about cervical cancer doubled audience awareness of the links between the human papillomavirus and cervical cancer. doclink

Access to Family Planning Alone Won't Stop the Population Boom

November 27, 2013, TheStar (Kenya)   By: Moses Wasamu

Last year at an International Conference on Family Planning in London, global leaders agreed to provide 120 million more of the world's poorest women with access to modern contraceptive services and supplies by 2020. This year a follow-up meeting in Addis Ababa released its plan for 2012 - 2016. Experts again spoke of the need to expand access to family planning options, and Prof Fred Segor, Principal Secretary for Health, told the forum that the government was on course to achieve its target of 56% usage rate by 2015. He said that the government had committed $9 million to family planning programs for this year, - a big improvement over previous years. What's more, Merck Sharp & Dohme have cut and Bayer HealthCare plans to cut the prices their long-acting and reversible contraceptive implants.

But access is not the only problem. Many women who said they wanted to delay their next pregnancy for several years were not using any modern method of contraception. Policy makers assume that improving access to contraceptives would close the gap between what women say they want and what they do. But, according to Charles Westoff of Princeton University's Office of Population Research, surveys indicate that even if contraceptives were freely available, about half the women who want fewer children would spurn them. 31% of these women rejected modern contraception due to fear of medical side effects, although Kenyan researchers said that objection is based on myths and misconceptions. Other reasons were religious prohibition (9%) and personal opposition (8%). Less than 1% cited lack of contraceptive access. 6% cited opposition from their husbands. Community Health Worker Beatrice Khalayi Shibunga, who goes door-to-door to offer family planning information in the slums of Korogocho, Nairobi says "Some women are forced to use contraceptives without the knowledge of their husbands," and Elizabeth Lule, Director of Family Planning at the Gates Foundation, says that women often choose injectable contraceptives because they can use them covertly. The Kenyan government acknowledges this concern and is developing a strategy for increasing male involvement.

The Heraf report found that 90% of reproductive health funds go to procuring contraceptives, and most of the remaining 10% goes to distribution. Very little goes to advocacy and communication. Abraham Rugo from the Institute of Economic Affairs agrees. He thinks many people have large families to care for them when they get old. They don't realize the connection between family size and prosperity, and programs do little to change these attitudes. Donors want to pay for contraceptives and think that is enough. We "need to spend more money on focal areas of attitude change, but that would mean that the Kenyan government will have to spend its own money. . . The government should come up with programs to motivate people to have small families." His suggestions called for financial incentives - though it was unclear where the money would come from.

Bill Ryerson, president of the Population Media Centre in the US, agrees that poor access is not causing the discrepancy between women's stated wishes and their behavior. He noted other factors that hinder the use of contraceptives. According to the 2008-09 Kenya Demographic and Health Survey, 97% of husbands and wives know about modern contraceptives, but 40% don't use them. He says that information and motivational talks can address these issues better than focusing only on access. People must understand the benefits in health and wealth that their families can enjoy by limiting and spacing births. He suggests role modeling family planning use, overcoming fear that contraceptives are dangerous, and getting husbands and wives to talk to each other more openly. Where you measure progress by access to contraceptives, but people want five or more children, you will not stabilize the population.

Successful nations emphasize changing people's attitudes about the role of women, ideal family size, age of first pregnancy, and the benefits of using modern contraceptives. They explain how reduced family size enables couples and nations to save more and invest in education, infrastructure, health and industry. The wider strategy could include raising women's status by providing mandatory and free education for children, especially girls. If more young women stay in school, they can later join the workforce and provide a better future for their families. doclink

Karen Gaia says: Other strategies include providing maternal and infant health care (which can be integrated with family planning), educating girls, sex education, promoting birth spacing, and involving communities and men.

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Malaysia Says Women Must Hold 30 Percent of Top Corporate Posts for Gender Equality

June 27, 2011, Associated Press

A landmark decision by the Malaysia Cabinet says women must hold 30% of top corporate posts by 2016 to bolster the role of women in Malaysia, a mainly Muslim country.

Prime Minister Najib Razak says says the government will help companies develop programs to train women for decision-making roles.

A similar policy instituted in 2004 for the public sector has raised women's participation from 19% to 32%. Women already hold some top government posts in Malaysia. doclink

Karen Gaia: There are many other countries that can benefit from Malaysia's example, including the U.S.

Ghana: Country May Miss MDG If Less Than 80 Women Win

May 18, 2011, All Africa (Ghana)

Twenty-three out of the 64 women who contested the New Patriotic Party (NPP) primaries were elected as parliamentary candidates and would contest on the ticket of the NPP in the 2012 general elections.

Women's rights advocates who called for reduced filing fees for all female hopefuls, and are happy that they have been successful.

Nevertheless, if the other parties, particularly the CPP and NDC do not field more women then Ghana will not be able to achieve the Millennium Development Goal 3: Promote Gender Equality and Empower Women. doclink

In a Land of Few Rights, Saudi Women Fight to Vote

May 4, 2011, NPR

Saudi women feel they have the least freedom or fewest rights of any women in the world. They have no right to vote, are not allowed to drive, have little say in matters of marriage and divorce, and cannot travel without a letter of permission from their male guardian.

They must wear a black robe and veil whenever they leave the house.

The government recently reneged on a promise to grant them the vote in municipal elections this fall.

The president of the Saudi Civil and Political Rights Association thinks the government is using it to make concessions to the hard-line Islamic fundamentalists in the kingdom, who, among other things, run the much feared religious police here and oppose giving women more rights. They also keep Saudi citizens in check at a time when political dissent in the kingdom is growing.

Small groups of women are going to the voting places and asking for a voting card. Others have tried to defy the ban against females driving. But then they are described as whores and their husbands as pimps and they suffer reprisals at work and have their passports confiscated by the government. doclink

Saudi Women Sore Over Men-only Polls

March 31, 2011, Gulf News (United Arab Emirates)

In Saudi Arabia, women have been banned from voting in this year's municipal elections. The first municipal elections were held in 2005, but they were men only. Dr Mohammad Al Zulfa, former member of the Shura Council and woman's rights advocate said that not having women take part in the first municipal elections could be justified but after five years of the experiment, depriving women from the elections is unjustifiable.

The elections will be held on September 22. The reform process was initiated by King Abdullah Bin Abdul Aziz. Lack of readiness at the polls will make it impossible for women to participate this year, the voting commission said. Also foreign organisations would not be allowed to monitor the elections.

"Women will be allowed to take part at the appropriate time," Election Commissioner Abdul Rahman Al Dahmash said.

A number of Saudi women activists and men advocating women rights described the decision as "unjustifiable and unacceptable". Saudi women have realized significant achievements at the local and international levels and so they are capable in being candidates and voters in the upcoming municipal elections. "We are looking for a political decision from King Abdullah Bin Abdul Aziz to have women, who constitute 49% of the Kingdom's population, take part in the forthcoming municipal elections," said Suhaila Zain Abdeen, a Saudi woman and human rights activist. doclink

UN: Women Farmers Could Slash Number of Hungry by Up to 17 Per Cent

March 8, 2011, Deutsche Presse-Agentur

The United Nations Food and Agriculture Organization (FAO) says that women in rural areas could help reduce by up to 17% the number of the world's hungry - currently at almost 1-billion people

"The report makes a powerful business case for promoting gender equality in agriculture," FAO Director-General Jacques Diouf said. "Gender equality is not just a lofty ideal, it is also crucial for agricultural development and food security. We must promote gender equality and empower women in agriculture to win, sustainably, the fight against hunger and extreme poverty."

The 2010-11 State of Food and Agriculture report says if women were given the same access as men to agricultural resources, this could increase crops yields on women's farms in developing countries by 20% to 30% and raise total agricultural production in developing countries by 2.5% to 4%, which could in turn reduce the number of hungry people in the world by 12% to 17%, or 100 to 150 million people.

Women make up on average 43% of the agricultural labor force in developing countries. However, where rural women are employed, they tend to be segregated into lower paid occupations and are more likely to be in less secure forms of employment, such as seasonal, part-time or low-wage jobs. Jobs in high-value export-oriented agricultural industries offer better opportunities for women than traditional agriculture, the report said.

"In many countries women do not have the same rights as men to buy, sell or inherit land, to open a savings account or borrow money, to sign a contract or sell their produce. Where legal rights exist on paper, they often are not honored in practice." Government officials must be held accountable for upholding the law and women must be aware of their rights and empowered to claim them. doclink

Africa: Call to Put Women's Rights at Centre of Development Plans

June 8, 2005, The Herald (UK)

Womens' rights should be at the heart of future development plans for Africa, MPs from around the world told the G8 leaders. 80 international parliamentarians said improving women's health, education and pay were vital to the continent's wellbeing and gender equality should be integral to the process. The declaration urged the G8 leaders to act on aid to Africa, fair trade, debt relief, health and HIV, as without change Africa would miss its Millennium Development Goals. A keynote speaker at the event said participation in primary education among girls is only 80% of the level for boys in sub-Saharan Africa. But by improving the education of women, their rights generally improved, and so did their maternal and sexual health which were vital to Africa's future. doclink

India: Kashmiri Women Lift Veil, Eye Career in the Skies

July 8, 2009, Reuters

Far from the capital of disputed Kashmir, a group of young women swap their burqas for smart suits and stilettos and dream of a career in the skies.

The inauguration of an international airport in Srinagar, Kashmir's main city provided an alternative to careers in medicine and teaching, and the valley's first aviation academy is now grooming them for the skies.

"We now have the opportunity to show the world that we can also become something in life", a trainee cabin said.

The year-long training is no different from that offered by hundreds of similar institutes that mushroomed across India. But in Kashmir, where thousands of people have been killed since a rebellion in 1989, the institute is, a god-send.

With protests and violence almost a daily occurrence in Srinagar, the institute chose to maintain a low- profile, picking an out-of-town location so the women, who often come in wearing burqas, are safe.

I was apprehensive and reluctant because I was worried she would go away from me," said Ayub's mother Mehfuza. "But then I realized that if she does some professional training, it will make her life better."

In the early 1990s, Islamist militants began imposing their own strict version of Islam, shooting at women who did not cover themselves in a burqa, and flinging acid in their faces.

Now, the militants' hold over daily life in the valley has eased, with violence ebbing since India and Pakistan, began a peace process in 2004.

A single cinema has reopened, traditional theater and music are being revived and young Kashmiri women are abandoning their veils and considering careers like aviation.

Youngsters like Ayub were keen to make up for lost time and hold out hope for better times.

"The present generation realizes that we must go forward, and see what opportunities are available and take them with both hands." doclink

Investing in Women to Advance Economic Growth

June 4, 2009, CEDPA

Congresswoman Yvette D. Clarke said in a Congressional briefing: "Despite the significant progress, there is still a wealth of untapped potential in women."

Economic growth for women has an important multiplier effect, which is why the World Bank calls investing in women .smart economics. Women tend to share their economic gains with their families and communities. One study concluded that investing in women's education and leadership in Africa can increase agricultural yields by more than 20%.

