World Population Awareness

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."

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

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.

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.

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.

What could we, should we actually do about human population growth? Can population trends be altered? If so, can they be altered without violating core human values about the worth of all human beings and the freedom of all to make decisions about their own childbearing? Does the idea of altering population trends lead inevitably to "population control," to walls erected to keep out immigrants, and to coercive policies on childbearing that punish poor women for environment problems that may be the fault of wealthy people living far away?

At the United Nations International Conference on Population and Development in Cairo in 1994, some 180 nations agreed with economist Amartya Sen that coercion has no place in any population program, whether it be a one-child policy, sterilization, forced marriage, forced childbearing, or forced sex. The Chinese, to their credit, are turning away from coercion and toward the approach that the United Nations Population Fund is the United Nations Population Fund is demonstrating, and groups such as Population Action International are advocating worldwide. This more democratic and comprehensive approach champions women's education and access to information and to reproductive-health to reproductive-health care. That care ideally includes not only contraceptives but also pre-natal and post-natal care, professional birth attendants, nutritional and child-care counseling, as well as H.I.V./AIDS prevention.

Policies based on population control are moving towards more people- oriented, reproductive health approaches. Although it takes time for policy and legal changes to benefit women and men at the community and household levels, such changes are a critical first step. Policies and laws are needed to hold health services courts, schools, and other institutions, as well as communities and families, accountable. As such, the policy and legal changes made since 1994 based on human rights, equity, and meeting people's needs--are central to fullfiling the Cairo Mandate.

As the global economic crisis stumbles on, social services are cut worldwide, and the planet faces ever wilder weather, decreasing biodiversity, and shrinking natural resources, we need an even larger investment in girls and women for the sake not only of people, but also for the planet.

Investing in girls and women -- and especially in family planning services -- is one of the smartest, safest, cheapest, most impactful decisions any nation can make. For example, in Texas, the state legislature is working hard funding for family planning services after the financial costs of 2011's funding cuts became apparent.

With simple investments in basic technologies like condoms, the pill, and prenatal healthcare, there's a powerful ripple effect that emerges from women's empowerment. Women and children are healthier. We also see noteworthy dividends for our planet's ability to sustain us all. When we empower individuals and families with the information and services they need to decide on all aspects related to reproduction and sexuality, we create more sustainable and just communities. Give women choices about their children, and they make smart choices about their environment, too.

Global funding for sexual and reproductive health and rights has decreased 65% from 1995 to 2007, leaving more than 200 million women and girls worldwide without access to the modern contraceptives they want and need, to delay or avoid a pregnancy.

When parents are worried about how to bring home enough food for their family's next meal, they don't worry about whether they're taking too many fish from the sea, or cutting down too many trees to sell or to grow crops.

And when the environment is threatened, women are threatened too. Women bear the brunt of the responsibility for providing food and water for their families, for collecting fuel to heat their homes and cook meals. A rapidly changing climate, increasing pressure on food prices brought about by drought, shrinking access to clean water, clean air and healthy forests -- all hit women and children hardest.

It's time for us all to make these connections. We have an unparalleled opportunity to secure a sustainable world of justice, choice and well-being for all people, and without a doubt, we need healthy, empowered women and girls to ensure that our planet can continue to care for us all.

This comprehensive report suggests that the best way to discuss population growth and the myriad of problems confronting the planet today is through a rights-based, holistic approach that includes both people and the planet:

Women's Rights - providing voluntary family planning services to the 222 million women in developing countries who want access to family planning services but do not have access to contraceptives;

Youth Rights - providing comprehensive sexual and reproductive health education to the nearly 3 billion young adults under the age of 25;

Rights of Nature - recognizing the legal right of ecosystems to exist; and

Rethinking the Economy - accepting that endless economic growth is unsustainable and that more efficient global indicators of human and environmental well-being should be adopted.

Click on the link in headline to read the entire report.

Interesting points from the report:

Norman Borlaug, the "father" of the Green Revolution, noted that this effort would only buy humanity a little bit of time. The New York Times wrote that he was frustrated throughout his life that governments did not do more to tackle population growth by lowering birth rates, and at one point said "If the world population continues to increase at the same rate, we will destroy the species."

The approaches we can take go beyond numbers and require a holistic, rights-based approach to talking about population and producing positive changes. Calling it the ‘Population Monster' or population control won't direct the conversation where it needs to be.