Women own only 1% of the world's wealth, have only a 10% share in global income, and occupy just 14% of leadership positions in the private and public sector. Women produce half of the world's food, but own a only 1% of its land.

ExxonMobil Foundation's Lorie Jackson said that "investment in women is not philanthropic, it's just smart business." Equipping women from all backgrounds with the education, skills and support systems necessary to be successful managers, business leaders and entrepreneurs is one of the most important means to ensuring economic growth in the developing world.

Evelyn Omawumi Urhobo of Nigeria's Morgan Smart Development Foundation her community bank gives loans to "rural poor women who did not have access to credit to start businesses that would enable them to lift themselves out of poverty. To date, the bank has given loans to over 15,000 people mostly poor women in the region." They have a 85% pay back rate on loans given to the women.

The Global Women in Management program is CEDPA's longest running training program, with thousands of graduate in almost every country worldwide. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

UN Women Calls on Global Citizens to Bring Gender Equality Into Focus

Launches Beijing+20 Campaign: Empowering Women, Empowering Humanity: Picture it!
May 22, 2014, UN Women

UN Women today launched a major campaign in the lead-up to the commemoration of the 20th anniversary in 2015 of the historic Fourth World Conference on Women in Beijing.

The campaign features a year of activities around the world which will aim to mobilize governments and citizens alike to picture a world where gender equality is a reality and to join a global conversation on empowering women to empower humanity.

Events will focus on achievements and gaps in gender equality and women's empowerment since 189 governments adopted the 1995 Beijing Declaration and Platform for Action.

The Beijing Women's Conference drew an unprecedented 17,000 participants while 30,000 representatives attended the NGO Forum. Next year, in 2015, the United Nations will assess progress on implementation of the Beijing Platform for Action over the past 20 years, based on national reports currently being prepared by UN Member States.

"Today I call on everyone to be part of the solution," said Ms Mlambo-Ngcuka. "Picture It! Together we can realize the promise of Beijing: equality between women and men." doclink

Women Must Be Treated as Human Beings, Not Commodities, Says UN

Population director tells politicians they have a duty to raise status of women and to reinvigorate commitments on equality
April 24, 2014, Guardian   By: Liz Ford

Babatunde Osotimehin, the executive director of the UN population fund, UNFPA, told almost 250 delegates attending the international parliamentarians' conference in Stockholm that women and girls are not commodities and must be treated as human beings with equal rights to men. He said they should remind their heads of state that they had a duty to raise the status of women in their countries and they should remember commitments they made to improve the lives of women and girls.

The purpose of the meeting was to discuss progress towards agreements made at the 1994 International Conference on Population and Development (ICPD).

"We say girls, you are old enough to be married and old enough to have sex and old enough to have children, but you are not old enough to have access to contraception, not old enough to have sexuality education, not old enough to have control of your own body. This simply does not make sense," Osotimehin said.

The ICPD conference, held in Cairo in September 1994 put women's empowerment centre stage in efforts to address population growth and sustainable development. The Cairo agreement - which came from that conference - made over 200 recommendations that sought to give women social and economic empowerment.

Baroness Jenny Tonge, president of the European Parliamentary Forum on Population and Development (EPF), said that politicians at Cairo discovered that sustainable development revolves around an individual and their access to sexual health services.

Tonge said "Delegates have recognised that sexual and reproductive health and family planning for individuals is good for basic wellbeing, it stabilises population growth, increases social and economic growth and that leads to sustainable development."

About 800 women die each day during pregnancy and childbirth, and more than 200 million women who want to use modern forms of contraception are unable to access services. Laws are not being implemented, which means FGM and violence against women is allowed to continue with impunity. UNFPA said progress had been patchy and achievements have been unequal within and between countries.

The Stockholm meeting, organised by UNFPA and the EPF, is seen as particularly important, not only because it marks the 20th anniversary of Cairo, but also because it comes at a time when the international community is debating what should follow the millennium development goals, which expire next year. doclink

Faster-Than-Expected Population Growth in Many 'Feed the Future' Countries

August 1, 2013, NewSecurityBeat

Feed the Future, President Obama's global hunger and food security initiative, started implementation in 19 focus countries in 2010. In that year, projections for population growth by 2050 were: Cambodia by nearly one-third; Kenya more than double; Mali to triple.

The goals of Feed the Future are to reduce both the prevalence of poverty and the prevalence of stunted children by 20%. Interventions include developing new seed varieties, training smallholder farmers in new management techniques, and strengthening delivery systems for maternal and child health and nutrition services.

Recently the UN Population Division revised its population projections upward, with populations in these countries expected to grow even faster than anticipated. Seven of the Feed the Future focus countries - Cambodia, Ethiopia, Mali, Mozambique, Senegal, Tajikistan, and Uganda - are projected to grow at least 20% more between 2010 and 2050 than projected just two years ago. Fertility is not falling as quickly as previously expected, particularly in many sub-Saharan African countries.

A greater-than-anticipated boost in population is likely to amplify the struggle for enough food. What else can be done for food security?

Access to quality reproductive health and family planning information and services is required for families to avoid unintended pregnancy and actualize their fertility preferences. More than 220 million worldwide women would like to avoid pregnancy but lack family planning.

34% of women in Uganda, 30% of women in Senegal, 28% of women in Mali, and 26% of women in Ethiopia lack have this unmet need for family planning. Many see meeting this need for family planning as a basic human right, and its importance for women and child health, community health, and overall development is reflected in the Millennium Development Goals and likely in whatever will replace them.

There is a correlation between the ability to determine the number, timing, and spacing of children and women's empowerment, which Feed the Future considers a critical component of strengthening prospects for food security, and why it is piloting the Women's Empowerment in Agriculture Index which measures gender parity within households, and extent to which women are empowered across five key domains: production, resources, income, leadership, and time. Having a measure of these forms of empowerment will facilitate informed interventions that can strengthen women's empowerment in ways that support food security outcomes. A woman's ability to plan her pregnancies is a relevant factor in each of these areas.

With population expected to increase even faster, there is a need to redouble efforts in promoting women's empowerment and expanding access to reproductive health and family planning services. In Malawi where population, land, and climate dynamics threaten food security, there have been faster-than-anticipated drops in fertility. The emphasis placed on girls' education, access to family planning, and women's economic empowerment by President Joyce Banda has likely contributed to these changes. doclink

Empowering Women to Improve Food Security - What Works and Why

March 12, 2013, Guardian Professional

The Mahatma Gandhi National Rural Employment Guarantee Act in India guarantees 100 days of minimum wage employment - or equivalent unemployment payments - to poor rural households. The program benefited 52.5m households in 2009-2010, and put people to work building productive assets or providing environmental services, such as water harvesting and conservation and the digging of irrigation canals.

Tens of millions are beneficiaries of the program, which aims to reduce poverty build infrastructure, as well as the empowerment of women, and which has resulted in the reduction the unemployment rate for women which was reduced from 141 days per year in 2005 (compared with 76 for men) to 48% in 2009-2010, spurred on, probably, by the promise of wage parity with men and the relative regularity and safety of the work.

As a result, women were empowered by allowing them to contribute to household income and decision-making, notably on food, consumer goods, children's education, healthcare and debt management; and they were allowed to take a more active role in the rural public sphere.

However many women are constrained by household responsibilities, looking after the young, sick or elderly or fetching water and firewood; in India this work is equivalent to 182% of total tax revenue.

Under the act, there should be a female worker who looks after her co-workers' children (and paid the same wage as others), but 70% of the women interviewed had no access to childcare facilities at work, while 65% were unaware of this provision.

In Bangladesh, its Challenging the Frontiers of Poverty Reduction - Targeting the Ultra Poor - is an asset transfer program. Launched in 2002 by the NGO BRAC and later expanded to cover up to 300,000 ultra-poor women and their households. The program provides women with assets such as poultry that require less labor to be maintained, while providing them with extensive asset management training as well as subsidized health and legal services, social development training, and water and sanitation.

A daily stipend is paid until the assets were able to generate sufficient income for the household, which alleviates the need for the women to work in other peoples' houses as maids which made it more difficult for them to focus on working on the assets transferred by the program.

Food security and anti-poverty strategies must be transformative and make the redistribution of roles between women and men a priority so that they not only sustain the poor but also avoid sustaining the gender divisions that characterize poverty and keep it locked in place. doclink

Karen Gaia says: Empowering women goes a long way toward making women aware that working mothers can do more for their families by providing for them rather than just producing more babies. And when womens' worth goes up, male preference is no longer a major factor in determining family size. When a woman wants only two children, but one of them must be a boy, she has three children, on average.

Taking Hope and Inspiration from Amazing Women

March 7, 2013, PopulationGrowth.org   By: Suzanne York, Www.howmany.org

Investing in women - namely providing education, healthcare, economic opportunities, sustainable livelihoods, and empowerment -, while good for population stabilization, is something the global community should be supporting anyway for the good of society. Numbers are important, such as the 222 million women around the world that want access to voluntary family planning services but do not have it. But population numbers should not be the main topic of discussion, especially when talking about women's rights and reproductive rights.

Last year, Malala Yousufzai, a Pakistani teenage advocate for girls education,was tragically shot in the head by the Taliban, bringing attention to the challenges of supporting education for girls. The Taliban fighters boarded her school bus, and severely injured her and two other students. Malala has made a spectacular recovery and last month, in her first public statement since the incident,said "I want every girl, every child, to be educated." Malala has just been nominated for the Nobel Peace Prize. Should she receive it, it would help her cause immensely, and improve the plight of girls around the world.

According to the Central Asia Institute, which builds schools in the region, Pakistan has the second-highest number of girls who are not enrolled in school. Its education budget is less than 2.3% of GDP.

The UN Special Envoy for Global Education (Former UK Prime Minister Gordon Brown) wrote that "Indeed, the new superpower that cannot be ignored is the power that girls are rightly seizing for themselves."

In India, Dr. Vanaja Ramprasad founded the GREEN Foundation that is trying to protect agricultural livelihoods, promote women's empowerment, and share best practices based on local and traditional knowledge. Nearly 80% of Indian women work in agriculture, yet less than 7% of women have land tenure. Dr. Ramprasad has worked tirelessly in the face of the green revolution and the industrial agriculture system to protect biodiversity and empower small-scale farmers. She and her foundation are promoting women's innovations, much of it based on ancestral knowledge and farmer-to-farmer exchanges, including seed banks, multi-cropping, the use of natural pesticides, water harvesting, and other natural farming practices. All this has resulted in a positive and lasting effect on women's food and economic security, and has empowered women farmers across India.

As we celebrate International Women's Day, let's keep the Dr. Ramprasads and Malala's of the world in our hearts and minds. When society empowers and values women and girls, it gives them the freedom to make positive choices for themselves and their families, which is good for the entire world. doclink

Women's Empowerment is a Fundamental Requirement for Sustainability and a Prosperous Future

March 8, 2013, Population Matters

International Women's Day 2013 - Women's empowerment is a requirement for sustainability and is in the interests of all, men and women. Only when women are fully empowered can they make independent choices, with their partners, about the timing and number of their children.