While the global rate of population growth has slowed, there are still 80 million people added every year. Africa's total population is predicted to increase from approximately 1 billion today to 2.2 billion by 2050. Pakistan could see a population increase from 175 million people to 335 million in the same time.

And it's not just numbers. In the developed world and emerging economies, it is about consumption, most of it occurring at unprecedented levels and still increasing.

The keys to keeping population numbers closer to the low-end projections are promoting women's rights and empowerment, reducing poverty and inequality, curbing unsustainable consumption, rethinking how we define economic growth and living in balance with nature.

When India and China implemented coercive policies as a means to reduce fertility rates, this gave a negative connotation to population issues for many years thereafter.It was not until the 1994 International Conference on Population and Development in Cairo that family planning issues came back to the forefront and in a more positive light. This time issues were framed around terms like reproductive rights and reproductive health, and moved away from population growth or too much focus on demographics.

The history of colonialism, racism, globalization, oppression, and global inequality cannot be disregarded, and a focus only on numbers and statistics misses the bigger picture.

And on the other hand, a focus only on human rights can overlook the needs of the rest of the ecosystem. A stable population of empowered people benefits the world, both people and the planet.

Ultimately though, it's about understanding rights for all in the face of increasing environmental degradation. In a world where an estimated 222 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception, we need to overcome different viewpoints and remove obstacles to talking about population growth and its impacts. Lack of access, information, education, poverty, and limited options are some of the main barriers.

Christopher Elias of the Gates Foundation talked of the importance of understanding the three main drivers of population growth:

1. continued high desired fertility by some families and the concurrent need to bring down child mortality;

2. the existing unmet need for access to family planning services - 215 million women (ed.note: now updated to 222 million) in developing countries want access to family planning services but do not have access to contraceptives. "Women should be provided the means to do what they already want to do", said Elias;

3. the largest driver of population growth is population momentum, the natural increase in population in a world where half of the population is under the age of 25 and are either in or will soon reach their peak reproductive years. The global community should focus on education for girls and women, and create opportunities for better livelihoods.

The Guttmacher Institute found that fully meeting all need for modern contraceptive methods would cost $8.1 billion per year. This would mean that unintended pregnancies would decline by 2/3rds, from 80 million to 26 million; there would be 21 million fewer unplanned births; and there would be 1.1 million fewer infant deaths.

The world should listen to what women want, for themselves and their families.

The UN report State of the World Population 2009 addressed women and climate change. It emphasized that educating women about reproductive health and providing them access to family planning would do more to reduce greenhouse gas emissions than ending all deforestation.

Women are on the frontlines, facing at times drastically changing weather patterns. In most countries around they world they are the main providers of food, water, and other resources for their families. Empowered women can better support their families and communities, take care of their local environment, and adapt to climate impacts.

The Center for Reproductive Rights states that “The focus on population numbers at the expense of human rights is counter effective and even harmful to the goals of social and economic development." Consider the following statistics from Oxfam: Just 11% of the global population generate around 50% of global carbon emissions, while 50% of people generate only 11%;

Americans trash 40% of their food supply every year, valued at about $165 billion. Some 25% of all the freshwater consumed in the U.S., along with 4% of the oil, goes into producing food that is never eaten. Uneaten food accounts for 23% of all methane emissions in the U.S.

Writer Laurie Mazur said that inequality makes it difficult to address and even acknowledge the environmental impact of population growth. A sustainable balance between people and resources can be achieved by: 1) using resources better; 2) addressing equity/ensuring basic needs are met for all people; 3) choosing a slower growth path.

A Times five-part series in July ( latimes.com/populationrising ) documented the hunger, environmental degradation, and political instability which were among the consequences of rapid global population growth. To follow up, population scholars have been invited to explain some of the approaches they've seen work -- or why they have not.

Malcolm Potts, professor in the School of Public Health at UC Berkeley, quoted the 9/11 Commission report, "A large, steadily increasing population of young men without any reasonable expectation of suitable or steady employment a sure prescription for social turbulence." He also talked bout the Sahel, that dry strip of land bordering the Sahara's southern edge, where the crisis is already acute. The region went from 30 million people in 1950 to 103 million today, and by 2050 -- when climatologists predict that global warming will have greatly exacerbated the region's problems -- is expected to a have totally unsustainable 340 million people if family planning continues to be neglected. Tens of millions of people will be forced to migrate in a humanitarian catastrophe.

The answer is family planning, which is not only a universal need but also a basic human right. Potts has worked internationally for almost 50 years, and has learned that, whenever women are offered a range of family planning methods, backed up by honest information about side effects, family size always falls. Smaller families mean children can stay in school and there is enough food for the family. When birthrates fall, family planning helps countries grow more prosperous.

But family planning can't be coercive or insensitive to culture or religion: one size doesn't fit all. The challenge is that there are still patriarchal individuals and institutions waiting to deny women their reproductive rights.

Gopi Gopalakrishnan, program director for World Health Partners, tells of Kulanjan village in the Indian state of Uttar Pradesh, where a local entrepreneur, working with the World Health Partners network, had organized a day in which village women could obtain the birth control devices and have them inserted for just $3. While 80 women registered to come, only one had the IUD inserted because there was the unanswered question "Where do we go for medical attention if we experience excessive bleeding or backache?" There was no plan in place for what would happen subsequently.

After arranging for a nurse to visit the village every two weeks to handle such problems, the program ended up providing eight times the IUDs and 31/2 times the number of sterilizations as comparable initiatives. Women require predictable follow-up care and sensitive communication that explains side effects, especially for methods such as IUDs and injectable contraceptives.

J. Joseph Speidel and Kirsten Thompson, with UC San Francisco's Bixby Center for Global Reproductive Health, reported that, -- while about 40% of the pregnancies in developing countries are accidental, and contraception is the obvious way to address unplanned pregnancy -- the currently available contraceptives have limitations. 20% to 50% of married women in developing countries complained of unpleasant side effects, health concerns and inconvenience, and which, in half of those cases, prevented them from using contraception, even though they would like to avoid pregnancy. Even in the U.S., half of pregnancies are unplanned or mistimed, and about half of those are due to inconsistent or incorrect use of a contraceptive.

The WHO recognizes that it is extremely challenging for any human to regularly take medicine daily, resulting in about 1 in 10 women who use the pill becoming pregnant during the first year of use. Only hormonal implants and IUDs are highly effective and reversible contraceptives that don't require ongoing vigilance. But both require skilled healthcare providers for insertion and removal.

Research shows that there is demand for a birth control method that is user-controlled and does not require daily action for effectiveness; one that would prevent the transmission of HIV; and one that can be used by women secretly.

The USAID the National Institutes of Health and the WHO developed most of the contraceptives now available in the U.S. But funding for this work has steadily declined in the last 30 years, and large pharmaceutical companies have withdrawn from contraceptive research and development. It is time to reverse this trend and restore funding for this important work.

Leona D'Agnes and Joan Castro of PATH Foundation Philippines and the Integrated Population and Coastal Resource Management initiative worked on a project in a remote and impoverished coastal region of the Philippines where a rapidly expanding population was dependent on a badly depleted fishery and a coastal ecosystem that was being destroyed, resulting in sharply rising malnutrition and poverty. Their team worked closely with community members to establish community-based family planning services and marine protected areas for the regeneration of fish stocks and mangrove forests. Programs aimed at young people encouraged postponing early sex and childbearing and taught environmental stewardship. Some adults worked on intervening against illegal fishing activities and others to provide family planning information. Technological assistance and microloans were available to retrain in another livelihood. Fertility fell, family income rose and coastal ecosystems began to come back.

Martha Campbell, a lecturer at UC Berkeley and the president of Venture Strategies for Health and Development, shed light on the strange silence that shadowed the topic of population and family planning for the last 20 years, when the world population grew from 5.5 billion people to more than 7 billion. It started at the "Earth Summit" in Rio de Janeiro in 1992. There, a number of activist women agreed that the International Conference on Population and Development, scheduled to be held in Cairo in 1994, should broaden its focus to include a wider range of women's concerns, including education, health and improved justice. However, a group of women's advocates devoted themselves to making the terms "population" and "family planning" politically incorrect, suggesting that focusing on numbers of people somehow invited coercive family planning that was aimed at preventing women in developing nations from having children they wanted. They seemed to overlook the fact that the vast number of family planning programs focused on enabling women to make their own decisions. Unfortunately, after the Cairo conference, international family planning budgets collapsed.