This ability to choose is key to reducing global birth rates to replacement level, which itself is necessary to achieve long term sustainability, protect the environment and biodiversity, slow climate change and ensure that there are sufficient resources for everyone. Only by ending and then reversing human population growth will there be sufficient resources to raise the living standards of the world's poor.

Women's empowerment requires:

*An acceptance that women should play a full role in social, political and economic life

*Universal access to modern family planning and maternal health services

*Equal access to education

*Equal access to employment

*Equal property, legal and other rights

*Legal and social protection from violence, inside and outside the home

*An end to female genital mutilation and child marriage

*Poverty alleviation

*Peace and security

Commented Simon Ross "Women and couples, given the ability to choose and the right circumstances, typically choose to have smaller families. Smaller families are a precondition for sustainability. Consequently, women's empowerment should be included in all strategies with the goals of sustainability, environmental protection and poverty alleviation." doclink

Religions and Babies

May 2012, Gapminder World

Is there a relation between religion, sex and the number of babies per woman? In this TED talk from Doha, Qatar, Hans Rosling discusses this delicate topic and explains the main reason why the world population will increase with another 3 billion people.

It's not religion; it's not income. What is it?

. http to see and explore the interactive map shown in the video.


Image from Qatar government website


Image from Gapminder World website at http://www.ted.com/talks/view/lang///id/1455 doclink

Why Women Are a Foreign Policy Issue; the Most Pressing Global Problems Simply Won't Be Solved Without the Participation of Women

May 2012, Foreign Policy

Melanne Verveer is the U.S. State Department's ambassador at large for global women's issues. In meeting with a group of Afghan women activists in Kabul, one of the women requested: "Please don't see us as victims, but look to us as the leaders we are."

For generations, the United States too often viewed the world's women as victims of poverty and illiteracy, of violence and seemingly unbreakable cultural traditions -- essentially, as beneficiaries of aid. Now that there has been a transformative change -- from the rise of new economic powers to a growing chorus of voices against repressive regimes in the Arab world -- promoting the status of women is not just a moral imperative but a strategic one; it's essential to economic prosperity and to global peace and security. In other words, it is a strategy for a smarter foreign policy.

Peace talks took place which left women out of negotiating rooms and treaty documents, an omission that weakened the chances of forging durable peace agreements. Development programs were designed without consulting women or considering the crucial role they played, whether it was agricultural training initiatives that targeted men even though women often represented the majority of small farmers, or building wells in areas where women could not go, never mind that women were the ones responsible for fetching water.

Secretary of State Hillary Clinton is working to ensure that advancing the status of women and girls around the world is fully integrated into every aspect of U.S. foreign policy. Advancing the status of women and girls worldwide is now officially a requirement in every U.S. diplomat's job description.

Those countries that deny women basic human rights are some of the poorest and least stable. Countries where men and women are closer to enjoying equal rights are far more economically competitive than those where the gender gap has left women and girls with limited or no access to medical care, education, elected office, and the marketplace, according to the World Economic Forum.

Goldman Sachs researchers found that closing the gender gap between male and female employment would be a powerful engine for global growth, even in the United States and the eurozone, where it could boost GDP by billions of dollars. The Economist has reported that the increase in employment among women in developed countries contributed more to global GDP growth than China as a whole in recent years.

Many women still lack access to capital, credit, and training and are prevented from inheriting or owning land. Cultural traditions inhibit women's participation in the formal economy. FAO estimates that if women farmers were provided the same access to seeds, fertilizer, and technology as men, they could improve their yields by 20 - 30% and reduce the number of undernourished people in the world by 100 million to 150 million.

In the 1990s, nearly half of all peace agreements failed within the first five years, according to the Human Security Report Project. Women, meanwhile, endure much of the residual violence and poverty caused by armed conflicts, and they bear much of the burden of rebuilding families and communities. Less than 8% of the hundreds of peace treaties signed in the last 20 years were negotiated by delegations that included women, and according to the World Economic Forum, women hold less than 20%of all national decision-making positions.

In 1994 the Lusaka Protocol ended two decades of civil war in Angola. The commission established to implement the protocol consisted of 40 men -- and no women. While there were demobilization programs for ex-combatants, there were no programs for the thousands of women who had been kidnapped and forced to work as military cooks, messengers, or sex slaves. Efforts were focused on roads and failed to target the fields, wells, and forests where women grew crops, fetched water, and gathered firewood.

In Egypt last year, women marched on the front lines of the protests, often leading their fathers, brothers, and husbands into Tahrir Square. A year later, the courageous women of the Arab Spring fear not just that progress on women's rights will halt, but that the rights they currently enjoy will be rolled back.

In Afghanistan the number of women attending school and serving in parliament and on local peace councils has increased dramatically over the past decade, but the country still remains the world's most dangerous for women in terms of health, violence, and lack of economic resources.

Give a small-businesswoman access to capital and training, and she can become a powerful contributor to GDP growth. Include women in governments and peace talks, and they can help ensure that ministries are better run and peace agreements are sustained. Educate a girl, and she will be more likely to raise healthier and more educated children -- and end the cycle of poverty.

Secretary Clinton has championed the use of "smart power": deploying all the tools at America's disposal to advance national interests -- not just military might, but also diplomacy, development, and America's enduring values. Advocating for women's full economic, social, and political participation around the world is one of the most potent weapons in America's smart-power arsenal. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Number of Women in Need of Publicly Funded Family Planning Services Increased by Nearly One Million Between 2010 and 2013

Publicly Funded Family Planning Services Helped Women Avoid Two Million Unintended Pregnancies in 2013
July 2015, Guttmacher Institute

Twenty million U.S. women were in need of publicly funded family planning services in 2013 -- 5% more than in 2010, according to a report "Contraceptive Needs and Services." This growth reflects the increase in the number of adults with a family income below 250% of the federal poverty level, or teens regardless of family income, who were sexually active, able to conceive and did not want to become pregnant.

The services of publicly funded family planning providers helped women prevent two million unintended pregnancies, one million of which would have resulted in unplanned births and 693,000 in abortions. Without these services, rates of unintended pregnancies, unplanned births and abortions in the United States would have all been 60% higher.

At the same time the need grew by 5%, Congress slashed funding for the Title X national family planning program by 12% and plans to cut funding even further, or eliminate it altogether. Kinsey Hasstedt, Guttmacher Institute public policy associate said: "This program isn't just good public health policy, it results in considerable savings. By helping women avoid pregnancies they do not want, the services Title X supports save $7 for every public dollar invested."

Title X clinics served 4.1 million women in 2013, allowing women to avoid one million unintended pregnancies, 501,000 unplanned births and 345,000 abortions. Without these contraceptive services, levels of unintended pregnancy and teen pregnancy would be 30% higher.

Title X clinics also provides preconception health care and counseling, STI testing and treatment, vaccines to prevent human papillomavirus (HPV) and Pap tests.

"Policymakers at all levels should be doing everything they can to support this critical safety net, which is vital to the health and well-being of millions of women and their families," said Hasstedt.

Click on the link in the headline to see a great infographic on the subject. doclink

Uganda on Track to Have World's Highest Population Growth

July 3, 2015, Worldwatch Institute   By: Alana Herro

A new report from the Population Reference Bureau (PRB) projects that the current population of the east African nation of Uganda is projected to explode from 27.7 million to 130 million by 2050, a nearly fivefold increase. Carl Haub, a demographer at PRB, says such expansion will entrap the country in poverty and instability. "No one would consider such a rate of growth to be sustainable," he says.

Uganda is currently growing at 3.1%, compared to the world average of 1.2%. Uganda's growth rate is exceeded only by the African island nation of Mayotte, growing at a rate of 3.6%.

To blame is the Ugandan government's lack of commitment to family planning. President Yoweri Museveni has called the nation's population explosion a "great resource." Only 20% of married Ugandan women between the ages of 15 and 49 have access to contraception. Women in Uganda have an average of 6.9 children, compared with a global average of 2.7 and an African average of 5.1. doclink

Karen Gaia says: This article is at least 2 years old, judging by the copyright on the page, but it's information is even older, claiming that the world population is at 6.6 billion. In July 2014, President Yoweri Museveni had a change of heart, saying "Family planning, if combined with economic growth and transformation, will improve the lives of women and children. It will also save families and country's expenditure on too many dependents."

See http://www.theafricareport.com/East-Horn-Africa/family-planning-ugandan-presidents-change-of-heart.html

Iran Bans Permanent Contraception to Boost Population Growth

Parliament prohibits vasectomies and other lasting birth control measures after Ayatollah Ali Khamenei calls for more babies
August 11, 2014, Mail and Guardian

Iran's supreme leader Ayatollah Ali Khamenei has called for more babies to be born and.parliament has voted to ban permanent forms of contraception. Khamenei's decree in May called for the ban in order to "strengthen national identity" and counter "undesirable aspects of western lifestyles".

The bill also bans the advertising of birth control in a country where condoms had been widely available and family planning considered entirely normal.

Reformists see the law as part of a drive by conservatives to keep Iran's highly educated female population in traditional roles as wives and mothers. Health advocates fear an increase in illegal abortions. Abortion is legal in Iran if the mother is in danger or if the foetus is diagnosed with certain defects.

In the 1980s, Iran offered incentives to encourage families to have more children, but that was reversed in the late 1980s, amid concerns that the rapid population growth could hobble the economy and drain resources. Subsequently the birth rate fell to 1.6 children per woman. It is projected that, at that rate, the population of more than 75 million would fall to 31 million by 2094, and 47% of Iranians would be above the age of 60. doclink

Yougov Poll Shows That the British Support Smaller Families

A YouGov survey survey released today shows support for smaller families and an end to UK population growth.
May 26, 2014, Population Matters

Commented Simon Ross chief executive of Population Matters, "The survey confirms the results of other studies we have conducted in recent years. People would prefer population to fall rather than to continually increase. The results support some of the key policies we advocate to stabilize and ultimately reduce our unsustainable numbers. Politicians should respond to this support by taking action to address our growing numbers, with all the problems they cause for housing and service provision, employment, resource sustainability, limiting carbon emissions and the environment."

With global human numbers growing by 80 million a year1, 83 per cent of those questioned thought that it would be better if the future world population stayed the same size or fell.

Similarly, with the UK population growing by two million every decade2, driven by relatively high birth and net migration rates, 84 per cent of those questioned thought that it would be better if the future UK population stayed the same or fell.

Almost two-thirds (63%) of respondents thought that, when deciding how many children to have, people should take into account at least one of the following: the future availability of housing, services and amenities; natural resource limits, and environmental conservation. Of these respondents, just over half (51%) thought that people should have no more than two children.