Kenya, for example, had reduced average family size from eight children per woman to 4.5 children with a completely voluntary family planning program. But when funding began to dry up Kenya couldn't sustain its progress, which means Kenya will have 12 million more people in 2050 than it would if family planning support had remained stable.

Fortunately, this year, exactly 20 years after the Rio summit at the London Summit on Family Planning, Melinda Gates and a number of world governments decided to break the silence and put family planning back on the agenda. Now sensible people can finally unite in condemning both coercive family planning and the coercive pregnancies that result when women are denied access to family planning. Due to the silence that began 20 years ago, hundreds of millions of women around the world have been forced to have larger families than they wanted, giving up on other goals for themselves and their children as a result.

Djavad Salehi-Isfahani -- professor of economics at Virginia Tech and a nonresident senior fellow at the Brookings Institution -- told the story of Iran, which in the 1980s, had a fertility rate of seven children per woman, and after two decades, dropped to two children per mother, setting a world record for the speed of fertility transition. Iran's turnaround was completely voluntary and occurred under a conservative Islamic government. The government started by building rural clinics across the country. By the time the call came for smaller families 5 years later, women had come to trust their health providers and were thus more likely to accept family planning advice when it was offered. The government also trained and employed young local women as health workers. And if a married woman failed to show up at the clinic at least once a year, a health worker visited her at home.

Unfortunately this fall, Iran's supreme leader, Ayatollah Ali Khamenei, begged forgiveness from God for having gone "too far with family planning."

William N. Ryerson, president of the Population Media Center said surveys reveal that many couples in the developing world want far more than two children. Other reasons people don't embrace contraception are fear of health effects, spousal opposition, religious opposition and a belief that how many children a woman has is up to God.

Population Media Center produces locally written radio and TV serial dramas which are gripping and entertaining, in which key characters embrace such things as family planning, schooling for girls and other social and health goals unique to each country. The idea is education to help people understand the health and economic benefits for them and their children in limiting and spacing births. It requires modeling good family planning and overcoming fears and cultural taboos. It requires getting husbands and wives to talk to each other. The programs have aired in 45 countries.

In northern Nigeria, the PMC radio serial was heard regularly by more than 70% of the population. In a study, two-thirds of those seeking contraception cited the program as a motivating factor. Those who listened to the program also reported wanting fewer children. In Rwanda, listeners were 50% more likely than non-listeners to want three or fewer children. And during the 2 1/2 years a PMC program aired in Ethiopia, 40% of listeners reported using modern contraceptive methods, compared with 25% of non-listeners.

John F. May, a visiting fellow at the Center for Global Development said that, to be truly effective, family planning efforts need a strong commitment from top leaders in the country. Some African leaders have claimed that Africa is underpopulated and that high fertility rates and larger populations make countries stronger.

On the other hand, Rwandan President Paul Kagame understands the implications of rapid population growth for the development prospects of his country. Kagame has rekindled efforts to bring fertility levels down and the Rwandan people -- particularly women and children -- have reaped significant health benefits.

East Asia has found that faster demographic transitions, including rapid declines in fertility, bring a demographic dividend: a period of fast economic growth. This economic growth occurs because declining fertility levels result in more productive people relative to dependents in a given population.

This could be a transformative tool for African countries too. But first, African leaders will have to embrace sound population policies. Without support from the top, family planning efforts in Africa will continue to struggle.

Rajiv Shah, administrator of the U.S. Agency for International Development, tells us that 6.9 million children under the age of 5 die each year. Worldwide, families have willingly chosen to have fewer children when they know each child will have a chance to survive and thrive. When East Asia and Latin America decided in the 1960s and 1970s to invest in voluntary family planning, they also reduced child mortality and educated girls and boys.

Meeting the unmet need for women to have access to the contraceptives of their choice will only work if they have confidence that the children they have will live to adulthood. By focusing on a range of life-saving interventions -- from bed nets that protect against malaria to new vaccines against diarrhea and pneumonia -- we can make it far more likely that children will live to celebrate their 5th birthdays.

Under the leadership of President Obama, USAID co-hosted a call to action on child survival that has resulted in more than 150 governments signing a new pledge to end preventable child death.

Increasing contraceptive use in developing countries over the past 20 years has, by reducing the number of unintended pregnancies, cut the number of maternal deaths by 40%. Preventing high-risk pregnancies where women have many births, and those that would have ended in unsafe abortion, contraceptive use has reduced the maternal mortality ratio by about 26% in just over a decade.

30% more maternal deaths could be avoided by meeting the unmet need for contraception. The benefits of modern contraceptives to women's health, including non-contraceptive benefits of specific methods, outweigh the risks.

In addition, contraception helps lengthen the interval of birth spacing, improving perinatal outcomes and child survival. In developing countries, the risk of prematurity and low birth weight doubles when conception occurs within 6 months of a previous birth, and children born within 2 years of an elder sibling are 60% more likely to die in infancy than are those born more than 2 years after their sibling.

Greater-than-average risk to maternal, perinatal, and child survival is associated with pregnancies at very young (<18 years) and old (>34 years) maternal ages, at high parities, and with short interpregnancy intervals, and with pregnancies that would have ended in unsafe abortion.

In countries of low and middle income an increase in contraceptive use by 10% reduces fertility by 0.6 births per woman, decreases the proportion of all births to women with four or more children by 5%, reduces births to women aged 35 years or older by 1.5%, and lowers birth intervals of less than 2 years by 3·5%.

Increases in contraceptive use account for about 75% of fertility decline in developing countries in the past six decades and have substantially reduced the proportion of pregnancies in women of high parity, which pose a greater-than-average risk to maternal survival

In 2008, contraceptive use averted over 250,000 maternal deaths worldwide by reducing unintended pregnancies, which is equivalent to 40% of the 355,000 maternal deaths that occurred that year

If all women in developing countries who want to avoid pregnancy use an effective contraceptive method, the number of maternal deaths would fall by a further 30%

Because of its effect on births to women of high parity and on the need to resort to unsafe abortion, contraception also reduces the risk of maternal death per pregnancy; each 1% increase in contraceptive use reduces the maternal mortality ratio by 4·8 deaths per 100 000 live births

In rich and poor countries the risks of prematurity and low birth weight are substantially raised by short intervals, and in developing countries, risk of death in infancy (ages <1 year) would fall by 10%, and in ages 1 - 4 years by 21%, if all children were spaced by a gap of 2 years

There are four measures used to describe maternal mortality:

* The MMRate is the yearly number of maternal deaths per 1000 women of childbearing age (15—49 years). It ties directly to fertility rates and thus quantify the risk of maternal death per woman.

*The MMRatio has the same numerator, but is expressed per 100 000 livebirths. It is indicative of risk per pregnancy due to poor access to and quality of obstetric services. It also responds to fertility rates, which can affect the proportion of births to women with greater-than-average obstetric risk. MMRatios tend to be raised at parity 1, then become lowered at parities 2-3, then raised again at 4-5, and highest at parities greater than 6. Raised maternal mortality risks at high parities have been seen in Pakistan, Senegal, and west Africa.

*Lifetime risk of maternal death is the cumulative probability of a woman dying of maternal causes during her reproductive life, and is a measure of pregnancy-related female death. It also ties directly to fertility rates and thus quantify the risk of maternal death per woman.

*The number of maternal deaths. A fall in the number of pregnancies lowers the number of maternal deaths.

Maternal mortality risk is affected by the number and timing of pregnancies in a woman's reproductive lifespan, by the presence of comorbidities (other diseases or conditions that may increase the risk), and by obstetric care.

Another category of high-risk pregnancies are those that end in unsafe abortion.

Singh and colleagues reported that, in 2008, there were 185 million pregnancies occurring in developing regions, of which 40% were unintended, with 16% ending in livebirth, 19% in abortion, and 5% in miscarriage. In 2003 they estimated that 42 million pregnancies were aborted worldwide in 2003, of which 48% took place in unsafe conditions. 97% of unsafe abortions occur in developing countries, with increased rates in sub-Saharan Africa and Latin America since 2003. About 47 000 maternal deaths (13% of all maternal deaths) in developing countries are caused by complications of unsafe abortions. Contraceptive use can prevent recourse to induced abortion and eliminate most of these deaths.