Most respondents supported a move towards balanced migration in the UK (54%) and limiting child tax credit (51%) and child benefit (50%) to the first two children in each household, with payments for further children being means tested.

There was also support for better sex and relationships education in schools (49%), better family planning services (41%) and promoting smaller families (37%).

Notes:

The study was commissioned by Population Matters from YouGov. A sample of 2,362 individuals selected to be representative of UK adults completed the survey online during the 15th and 16th May 2014. The figures have been weighted and are representative of all UK adults (aged 18+).

1. Source: UNDESA Population Division

2. Source: Office for National Statistics doclink

The Gulabi Gang - India (video)

October 30, 2013, Journeyman Pictures



In Uttar Pradesh, one of the poorest and most feudal areas of India, there is a long history of patriarchy, abuse and corruption. Now, an aggressive and outspoken gang of women are fighting the system. Sampat Pal is the leader of the Gulabi, or 'Pink', Gang. This feisty crusader is making headlines with her vigilante tactics; when she isnt attacking police, she is teaching women how to wield the 'lathi' - a long, wooden staff - to protect themselves against domestic violence. With over 40,000 members, the Gulabi Gang has quickly become a mass movement. Why do we have to take the law in our hands? I'll tell you. The government doesn't obey its own laws. They're making fools of everyone. The gang are on a mission to ensure that those born into the lowest caste have an education, avoid child marriages, and earn a decent wage. Mahatma Gandhi famously preached non-violence. Sampat Pal says times have changed. I salute Gandhi. He was the father of our nation. But my style is different. doclink

U.S.: First Trimester Abortion: It's a Good Day to Be a Woman in California

October 9, 2013, ACLU of Northern California

Governor Brown recently signed AB 154, a bill authored by Assemblymember Toni Atkins that expands access to abortion care by authorizing trained health professionals to provide early abortions. The legislation addresses a current shortage in the state -- 52% of California counties don't have an accessible abortion provider -- and allows women to receive care in their own communities from providers they already know and trust.

AB 154 is not just a California victory, it's a national one.

It's not enough to protect what we already have. Even though we are fortunate not to be suffering the harsh political attacks felt elsewhere, there is still much hard work to be done to make reproductive rights a reality for all. This law is necessary for rural women, who often have to travel long distances and make arrangements at work and for child care in order to obtain an abortion. It is also necessary for urban women, many of whom face long delays in getting medical appointments. By expanding the types of health professionals who can provide early abortions to include nurse practitioners, certified nurse midwives and physician assistants, AB 154 significantly reduces these barriers and improves access to care for Californians.

A 16,000-patient study has already shown that trained health professionals can safely provide early abortions and that women appreciated receiving care in their own communities. Other states have seen restrictive bills pthat rely heavily on junk science - like the Kansas law requiring that, among other things, women be told by their doctors that there is a link between abortion and breast cancer.

Other reproductive justice bills recently signed include a bill to protect patient privacy for sensitive services by closing a health insurance loophole, another ensuring that abortion-providing clinics are not subjected to different licensing and building standards than other primary care clinics, and one that expands paid family leave, and another that improves access to child care and reproductive health education for foster youth. doclink

Karen Gaia says: California has reason to be cautious. The city council in Bakersfield wanted to pass an anti-abortion 'human-life' ordinance last July. When they found out they would be illegal, they decided to make it a resolution, which will be voted on this Wednesday night. See http://www.bakersfieldnow.com/news/local/Opponents-proponents-speak-out-on-proposed-human-life-ordinance-215945051.html?tab=video&c=y

Ethiopia: Rethinking the Model Family

August 26, 2013

In Ethiopia the government has been organizing "community conversations". In one meeting, for example, a priest with Ethiopia's Orthodox Christian church says "Christianity is not opposed to contraception. It's opposed to killing and lying - not to birth control," and a female government health worker says that having too many kids, and not spacing pregnancies, increases the risk of illness and death for mother and child.

While in rural areas lots of children - to herd cows and plow fields - has been the norm, a health worker says she targets women who are having a lot of children. "We approach them as sisters, and we say, 'Look, you are pregnant and you already have two babies - look at how you are struggling.'"

A farming woman says when she first got married, she wanted a lot of children. "We wanted at least five. But then we met with the health workers, and they changed our mind," she said. She and her husband decided to have just two kids. She began using a contraceptive injection, which she gets from the government for free. The couple was publicly praised by the government and received a certificate, which hangs on the wall of their hut, recognizing them as a "model family."

"Large families used to be admired," she said. "Now, it's people who use birth control and only have a few children who are respected. Families with a lot of children are criticized."

Ethiopia's foreign minister, Dr. Tedros Adhanom, says the country has an unhealthy age structure - too many kids, and not enough breadwinners, which puts a big financial strain on the country, and it needs to change.

Tedros says the government never tells couples how many kids they should have because that is, ultimately, a personal choice. "We don't put a number, saying, this number is good," Tedros says. Instead, the government teaches families about the benefits of having fewer children, and it lets parents decide for themselves.

Over the past decade, the country's fertility rate has fallen, at least a little. doclink

Karen Gaia says: another reason Ethiopia's age structure is skewed is too many deaths of adults from AIDs.

U.S.: State Facts About Unintended Pregnancy

December 19, 2012, Guttmacher Institute

There are 6.7 million pregnancies in the U.S. each year About half of these are unintended. Births resulting from unintended pregnancies have been linked to adverse maternal and child health outcomes and myriad social and economic challenges, including costs to the federal and state governments of $11 billion (2006).

The Guttmacher Institute has launched a new tool that gives the incidence and outcomes of unintended pregnancy in each state, including the proportion of all pregnancies that are unintended; the rates of unintended pregnancy; the proportions of unintended pregnancies that result in births and abortions; and the proportion of all births resulting from unintended pregnancy;

Also given is the public cost of unintended pregnancy in each state, and the impact in each state of publicly funded family planning services.

Adam Sonfield, senior public policy associate at Guttmacher, said of the fact sheets: "They are a comprehensive resource that documents the significant state-level benefits of investing in publicly funded family planning services, both in helping women avert unintended pregnancies, births and abortions, and generating considerable savings to the federal and state governments." doclink

Karen Gaia says: Sounds like a very useful tool for activists to use when having a conversation with their legislators.

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Men in Pakistan Want Fewer Children, Eager to Learn More About Family Planning

April 21, 2014, World Bank

Healthcare systems there have numerous opportunities for women to discuss family planning (e.g. antenatal care, deliveries, mother-and-child health services), but men don't have the same opportunities. A recent study by the Population Council with funding from the World Bank through the Bank-Netherlands Partnership Program (BNPP) found that Pakistani men indeed want fewer children and are eager to receive technical information about family planning. As primary breadwinners and household decision-makers, their motivating force is meeting the needs of expenses. More children incur greater expenses.

Economic concerns also stimulate communication between husbands and wives on family size and contraceptive use. There may be a divergence in opinion on ideal family size and contraceptive use or choice of method, but increasing spousal communication makes it easier for women to convince their husbands about the need for family planning.

The lack of availability of family planning services and contraceptive methods, method failure, and costs impede men from using contraceptives, despite their increasing acceptance of family planning. In addition, limited knowledge of specific family planning methods, perceived or experienced side effects of modern methods, and lack of provider skills for managing side effects, also act as barriers.

Male group meetings are suggested (both by men and women) as the most appropriate intervention for providing men with method-specific knowledge. A suggested male group meeting strategy includes involving local persons to organize meetings and an educated and skillful outsider (preferably a doctor) to conduct them. The strategy also includes immediate provision of contraceptives after the meeting so men who want to start using contraception are not delayed.

Women favor involving religious leaders as an intervention more than men: Those in favor of involving religious leaders suggest that they be trained and discuss family planning with reference to the Quran and Hadith, communicating and endorsing the message that family planning is permitted in Islam.

The role of the media is limited because there is the impression that providing details on contraceptive methods is inappropriate for television because they cannot be viewed in the presence of other family members (i.e. elders and children).

Demand for male health workers: Appreciating the role and effectiveness of the government's Lady Health Worker program, men suggested recruiting male health workers in communities, with roles similar to Lady Health Workers, providing services to men at the community level. doclink

'i Have Seen My Friends Die': Why We Need to Talk Frankly About Girls' Reproductive Health

July 9, 2013, Huffington Post

Last year at the London Family Planning Summit a global movement was catalyzed to ensure that 120 million more women and girls have access to contraception by 2020. World Population Day 2013 focuses on adolescent pregnancy. Complications in pregnancy and childbirth are the leading causes of death among adolescent girls ages 15-19 in low- and middle-income countries.

One in three of girls under 18 in the developing world are married; many without their consent. 15% of all unsafe abortions in low- and middle-income countries are among adolescent girls aged 15-19 years.

Because of these alarming numbers, we need to talk frankly and openly; we cannot shy away from tough conversations when girls are at risk.

Young women face barriers when they seek contraception or access to information and commodities to practice safer sex. This must stop.

A young woman in Ethiopia, Haregnesh, says girls she knows who were very young when they got married and starting having children and she has see some of them die. "I have seen educated people and I saw the difference in their lives. ... I watched as they had no food to eat or feed their children and they just kept getting pregnant and having babies. I could see that they were suffering and I wanted to go to school." A Pathfinder International program in Amhara, Ethiopia supports girls to continue their studies. Haregnesh's strength and resolve to stay in school, as well as talk openly about girls' education, early marriage, and childbirth, has shifted the approach to girls' education in her family and in her community.

Haregnesh's father, who had not wanted her to attend school said. "Haregnesh is our third child and she made all the change happen in our family. My three younger children now attend school as well."

We must commit to ensuring adolescent girls have the support and resources they need to delay marriage and childbirth, stay in school, and start their adult lives the way each of them want to. doclink

Karen Gaia Pitts says: it is important to note that patriarchal attitudes can be changed. That is why I am such a fan of programs like PAI's or the Population Media Center soap operas.

Reproductive Health 101 for Adolescent Girls

March 8, 2012, EngenderHealth News Blog

Lesson #1: Information Is Power In many parts of India, teenagers lack access to quality reproductive health services, including counseling about contraception and HIV prevention. Read more. "http://www.engenderhealth.org/our-work/success-stories/arsh-story.php

Lesson #2: Protect Yourself against HIV and STIs In many urban areas of Ethiopia, adolescents find themselves in situations that jeopardize their health. Read more about our Most At Risk Populations (MARPs) program "http://www.engenderhealth.org/our-work/success-stories/ethiopia-marps-ayenalem.php

Lesson #3: Make Smart Choices to Inspire Your Future. Harmful gender norms can undermine the health of girls and women. That's why we engage boys and men around the world and encourage them to help support their partners' health. Read more about our Gender Matters program. http://www.engenderhealth.org/our-work/success-stories/genm-story.php doclink

Involving Men in Family Planning

December 10, 2011, Philippine Daily Inquirer

At the Second International Conference on Family Planning,held in December in Dakar, Senegal, at a workshop on "Men Behind Family Planning," a speaker from Nigeria explained that while men have "high awareness" of the need for and importance of family planning, they have "poor knowledge" of the various modern methods of family planning and how these work. Men are "unwilling to use family planning" mainly because they were apprehensive and insecure, and didn't know how exactly they fit in the scenario, he said.