Infant and child mortality and health: For infants (children younger than 1 year), the shorter the interval (18 months or less), the greater the mortality risk. Children born within 2 years of an elder sibling have a 60% increased risk of infant death, and those born within 2 - 3 years a 10% increased risk, compared with those born after an interval of 3 years or longer. Also, conservative interpretation of all major studies suggests that a preceding interval of less than 2 years raises risk of death at ages 1—4 years by about 40%. Other studies reported that the birth of a younger sibling within 2 years of the index child was associated with a doubling of mortality at ages 1 - 2 years, and smaller adverse effects at ages 2 - 4 years. If all children were spaced by a gap of at least 2 years, estimates suggest that the infant mortality rate would fall by about 10%, and mortality of children aged 1-4 years by 21%.

Children born to women younger than 18 years have an excess mortality risk of about 40% and are more likely to be stunted and anaemic than are those born to women older than 18 years.

The most prevalent method of contraception worldwide is surgical sterilisation. Female sterilisation (tubal sterilisation) and male sterilisation (vasectomy) have immediate surgical risks, but the risks of death and serious morbidity are very small with tubal sterilisation and even lower with vasectomy. Although the risk of pregnancy is low after tubal sterilisation, when pregnancy does occur, it is more likely to be ectopic; however, the absolute risk of ectopic gestation is lower than when no contraception is used.

Intrauterine devices (IUDs) are the most widely used modern method of reversible contraception. The risk of pelvic inflammatory disease is very low in women fitted with an IUD who have a low risk for sexually transmitted infections, but women with cervical chlamydial or gonococcal infections who have an IUD are at increased risk. IUDs have been associated with a reduced risk of endometrial cancer, and a pooled analysis suggests a possible reduced risk of cervical cancer. Levonorgestrel-releasing IUDs reduce menstrual blood loss. As with tubal sterilisation, pregnancies during use are very uncommon, but are more likely to be ectopic when they occur, but the absolute risk is lower than when no method is used.

Combined oestrogen—progestogen oral contraceptive pills (OCPs) are among the most widely used modern contraceptive methods in many countries and are also among the best studied drugs in history. An analysis of data from a large UK cohort study with long-term follow-up reported that use of OCPs slightly reduces all-cause mortality. OCPs are associated with very low relative and absolute risks of cardiovascular disease in young healthy women who do not smoke, although women aged 35 years or older who smoke are at increased risk. Whether OCPs have any effect on the risk of breast cancer is unclear. Studies suggest an increased risk of cervical cancer in OCP users who are positive for human papillomavirus (HPV) DNA, but not in those negative for HPV DNA. A pooled analysis showed that OCP users had a raised risk of cervical cancer that increased with duration of use and decreased after cessation of use, with the risk returning to that for never users after 10 years.

A 2012 WHO technical consultation concluded that the use of hormonal contraceptive methods by women with HIV or at high risk for HIV should not be restricted, but issued a detailed clarification for women receiving progestogen-only injections because of the inconclusive evidence about risk of HIV infection.

Although serious health risks associated with contraception are uncommon, side-effects are common, particularly with the most effective methods. For example, menstrual bleeding abnormalities are a frequent side-effect of hormonal contraceptives and IUDs, and the loss of regular menses might affect the acceptability of these methods in some regions. In general, although side-effects are minor, they can be unacceptable and are the most frequently cited reason for discontinuation. Typically, 30—50% of women discontinue use of OCPs or contraceptive injections within 12 months because of side-effects or health concerns, although most switch promptly to alternatives.

By freeing women from an incessant cycle of pregnancy, breastfeeding, and child care, contraception represents a huge step towards greater gender equality. The benefits to families of fewer children, in whom more resources can be invested, and the benefits to societies of reduced fertility and slowed population growth for social and economic advance and preservation of local environments are likewise important.

Two independent analyses using different methods came to the same conclusion: elimination of the unmet need for contraception in developing countries would reduce maternal deaths by about 30%. This estimate overstates the potential short-term contribution of contraception, because unmet need can never be eliminated; however, it understates the long-term contribution because need for contraception in high-fertility countries will inevitably increase over time. Especially in rural areas with poor health infrastructure, family planning is the most cost-effective and feasible way to reduce maternal deaths because it does not rely on complex technology, unlike some alternative interventions.

The relation between spacing and infant survival is well known and frequently given as a compelling reason for investments in family planning. Less well known is the persistence of the effect of short preceding intervals into early childhood (ages 1-4 years). Moreover, survival chances in early childhood are seriously jeopardised by the birth of a younger sibling within 2 years. This double jeopardy is of huge importance for child health programmes in high fertility countries of sub-Saharan Africa where about 60% of children have older and younger siblings and where deaths of children older than 1 year comprise 30-50% of all deaths in children younger than 5 years.

The effect of contraceptive use on interbirth spacing has been disappointingly small. One reason for this weak link is the emphasis in some countries on sterilisation to restrict family size, which has overshadowed promotion of methods for birth spacing. A greater emphasis on post-partum family planning services is needed and attempts to re-invigorate the idea of birth spacing, spearheaded by USAID and WHO are welcome. This initiative holds particular promise in Africa, where great value is attached to adequate intervals between successive births.

The substantial effect of contraception on health is often overlooked by medical specialists, perhaps because the evidence, with the exception of the important non-contraceptive health benefits of specific methods, has been generated largely by demographers and reported in non-medical journals. Another reason for neglect might be that contraceptive technology is well established and perceived as unexciting. Additionally, emphatic advocacy of family planning is linked to population control, which has become deeply unfashionable. One result of the long silence on these subjects has been the steep decrease in international funding of, and vocal support for, family-planning programmes. In terms of maternal and child health, a heavy price has been paid for this neglect, particularly in Africa. We believe that redress of this imbalance is long overdue.

In the book State of the World 2012: Moving Toward Sustainable Prosperity, in the chapter titled "Nine Population Strategies to Stop Short of 9 Billion," Worldwatch Institute president Robert Engelman outlines a 9 step plan that assures declines in birthrates that would end population growth before 2050 at less than 9 billion people. "Unsustainable population growth can only be effectively and ethically addressed by empowering women to become pregnant only when they themselves choose to do so," Engelman writes.

All over the world examples can be found of countries that demonstrate effective policies which not only reduce birth rates, but also respect the reproductive aspirations of parents and support an educated and economically active society that promotes the health of women and girls.

Engelman opposes 'population control' and the idea that anyone should pressure women and their partner on reproduction. Instead he proposes the following:

1. Provide universal access to safe and effective contraceptive options for both sexes. Nearly two in five pregnancies are reported as mistimed or never wanted. Each baby should be wanted and welcomed in advance by its parents.

2. Guarantee education through secondary school for all, especially girls. Women who have completed at least some secondary school have fewer children on average.

3. Eradicate gender bias from law, economic opportunity, health, and culture. Women who can own, inherit, and manage property; divorce; obtain credit; and participate in civic and political affairs on equal terms with men tend to have fewer children.

4. Offer age-appropriate sexuality education for all students.

5. End all policies that reward parents financially based on the number of children they have.

6. Integrate lessons on population, environment, and development - refraining from advocacy or propaganda - into school curricula at multiple levels.

7. Put prices on environmental costs and impacts. Couples may decide that the cost of having an additional child is too high..

8. Adjust to an aging population instead of boosting childbearing through government incentives and programs. Population aging must instead be met with the needed societal adjustments, such as increased labor participation.

9. Convince leaders to commit to stabilizing population growth through the exercise of human rights and human development, using rights-based population policies, which empower women to make their reproductive choices.

Acknowledges the complex personal and social contexts within which decisions about childbearing are made. It separates the problem of unwanted fertility, which can be addressed by access to family planning services, from other causes of population growth, including the desire for large families. Calls for other social investments -- such as the education of girls and the reduction of infant mortality -- to help make small families the norm.

It took 40 years to build consensus.

1954 - The Club of Rome

1960 - USAID family planning services in the developing countries increases contraceptive prevalence from 14% in 1965 to 57% today. "Population control" sometimes used.

1974 - Bucharest UN World Population Conference. Industrial countries wanted to control population growth, while developing nations said that "development is the best contraceptive."

1984 - Mexico City U.N. Conference on Population becamed emeshed in U.S. debates over abortion and contraception.

1994 - Cairo International Conference on Population and Development (ICPD)- characterized by an extraordinary degree of international cooperation and consensus, by improving health, education, and access to opportunity

The UN General Assembly has decided to hold a special session on Sept. 22, 2014, on the anniversary of the 1994 Cairo population conference - when some 180 nations adopted a plan that focused on birth control, economic development and giving women more power over their lives - to assess implementation the 20 year-old plan to slow the global population explosion.