The project intervention among village families included training in spousal communications, encouraging spouses to discuss health issues and engage in "joint decision-making" in choosing the method that best worked for them.

One male workshop participant said "there are not enough options for men." "We can only choose between using condoms or having a vasectomy, and I tell you, both options are not attractive to me," he said. "But if only they would come up with a pill for men, I would take it at once."

Another presentor told of research that found that 72% of those surveyed would be "very comfortable" with being counseled on family planning with their partners; while 75% stated that it was "very important" for men to be part of family planning. "The more a man believed in gender equality, the more likely it was for him to believe in taking part in family planning," the researcher said. But two out of every five respondents said they "believed that health facilities do not welcome men," with some reporting that health workers were unaccommodating, if not hostile, to the men among their women and children clients.

This is unfortunate, given the generally positive results seen when men are actually encouraged to take active part in promoting the health of family members.

Bangladesh, has a high contraceptive prevalence rate of 56%, but only 5% of method users are men. Studies have shown that "husbands play an important role in family planning decisions," since a disapproving or indifferent husband can actually discourage a woman from using a family planning method.

An Engenderhealth researcher gathered "satisfied clients" and found what made them satisfied: a skilled surgeon, prompt and effective management of side effects, and effective client follow-up. The "champions" turned out to be excellent promoters of vasectomy, using themselves as examples, and engaging men in the neighborhood or in community centers in discussions about their family planning needs and health concerns. The "champions" were able to refer an average of two or three clients a month to undergo a vasectomy.

In the area of female genital, after undergoing training in human rights, including women's rights, men have come around to the idea of banning FMG cutting. At the health center midwives explain the injury done by cutting and the health risks a scarred or wounded cervix posed to a woman during delivery.

"After being educated on the right to health of women, and of the dangers posed by cutting, I could no longer support the practice," one man said. doclink

Talking Their Way Out of a Population Crisis: by Emboldening Women, Evangelical Churches in Africa Help Them Overcome Traditional Resistance to Family Planning.

October 22, 2011, New York Times

The world is soon to reach 7 billion people and cound see 10 billion by the end of the century, according to the U.N. Most of these additional people will be born in Africa, where women in some countries bear seven children each on average, and only 1 in 10 uses contraception. With mortality rates from disease falling, the population of some countries could increase eightfold in the next century.

In many parts of Africa, people already scramble to obtain food, land and water, and discontent provides fertile ground for extremism. So it is important to think carefully about the response to Africa's exploding population.

Researchers have found that relaxed, trusting and frank conversations between men and women may be the most effective contraceptive of all.

We learned this lesson from Western history. In Europe and the United States, birthrates plummeted between the late 18th and early 20th centuries. This had nothing to do with modern contraceptives, which had not yet been invented, or with government policies, a research team led by Ansley J. Coale of Princeton University found in the 1980s. Australian demographer John Caldwell speculated that is was due to the idea that childbearing was something couples could discuss openly and decide for themselves.

Many researchers have more recently found that spousal communication is a powerful predictor of both contraceptive use and smaller family size. On the other hand, wherever such discussions are silenced by churches, governments, patriarchy or puritanism, birthrates remain high.

Such a "cure" might work in Africa, as seen in what is happening in Africa's evangelical churches, long seen as the bane of family planning programs everywhere.

10 years ago a Columbia University demographer, James F. Phillips, discovered this when he and a group of Ghanaian colleagues had spent a decade trying to encourage contraceptive use in the Kassena-Nankana district of northern Ghana, with little success. When they started on the project, the people were among the poorest in the world and losing one child in four to disease and malnutrition. Large families were considered an asset.

Women who refused to have sex with their husbands, or who tried to use contraception secretly, were beaten. When asked about family planning, another woman said, "If you talk about such issues, you are a fool."

A program where nurses went from hut to hut on motorized scooters treating sick children and pregnant women and offering contraceptive pills and injections resulted in a decrease in child mortality by 70%, but most women were still afraid to even discuss family planning.

They organized all-male political gatherings presided over by the village chief to help explain to men that family planning would make their women and children healthier and stronger. These efforts weren't very successful.

But suddenly data showed that large numbers of women were having fewer children, whether or not they lived near the experimental family planning programs. And at the same time large numbers of evangelical preachers were establishing churches in the Ghanaian hinterlands to which, every Sunday, Kassena-Nankana women dressed in Western-style finery headed in droves.

Dr. Phillips and his team found that female Christian converts were three times as likely to use family planning as women who retained their traditional African faith, and had significantly smaller families, even though the churches didn't promote family planning. It turned out that many churches were giving women a voice denied them by their own culture.

The born-again women were forming committees, making speeches and organizing outings, fund-raisers and other activities. Traditional religion forbids women to communicate with ancestors and other spiritual beings, but the Christian women were speaking directly to Jesus about their problems. He was, many of them may have felt, the first man ever to listen. This may have given them a language for speaking to mortal men as well, even about such sensitive matters as contraception.

Then Dr. Phillips and his colleagues urged elders there to admit women to the traditionally male-only health and family planning meetings.

At one of the first events, a woman spoke of the burden placed on women by men who demanded that they produce so many children. The local women in the crowd went wild with enthusiasm.

Men who beat their wives were urged to stop. Since the start of the program wife beating has declined and the fertility rate has fallen to 3.5 children per woman, a drop of more than one birth.

Being able to express oneself and exchange ideas without fear of reprisal may be the very essence of empowerment, and potentially more important to lowering birthrates than money or access to health services, or even education. This ability for self-expression may be a path to Africa's broader political and economic development as well. doclink

Karen Gaia: another reason to put more funding into such programs. Now, not tomorrow.

In Nigeria, Selling Men on Birth Control is An Uphill Battle

August 9, 2011, NPR

Nigeria, with about 155 million people, is the most populous nation in Africa and the fertility rate has changed little, still at about five kids on average.

Although various types of contraceptive methods are available, about 20% of Nigerian women say they're not able to access them. Often their husbands stand in the way.

For six years the Society for Family Health, or SFH, an affiliate of the international non-profit PSI, has been trying to promote long-term birth control, such as intrauterine devices or contraceptive implants. Women who came and expressed interest in birth control went home to tell their husbands, but never came back.

So on family planning posters around the community, they started portraying men as caring and supportive. Men started accompanying their wives to the clinic. "Men felt ownership. The men felt that, 'this was about me and my family,' " said Dr. Anthony Nwala, with SFH.

SFH also identified men who were pro-family planning and trained them to educate other men.

Today families are moving away from the farms and moving to an urban area where providing for a large family in is more of an economic burden.

Daniel Smith, associate professor at Brown University, disagrees, saying "Women are more educated and liberated today, and yet they still want to have five or six children." He thinks Nigerians favor large extended families as a way to stay socially connected.

But Nwala still believes women - and men - are slowly learning that having fewer children will help them economically. doclink

Family Planning: It's Time to Welcome Men Into the Discussion

July 12, 2011, Huffington Post

Every year on July 11 is World Population Day, but this year, July 11 2011 was particularly important because this year somewhere around October 31, the world's population will reach 7 billion. In response to this, the United Nations launched a campaign entitled 7 Billion Actions to educate, raise awareness and encourage action around the growth of the world's population. As Ashley Judd puts it "the campaign is a wake-up call to the health, environmental, and social challenges associated with rapid population growth. It is also a wake-up call to the importance of voluntary family planning." Judd claims that, "in 2011, more than 200 million women worldwide are still denied access to desired family planning services due to unavailable resources or lack of support from their husbands and communities." It is her sense that it is time to make universal access to family planning a global priority, and that it is essential to welcome men into the conversation.

Judd's service as Global Ambassador to Population Services International(PSI) has given her the opportunity to witness first hand the unnecessary dangers that women face in developing countries due to childbirth and pregnancy. Judd cites World Health Organization statistics stating that world wide 1000 women die every day from complications of childbirth and pregnancy, and that over 99% of these maternal deaths occur in the developing world, in countries where a mother's death can leave children -- and entire families -- in a perilous scenario. Many of these women would choose to have smaller families but do not know how to prevent pregnancies. Some choose to use toxic, poisonous herbs and risk their lives to attempt to prevent or terminate pregnancies while husbands and partners are relegated to worriedly and helplessly watching their wives struggle with these poisons. Judd's point is that family planning education and methods must be more accessible to these families, and must include the men.

It turns out that men in these countries are worth including in the family planning decision making process, because research suggests that when they are included they are more likely to support their partner's family planning choices. Unfortunately though, few of the family planning programs used in developing countries include men in their educational models. But a program in the Democratic Republic of the Congo (DRC) is working to change this model. To do this, it is incorporating the use of cell phones to increase communication to both men and women of the DRC.

Because in 2011, 70 percent of world-wide cellular phone users live in developing countries, the World Bank has recommended contacting cell phones to deliver health services, particularly in remote areas like the Democratic Republic of the Congo .

Recognizing these statistics as well as the fact that 24% of the women of reproductive age in the DRC have unmet family planning needs, the Population Services International (PSI) and its local partner, Association de Sante Familiale, have moved to use cell phone technology to launch a "family planning hot line in the DRC called La Ligne Verte" (Judd)

Ligne Verte is open 5 days a week for 8.5 hours and offers no-cost, accurate information on family planning. Moreover it refers callers to family planning clinics across a wide geographic area.

But probably the most significant offering of the Ligne Verte is that it supplies a "safe, confidential zone for Congolese men and women to ask sensitive questions about family planning, as well as other sexual health concerns such as HIV."

Apparently to date, 84% of Ligne Verte callers have been men. Similar PSI hotlines in other countries reflect corresponding statistics. More that three quarters of the callers to national PSI family planning hotlines in Benin and Pakistan were men.

These are significant statistics. Men, as well as women, are asking questions about family planning and seek answers about how to keep their families physically and economically healthy. To continue listening to questions and to continue finding ways to answer questions helpfully, The Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health and the Ministry of Health and Prevention in Senegal will co-host with over thirty other co- sponsors, the second International Conference on Family Planning: Research and Best Practices November 29-December 2, 2011 in Dakar, Senegal. doclink

Counselling Key to Success of Male Cut

November 2, 2010, PlusNews (Johannesburg)

When Kenya launched its national voluntary male circumcision campaign in 2008, critics worried that it could lead to greater sexual risk-taking - but men in the western Nyanza Province seem to be disproving this theory.

For example, a 23-year-old said: "When I heard people say male circumcision helps in reducing HIV infection, I went there with the sole purpose that it would lessen the burden of having to use a condom. But after that, I have known a lot through the counselling I received; I use a condom every time with anybody ... I am not married so I am not going to trust anybody."

Kenya's programme aims to circumcise more than one million men by 2013, while doing HIV testing and compulsory counselling on HIV prevention, including messages about the importance of continued condom use, since circumcision does not offer full protection from the virus.

A small 2010 study by the University of Illinois in Kisumu found that most respondents - whether circumcised traditionally or in health facilities - reported either no behaviour change or improved protective behaviour, such as increased condom use and fewer sexual partners. Respondents understood that that male circumcision only provided partial protection against HIV.

Another study found that circumcised men did not engage in more risky sexual behaviours than uncircumcised men in the first year after the operation.

Most men in Kenya are circumcised as teenagers during rites of passage into adulthood that do not generally feature HIV education. One young man told the story about how, after he was circumcised during the traditional ceremony of western Kenya's Bukusu community, he was told that he was man enough to have sex with as many girls as he chose. But he heard it being talked about on the radio and everywhere that "circumcision cannot prevent you from HIV unless you use a condom or are faithful." Studies show that not all traditionally circumcised men heed the message about the HIV risk with unprotected sex. doclink

Karen Gaia says: It might be a good idea to investigate whether clinical circumcisions are a culturally acceptable alternative to ritual circumcisions, and, if the use of a condoms might be curtailed by the culturally inspired desire to father many children.

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

'So What If I'm on the Dole'?' Mother of Ten Children by Five Fathers Now Wants 50 Grandchildren to Keep Benefits Rolling in

May 19, 2015, Daily Mail   By: Martin Robinson

A single mother with ten children by five fathers has said she wants 50 grandchildren so they can become Britain's biggest benefits family. Mandy Cowie, 49, has lived on benefits for 30 yr., and her own children have been following the same jobless path. She receives about £22,000-a-year in government handouts and encourages her children to have 5 babies each so the checks will keep pouring in.

Ms Cowie has spent £2,000 on tattoos, including one that says: "Only God can judge me." In a recent TV show, her children describe how to milk the system to gain as much cash from the state as possible. doclink

Art says: Fear that welfare was becoming a way of life lead the Clinton administration to introduce TANF (a.k.a. Welfare to Work). An additional safeguard (not in use) would provide benefits more directly to children (through the schools and health insurance) without handing any checks to parents. Section 8 housing would allow parents to house their children and themselves, but since all other benefits would go directly to the children, parents would need to fend for themselves.

Karen Gaia says: there is plenty to be gained by focusing on meeting the unmet need for contraception in the U.S. (and probably in the U.K.) 50% of pregnancies are unintended, and many of these can be prevented by making long-acting reversible methods free and available.

Let's focus our efforts in developed countries on the unmet need, rather than on shaming people for how many children they have.

Child Marriages, Trafficking Will Soar After Nepal Quake - Charity

May 19, 2015, Thomson Reuters Foundation   By: Emma Batha

With more than 8,500 fatalities, the two earthquakes that struck Nepal on April 25 and May 12 have yielded catastrophic repercussions that many overlook. Due to criminals seeking to take advantage of orphans and increased rape, there will be a significant surge in child marriage and trafficking rates, which are already high in Nepal.

According to Anand Tamang, the director of CREHPA, a Nepalese organization against child marriage, children will become more vulnerable in the aftermath of the earthquakes. "Rape is taking place. Almost every week we have a case of a young girl being raped... Parents who have young girls... will think the best way to ensure her safety will be to marry her," he said. In addition to concerns about safety, families will also marry off young girls with the expenses or destruction of schools.

Child marriage increases the probabilities of childbirth complications and sexual and domestic abuse. Tamang describes child marriage as "a social evil [that deprives] the chance to enjoy the life of an adolescent... of her education and her aspirations." This is not only an issue in Nepal; throughout the world, more than 700 million women today were married before they were 18, with one in three girls in developing nations married before the age of 18.

To combat this problem, almost 300 delegates are attending the three-day meeting in Casablanca hosted by Girls Not Brides (GNB) doclink

Heejin says: Although many do not think of the issue of child marriages and trafficking as one of the more major ramifications of the Nepal earthquake, it is essential for people to recognize this problem, as this directly affects future generations.

Karen Gaia says: Trafficking is a big problem in Nepal. Not only trafficking of sex, but also of body parts. Most of it is to India. Children are also given into slavery to a neighboring, more well-off, family.

Feminist Writers Are So Besieged by Online Abuse That Some Have Begun to Retire

February 26, 2015, RSN - Reader Supported News   By: Michelle Goldberg

While digital media has amplified feminist voices, it has also extracted a steep psychic price. Women are being ferociously punished when they tell their stories. Some have been driven from their homes or forced to cancel public appearances. "Being insulted and threatened online is part of my job," Lindy West, formerly of Jezebel, recently said on "This American Life."

Jessica Valenti, columnist for the Guardian, thinks about quitting "all the time." She recalls being referred to as a c--- day in, day out for 10 years. She questions what effect that has on one's psyche.

In 2013, the pro-choice activist Jaclyn Munson wrote about going undercover at an anti-abortion crisis pregnancy center. Soon a stalker was sending her death threats. She gave up writing online and now plans to go to law school, which she hopes will let her work on the issues she cares about in a safer, less exposed way.

She says what's different now is the existence of organized misogyny, with groups of men who are gathering under banners such as the Men's Rights Movement and Gamergate. Nation columnist Katha Pollitt points out that there is a cadre of incredibly enraged men who have all found each other, thanks to the internet.

Once a woman is singled out by a men's rights group such as A Voice for Men, the misogynist Reddit forum The Red Pill or even just a right-wing Twitter account like Twitchy, she is deluged with hatred.

Filipovic, the former editor of the blog Feministe, says that, although her skin has thickened over the years, the daily need to brace against the online onslaught has changed her. "You read enough times that you're a terrible person and an idiot, and it's very hard not to start believing that maybe they see something that you don't." She also finds it harder to let her guard down.

Many feminist writers have decided to end their online presence. Writer Lauren Bruce, Emily McCombs, executive editor of women's site xoJane, are among them. doclink

Richard says: The Danish newspaper Jyllands-Posten, which received numerous death threats since the depiction of cartoons of the prophet Mohammed, is proof positive that internet bullying works.

Fracking and Trafficking

January 5, 2015, Trafficked

In the Balkan Oil Patch and beyond -- in North Dakota, South Dakota, and affecting young girls in Minneapolis -- the high ratio of men to women has created an issue of supply and demand. In the summer of 2014, Forum News Service set out to shed light on what we saw as a growing problem in North Dakota: human trafficking. It wasn't until we began reporting that we realized truly what a serious issue our state had on its hands. Not only because of the depravity of the crimes taking place in our own communities, but also because of the difficulties in detecting trafficking victims and given the unique nature of the Oil Patch, where the high ratio of men to women has created an issue of supply and demand.

Excerpts:

*Native American populations are 'hugely at risk' to sex trafficking.

*Tim Purdon, U.S. attorney for North Dakota, often says he realized that sex trafficking was a problem in western North Dakota after a November 2013 sting in Dickinson was shut down early because of such high demand for commercial sex with minors.

*The closest dedicated shelter for trafficking victims is more than 500 miles away from the Oil Patch.


. . . more doclink

Niger: Population Explosion

Runaway birth rates are a disaster
August 16, 2014, Economist

A woman in southern Niger has 8 children, 3 of them triplets and her babies scream for food. "If they cry and I have nothing to give them, then I must let them cry," she says, her children suffering from malnutrition, lacking the energy to shake the flies from their faces. It is a common picture in west Africa's largest country.

The UN's Human Development Index places Niger at the bottom of the list in terms of poverty. Most inhabitants grow subsistence crops on small plots of dusty, infertile land. An estimated 2.5 million people out of a total of 17 million have no secure source of food. In 2012, harvests failed and almost a quarter of Niger's population was said to be going hungry.

This problem is compounded by high fertility rates. Niger has an average of 7.6 children per woman - the highest in the world. Poverty, ignorance and poor access to contraception are contributing factors, in addition to cultural factors. Many men are polygamous, and local doctors note that the wives often try to prove their value by outdoing each other in child births. Niger's population will more than triple between now and 2050.

Modern contraceptive use went up from 5% to 12% from 2005 to 2012 but this rate is still dismally low by global standards. About 50% of women of child-bearing age use modern contraceptives in Rwanda and Zimbabwe.

Foreign-funded health centres promote long-term options like contraceptive implants. The United Nations Population Fund (UNFPA) runs a "school for husbands" which teaches men, who traditionally tended to obstruct women seeking birth control, about family planning. The schools hope to dispel wild rumours about contraception.

Only a tiny proportion of the government's budget is devoted to family planning. Only about 25% of women express any desire to space out their births. It has been over 20 years since Niger identified population control as a priority in the fight against poverty, yet birth rates are still rising. doclink

Killed by Stork

Family planning is vital for Pakistan's security
June 25, 2014, Newsweek Pakistan   By: Roshaneh Zafar

In 1978 Thomas Malthus predicted that the world population was bound to outstrip food production, leading to a state of "natural distress." To strike a balance between global natural resources and population, Malthus proposed family planning through "moral restraint," that is, rallying men to delay marrying until later. Malthus has been proven right on the significance of family planning, which is today inextricably linked with economic and security challenges in developing countries, like terror-stricken Pakistan.

The 2009 Failed States Index by the Fund for Peace showed that "failed" states had a total fertility rate -- the number of children per woman -- at five, while the global average was 2.6 at that time. The 2013 Failed States Index, where Pakistan is No. 13, connects the risk of radicalization to the lack of economic opportunities and unemployment. When states are unable to afford the basics for their people (schooling, nutrition, health care, etc.) the denudation of the state is hastened by the employment of its people for radical causes. It's also now evident that having more children results in more, not less, poverty.

The 18th Amendment to the Constitution keeps Pakistan from pursuing a cohesive national program for family planning. The amendment laudably recognized the socioeconomic rights of Pakistani citizens, including the right to an education, as a basic human right. However, it also devolved many previously federally-held responsibilities-including population planning and management-to the provinces.

Pakistan's children-per-woman figure has gone down from 6.7 in 1970-1975 to the present-day 3.3. In comparison, Bangladesh has gone from from 6.2 in 1970-1975 to 2.5 today.

On the bright side, the 2013 Pakistan Demographic and Health Survey shows that almost all married women and 95% of married men were aware of at least one modern family-planning method, and that between 20 to 25% of married women wanted to wait before having another child or even to limit the number of children. doclink

Iran's Baby Boom Decree Prompts Fears for Women's Rights

Reformists warn Ayatollah Ali Khamenei's population drive could restrict access to contraception and further marginalise women
May 30, 2014, Guardian

During the 1980s, Iran's clerics and political leaders joined forces to reduce birthrates. Billboards displayed smiling small families with the motto 'fewer kids, better life.' This resulted in the world's fastest decline in birthrates for any voluntary family planning program. Then, abruptly, former president Mahmoud Ahmadinejad and Ayatollah Ali Khamenei changed course and called for larger families, a request that people have mostly ignored. Now the Ayatollah has mandated more forceful tactics that could restrict access to contraception and further unravel some of the few rights that women have recently gained.

In his 14-point decree, Khamenei claimed that increasing Iran's 76 million-strong population would strengthen national identity and counter undesirable aspects of western lifestyles. On his website, he said,"Given the importance of population size in sovereign might and economic progress" Iran needs "firm, quick and efficient steps" to reverse the recent trend. All three branches of government are required to obey this order, which calls for nearly doubling the population to 120 million.

The falling fertility rate is one of several issues that divides Iran's conservatives and reformists. Most Iranians dislike the policy shift. Reformist Iranians fear the fertility campaign could undermine the position of women in a country where, according to the Statistical Centre of Iran, 60% of university students, but only 12.4% of the workforce, is female. And, with his energies fully committed to removing the economic sanctions related to Iran's nuclear program, reform-minded President Hassan Rouhani remains mum on birth control.

Farzaneh Roudi of the Population Reference Bureau, a Washington-based think tank, said that Tehran could stimulate its economy by hiring more women, "many of whom do not work in the formal economy."

She added that the political push for a baby boom is unlikely to succeed. "It's hard for me to imagine that people will have more children because Khamenei wants them to." doclink

Madhya Pradesh Tribal Women Have No Idea of Contraceptive Use

January 24, 2014, Times of India

The state government of Madhya Pradesh claims to be actively educating residents about family planning, but evidence shows that half of the tribal women residing in the state are clueless about modern family planning methods.

Vandana Tamrakarm, a research scholar from Jawaharlal Nehru University conducted a study that revealed tribal women in Madhya Pradesh do not understand the concept of birth control.

The study found that only 49% of tribal women have knowledge of contraceptive use. Only 41% women are aware of male condoms, 29% know about IUD (intrauterine device), and only a mere 14% know about the Emergency Contraceptive Pill (ECP).

"The reason for the low awareness could be attributed to low literacy rate and lack of exposure," explained Tamrakar. Results also showed that middle-aged, higher educated women are likely to use the modern method of contraception as compared to the younger women (aged 15-24).

Using the information collected from District level Household Survey (DLHS), Tamrakar collected information from 51,419 households, 46,634 currently married women (aged 15-49), and 9,940 unmarried women (aged 15-24) from 45 districts of Madhya Pradesh.

Tamrakar explained that adding that use of modern methods in Madhya Pradesh is affected by many factors like age of women, religion, couple education and economic status.

Additional findings of the study have also found that despite some women in the study possessing higher levels of education, there was no significant association of contraception use. Tamrakar believes the situation could improve with the positive changes in economic statuses of families. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Sex Selection Skews Sex Ratio

August 21, 2009, InterPress Service

In Vietnam there are laws against domestic violence and discrimination, and very high female literacy, yet its sex ratio is skewed: 100 girls to 112 boys at birth. The "average" is 105 boys to 100 girls.

People prefer sons. "If you have sons and they have children, they will carry on the family name." People who want boys do abortion when they are pregnant with girls.

Families in Vietnam are restricted to two children. This ordinance was reinstated in November 2008, after being rescinded in 2003, originating in the 1980s thanks to government fears of a population boom and strains on resources.

The highest skews gender ratio is 120:100, in the northeast.

"Confucian values" which prize sons over daughters and men over women have been blamed in part. Vietnam traditionally has been a patrilineal society, with sons responsible for caring for parents in old age. Daughters, who marry and leave, are considered "outsiders". "In the household, the decision making process is very traditional. Nothing has changed."

The authorities seized 30,000 sex-selection books in early July and shut down seven websites that were advising couples how to have sons.

Revealing the sex of the foetus is illegal but doctors find creative ways around direct statements.

The abortion rate in Vietnam is one of the highest in the world.

Vietnam's gender imbalance "holds the potential for increased levels of antisocial behaviour ultimately presenting a threat to stability and social order," a 2007 UNFPA report has warned. Some experts have worried that this may lead to an increase in the trafficking of women. doclink

Where Women Are Worth Less Than Cattle; as Selective Abortion Makes Girls a Rarity in Parts of India, a Warning of Rising Sexual Exploitation

November 20, 2005, Sunday Herald (UK)

A prolonged cultural norm of favouring boys has left whole villages without women, young men without wives, and a society where infanticide is common. Trafficking of women is now booming in the region as sex-selective abortion has created a big demand. There is a big problem in Haryana, Rajasthan and the Punjab. In recent decades the trend of decreasing female births is beyond doubt. National census figures from 1991 to 2001 show a 2% drop in the number of girls in relation to boys, and the reduction is accelerating as access to technologies to scan the sex of a foetus becomes widespread. In Haryana, there are only 819 girls per 1000 boys up to six whereas in 1991 there were 879 per 1000. In some areas there are as few as 600 girls per 1000 boys. There are rising numbers of trafficked women, known locally as paros, who are bought for '50 to '60. About 8000 women have been sold in Faridabad, initially as wives, many are then resold into sex work or as slaves. Women are cheaper than cows. Many end up in forced labour and subjected to rapes and beatings. A shortage of women is not new in India, British officials reported villages with no women in northern India in the early 19th century, some believe the country's rapid modernisation is creating a time bomb. In September, Indian census figures suggested a link between higher incomes, access to pre-natal scans and declining female birth rates. The data shows it's predominantly an urban problem caused by religious, cultural and economic factors. Costly dowries, illegal but still common, are a major burden across the country and fuel resentment towards having daughters. Indian religion and culture puts greater value on boys and only sons can give the last rites to their parents. When there are proven cases of illegal abortions and trafficking of women, it's very difficult to get a case filed with the police. Mounting criticism at home and abroad is starting to push the issue up the political agenda. Last month, India's Ministry for Home Affairs called police chiefs to Delhi for a seminar, in a bid to raise awareness of trafficking issues. Improving and extending women's education and reducing poverty in states where trafficking is concentrated will yield results in the long run. But changing the mindset of a billion-strong population will take generations. doclink

Ralph says: I met a very well educated young Indian couple who told me they had been totally ostracised by their families because they had two daughters and refused to continue having more children to add a boy to their family.

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Ugandan Women Poverty Levels Alarming

February 8, 2006, The Monitor (Uganda)

Despite the poverty eradication plan, the level of poverty amongst women in Uganda is alarming. The poverty has persistently increased due to gender inequality and the existing poor macroeconomic policies. Ugandan women constitute 75% of agricultural labour yet own 7% of registered land. 51% of women have wages which cannot sustain them, especially, in rural areas where there is 20% of the micro finance. The gender dimensions of poverty are escalated by unequal relations within households, powerlessness due to weak property rights, inability to enforce legal rights as well as limited access to services by women. Women should be allowed access to and control over all the five assets including natural, human, financial, physical and social among others. doclink

Achieving the Mdgs in the Middle East: Why Improved Reproductive Health is Key

September 2005, Population Reference Bureau

Improving women's reproductive health is crucial to achieving the Millennium Development Goals (MDGs). But investing in reproductive health often does not make the top of national priorities. Making women's reproductive health a national priority would accelerate progress toward MDGs across the world. MDG number 1 is to: Eradicate Extreme Poverty and Hunger. Despite poverty reduction across the region, poverty seems entrenched in the MENA region where the poverty rate has not improved since 1990; 23% live on less than $2 a day. The percentage in poverty is the highest in Yemen. More than 20% of Egyptians could not afford the minimum daily calorie. The average enrollment for primary education in the MENA region is about 85% and some countries are on track to achieve this goal. Literacy among 15 to 24 years olds ranges from 68% in Yemen to 99% in Jordan. Literacy remains low for poor women. In Egypt, 91% of women 15 to 49 in the richest one-fifth of the population had completed five years of primary schooling, compared with only 22% of the poorest one-fifth and the cycle of illiteracy, high fertility, and poverty continues. The gender gap in education has been narrowing throughout the MENA region. But Yemen, Morocco, and Egypt have had difficulty closing the literacy between women and men: While 84% of Yemeni males between the ages of 15 and 24 can read, only 51% of Yemeni women can. In these three countries there are nearly 5 million illiterate women. Maternal health has improved in almost all MENA countries, but remains a challenge in parts of the region. Algeria, Iraq, and Syria are expected to miss this MDG, which calls for reducing maternal mortality by three-quarters by 2015. Even in countries such as Jordan and Saudi Arabia, there is need for improving maternal health. Maternal deaths are estimated at more than 40 per 100,000 in Jordan and more than 20 per 100,000 in Saudi Arabia both higher than the average for developed countries of 14 deaths per 100,000 births. While the MENA region has the lowest rate of HIV infection in the world, they are growing in every MENA country, and there is potential for rapid spread of the disease through injecting-drug use. In Iran one-half of injecting-drug users are married and one-third have extramarital sex. Sex workers appear to be poorly equipped to handle the threat of infection. The MENA region is the most arid in the world, and freshwater scarcity tops the list of environmental concerns. Fresh water in most MENA countries now averages 1,500 cubic meters per capita per year, well below the 1,700 cubic meters that defines "water-stressed" countries. Only Iran, Iraq, and Turkey hold two-thirds of available freshwater resources. Oil-rich Gulf states are dependent on technologies like desalinization to meet their increasing demand a strategy not available to Yemen. MENA countries continue to face challenges to meeting their family planning and reproductive health care needs. Contraceptive use ranges from 74% in Iran to 23% in Yemen. Rural women generally have a greater need for accessing quality health services. doclink

Poverty Rate Down to 30.4 Percent in Philippines

May 10, 2005, Agence France-Presse

The poverty rate in the Philippines fell 2.5% over three years to 30.4% of the population in 2003. The Anti-Poverty Commission sets the poverty threshold at 31.37 pesos (58 cents) a day, barely more than the 25-peso (46.3 cent) cost of a hamburger at the country's largest restaurant chain. Some 13.8% of the population earn less than 21.11 pesos (39.1 cents) a day, the minimum amount needed to acquire the most basic of food items, down from 15.8% in 2000. The World Bank says 43.2% of the population, or some 35.7 million, earned two dollars a day or less last year. doclink

Kenyan Village Serves as Test Case in Fight on Poverty

April 4, 2005, New York Times*

A settlement in western Kenya has become a giant test tube and there will be 10 such test villages across the world's poorest continent. The project aims to fight poverty to prove that conditions for millions of people can be improved in just five years. If it fails, initiatives like increased foreign aid to Africa may seem foolhardy. The project grew out of the Millennium Development Goals, and today they keep slipping further into the future. The remoteness of this settlement has allowed poverty to get a foothold here. The Millennium Development Goals seem to have been forgotten in a country that has seen corruption devastate its economy. Researchers behind the program are keeping track of every penny to demonstrate that for a modest amount, around $110 per person, a village can be tugged out of poverty. Every home was surveyed to get an accurate portrait of the population. Blood tests were taken for a nutritional analysis and to determine how widespread malaria is, and then later, to see whether the mosquito nets given to every villager help keep people alive. A new health clinic has gone up. Villagers did the labor, and the project pitched in the sacks of cement, the sheets of tin and the white and blue paint. The Kenyan government must provide the drugs. Before the health clinic, villagers relied on the district hospital, which got its first government doctor as part of the project. The villagers will receive a truck to double as an ambulance and for farmers to get their produce to market. Projects come and go in this part of the world and some people participate to get a free lunch and do not see the long term benefits. People need to stay involved after the experts go home. Most of the aid will come from shared knowledge from experts on health, agriculture, energy and economics. Residents will lift themselves out of poverty. A soil scientist is advising the people how to revive their damaged fields and plant trees as a way of fertilizing the soil for free. Yields could double or triple. Not all the new food the farmers produce will remain theirs. In exchange for free fertilizer and seeds, farmers had to agree to give 10% of their yields to local schools that will start a program to feed children at noontime and, bring more of them into class. The project plans to bring electricity by extending the power grid that never actually reached them. It is too early to say whether this will be another failed venture. Village leaders persuaded one farmer not to sell his free fertilizer. Although an estimated one-fifth to one-third of the people are H.I.V. positive, many fear the stigma if others find they have the disease. Some volunteers came by the village to encourage people to have their blood checked. The reward was a free bed net and a free paper visor to shield one's face from the sun. doclink

Banking on Reproductive Health

January 24, 2005, Global Health

Women of childbearing age constitute a billion of the world's poorest people. The Millennium Development Goals (MDGs) do not include a goal specific to reproductive health. Without the participation of nearly one-third of humankind in economic life, poverty reduction fails. For those in Heavily Indebted Poor Countries (HIPC), with no adequate access to family planning methods, fertility rates have not begun to decline. Rapid population growth challenges modest improvements in the numbers enrolled in school and makes new job creation an endless treadmill. A comprehensive approach to sexual and reproductive health is necessary to turn the tide on AIDs. The World Bank is committed to the expansion of health and development strategies. Universal access to reproductive health has seriously lagged behind the commitments. Key challenges include an assessment of investments and the place of reproductive health in development and it is unlikely that goals can be met without increased support of resources and technical expertise, and collaboration between donors and recipient countries. The Bank can leader in promoting universal access to reproductive health as a means of achieving the MDGs. doclink

Dayrit, Villegas Accused of 'Misusing' Population Figures

November 9, 2004, Push Newsfeed

Messrs Dayrit and Villegas have maintained that more people do not cause slower economic development. However, Mercedes B. Concepcion, former dean of the University of the Philippines, said that Mr. Dayrit's insistence that the fertility rate was 2.1%, not 3.5% as found in a NSO survey was wrong. The 2.1% did not refer to fertility, but the mean number of children born. The 3.5% was the fertility rate - one of the highest in Asia. NSO Administrator said the survey was nationwide, had a high response rate, and less than 10% error. Officials also hit the Health secretary and Mr. Villegas for denying a link between population and poverty, noting findings proved that poverty would rise with increasing family size. The poorest have a mean family size of 6.1. The poorest groups had the largest fertility rate at 5.9%. In the last 10 years, women had one more child than they wanted and the poorest group had the lowest contraceptive use with 62.6% using no contraceptive at all. Population experts said the government should provide access to contraceptives, especially to the poor, also for accurate information on the side effects of contraceptives as some women discontinued their use due to their fears of side effects. For every 1,000 births, 29 children will die before their first birthday, and 40 will die before five. The infant mortality rate in the Philippines has decreased from 34 in 1998, it is high compared to other countries in the region. Spacing births to at least three years apart and improving maternal and child health services can reduce infant mortality. doclink

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3
End of this section pg 1 ... Go to page 2 3
End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

End of this section pg 1 ... Go to page 2 3

Maternal, Infant, and Child Health Care

Country and desired family size

June 2003, Alan Guttmacher Institute

Country and Mean desired survey year family size 4 Sub-Saharan Africa Botswana, 1988 4.7 Burkina Faso, 1992-1993 5.8 Burundi, 1987 5.4 Cameroon, 1991 6.7 Central African Rep., 1994-1995 6.3 Cote d'Ivoire, 1994 5.5 Ghana,1993 4.5 Kenya, 1993 3.8 Liberia, 1986 6.0 Madagascar, 1992 5.6 Malawi, 1992 5.2 Mali, 1987 6.7 Namibia, 1992 5.1 Niger, 1992 7.9 Nigeria, 1990 5.9 Rwanda, 1992 4.3 Senegal, 1992-1993 5.9 Tanzania, 1991-1992 6.1 Togo, 1988 5.3 Ug... doclink

Opinion: South Korea's Fertility

July 7, 2003, Robert Cohen

The fact that South Korea's fertility declined as its per capita income increased is probably just a coincidental happenstance. Per capita income, industrialization, and urbanization may well be irrelevant to fertility, while the significant determinants thereof could be factors such as postponement of marriage, education, and extensive use of contraceptives. For example, the USA has a per capita annual income of around $36,000, yet has a fertility of about 2.1, whereas Kerala, with a per capita annual income of about $1,000 (ca. $3 per day) has achieved a fertility of around 1.8 or perhaps lower. Using the GDP or GDP per capita as a significant indicator of societal well being is outmoded, and is a dangerous concept to promulgate from the standpoint of achieving resource sustainability and has little relevance to the quality of people's lives. We should be replacing it with a Quality of Life (QOL) indicator based on factors such as levels of education, infant mortality, fertility, life expectancy, nutrition, and health care. For example, Kerala, has basic health care for everyone, while in the United States 41 million people are without health care insurance and tens of millions more have inadequate health care insurance. WhatWorks_new;Headlines_demographics;`A%%">doclink

Problems with Separating Family Planning From Reproductive Health

November 6, 2003, Karen Gaia Pitts

Re: 34 Million Friends Campaign Having control of your bodily functions, reproductive and otherwise, is part of the family planning effort. It should not be considered separate from family planning. When a woman has no control over her own body, or she sees what little control her sisters have over theirs, she has difficulty seeing herself as other than a baby machine. She surrenders to 'fate'. She does not assert herself and make that effort i... doclink

China's Population to be Kept Within 1.3 Billion by Year End

December 26, 2003, People Daily

The birth rate in China is 13.37 per thousand, and natural increase 7.25 per thousand. Births are below 10 million, the average per woman is around 1.8. The population is expected to be controlled within 1.294 billion by this year end. The low-birth level is unstable because of the low and high birth rate imbalance between regions. In eastern regions population growth has been reduced to 10 per thousand, and natural increase rate below 5 per thousand. In western regions there are six provinces whose birth rates are higher than 16 per thousand, natural increase rate is higher than 10 per thousand. The conflicts between population, economy, society, resources and environment still stand out. Grassroots work in rural areas is weak; management and service for migrant population are not in place; legal rights of the masses are not well protected; social security system favoring family planning needs to be improved; and the aging problem in rural areas is increasing. The Commission will focus on stabilizing low-birth level and pay high attention to population security. Support will be strengthened for rural households who have done a good job in family planning; service for migrants will be stepped up and attention to the high sex ratio among newborns. doclink

Knowledge and Attitudes Among Women in the Arab Village Regarding Contraception and Family Planning and the Reasons for Having Numerous Children

January 6, 2004, National Institute of Health (NIH)

This study examines to what extent family planning and contraception exist in the Arab population in Israel and the reasons for having children. Clinic staff interviewed 303 women aged 20-45, who had 5 or more children. 60% were married before 18 and most are housewives 96.4%. 18.8% had an education of 0-4 years, 66.5% of 5-8 years, and 14.8% 9 or more years. Most, 92%, claimed the decision regarding the number of children was jointly made with their husband; 24.8% thought that breastfeeding prevents pregnancy. Contraceptive pills were used by 6.9%; IUD, 60.8%; and tubal ligation, 11.2%. A correlation was found between women with a low level of education and more than seven children. As the educational level rises there are fewer children in the family. A correlation was also found between the education of the husband and the number of children greater than seven. doclink

Philippines: Muslim Religious Leaders Support Family Planning

March 12, 2004, Philippine Daily Inquirer

200 Muslim clerics met at the Marco Polo Hotel in the Philippines and agreed that family planning was important. They issued a fatwah to Muslim communities where about 55% of women wanted to practice family planning but were afraid that Islam would not allow it. No vasectomy or ligation but the fatwah allows the use of legal contraception approved by a Muslim physician. The country's Muslim clerics have a more liberal view of population control than the Catholic Church. While Muslim leaders agree on family planning, they have been divided on the methods to be adopted. In the latter part of 2003 a massive research, using the Koran, arrived at a common stand on birth control. The Grand Mufti of Egypt said he too was for population control. It is hoped the fatwah would help in reducing the mortality rate of infants and women in the region. 200 to 300 women die each year in Northern Mindanao from pregnancy-related illnesses. Some 55 babies born every year die at birth. With one of the highest birth rates in Asia, the Philippines will add 1.6 to 2 million people this year, raising it to 84 million. The country's population could explode to 170 million in less than 30 years, that will trap millions of Filipinos in poverty. 40% of Filipinos live below the poverty line. Population control has taken a back seat in the election, with the front-runners, President Macapagal-Arroyo and Fernando Poe Jr., campaigning mainly on pledges to fight corruption and enforce law and order. doclink

Turkish Army Recruits to Receive Sex Education

June 16, 2004, Push Journal

The United Nations Population Fund (UNFPA) program in Turkey will provide sex education, family planning and free condoms to the half a million young men conscripted into the Turkish army. They will be shown a at least 30 hours of educational programmes, in the presence of specialists. Topics include the use of contraceptives, sexually transmitted infections (STIs), sterility and its cures, and women's menstrual cycles. The head of the Ankara military hospital said that 70,000 soldiers had followed the education programme. When they finish their service they are given a supply of condoms. doclink

For Chinese Parents, Having Girls Pays Off

July 9, 2004, Knight Ridder

In rural China, a program called "Caring for Girls" allows village officials to pay for girls' schooling, exempt parents from taxes and help build new homes for parents with two girls as long as they stop having children. According to tradition, most parents, after having two daughters, want to have a boy. But the government wants them to stop. The country established a "one-child policy" in 1979 that was relaxed to let rural women have two children. Rural Chinese want sons because sons care for aging parents and carry on the family line. The use of ultrasound for sex-selective abortions is illegal but the practice has been common, resulting in a gender imbalance of 100 girls to 117 boys. Family planning is enforced and children must be four years apart. Local officials gave Chen Shumei and her husband, $2,400 for a house they built themselves, about a third of the cost for materials. Elsewhere in China, family planning officials give parents of two girls seed money for income-generating businesses. In other areas, the government has pledged a monthly subsidy of $6 for couples with single children or two girls once the parents turn 60. Even with assistance, some parents seem glum at the prospect of having no boys. doclink

End of this section pg 1 ... Go to page 2 3