The world's population has grown since the 1994 conference, from 5.7 billion to about 7 billion. The U.N.'s top population official, Babatunde Osotimehin recently said the world will add a billion people within a decade, further straining the planet's resources.

Kenya's deputy U.N. ambassador Koki Muli said there will be no final document from the 2014 session, a move that will avoid contentious negotiations on issues such as reproductive rights for women, sex education, abortion and family planning.

The Cairo conference changed the U.N. Population Fund's focus from numerical targets to promoting choices for individual women and men, and supporting economic development and education for girls. Underlying the shift was research showing that educated women have smaller families.

At the heart of the 1994 action plan is a demand for equality of women through education, access to modern birth control, and the right to choose if and when to become pregnant. It also recognized that abortion is practiced around the world and should be treated as a major public health issue and indicated that affordable and acceptable family planning is central to achieving safe motherhood.

In 1994 in Cairo, Egypt, the International Conference on Population and Development (ICPD) instituted a Programme of Action which is the guiding document for the United Nations Population Fund, UNFPA.

Recently, at the Ford Foundation in New York, a new 26-member high-level task force assembled to galvanise support behind the goals of the International Conference on Population and Development (ICPD).

Gita Sen is a professor of public policy at the Indian Institute of Management in Bangalore, and has worked on population policies for 35 years. She is a member of the new task force, and attended the conference in Cairo in 1994.

"I would not say that the goals have not been fulfilled, but that they have only been partially fulfilled," she said. "One thing that has definitely happened in those 18 years is that there is a language of sexual and reproductive rights, which was never there before." "This language has scared some people in governments, some very religious people, some social conservatives," she said.

"They think that if women are empowered, if young people get autonomy and choice, they are going to lose out in terms of their ability to control them. Which is probably true, to some extent. But in the end it is for a better life for everybody."

Sen said "The spread of evangelical conservatism in Africa is funded heavily from" the U.S. ..."It is funded by very rich people who are pouring their millions into very poor countries, in order to ensure that they turn their agenda away from sexual and reproductive rights, against gender equality. And with that much money pouring in it is hardly surprising that we have faced so much trouble as we do."

Yet Sen maintains a positive attitude. "We are going to win this one. You can not keep young people and women back forever. This is not the dark ages," she concluded.

200 million women worldwide still lack access to effective contraception, resulting in 80 million unintended pregnancies each year, with 40 million ending in unsafe abortions, many with life-threatening consequences. 800 women who carry out their pregnancies, wanted or unwanted, die every day in childbirth - 99% of them in developing countries.

Ishita Chaudhry, a member of the new task force and the leader of the youth organisation TYPF in India, highlighted the importance of banning child marriage in order to achieve the ICPD goals.

Child brides, girls married before their 18th birthday, run especially high risks of unwanted pregnancy and also of abuse. And there are currently over 60 million child brides worldwide.

One in seven women experience domestic or sexual violence in their lifetime. Up to one in four women experience abuse during pregnancy.

"Women's sexual and reproductive rights are at the heart of sustainable development," said Tarja Halonen, a former president of Finland and co-chair of the new high-level task force.

"Pregnancy should be one of the happiest times in our life… Girls pay the price of taboos and double standards," she said.

In late May in Istanbul some 400 delegates, including more than 200 parliamentarians, discussed a course of action over the coming years to implement the ICPD Programme of Action by 2014 and beyond. They also considered ways to influence any new development framework to follow the Millennium Development Goals (MDGs) in 2015.

Congresswomen Carolyn Maloney and Jan Schakowsky from Chicago represented the United States at the parliamentarian conference.

"ICPD is about human beings, respect, rights, and what we can do to ensure that every individual can make his or her own decisions," said Dr. Babatunde Osotimehin, Executive Director of UNFPA, the United Nations Population Fund.

Delegates committed themselves to its unfinished Cairo agenda plan by unanimously adopting the Istanbul Declaration of Commitment. In it, and under the theme, Keeping Promises — Measuring Results, they determined to advocate for increased national and external funding for the entire implementation of the ICPD agenda in order to achieve access to sexual and reproductive health, including family planning. They committed to strive to "attain at least 10 per cent of national development budgets and development assistance budgets for population and reproductive health programmes." That includes HIV prevention and reproductive health commodities.

They pledged to support policies that give special attention to the specific concerns and needs of young people by promoting and protecting their right to "access good quality education at all levels, health, sexual and reproductive services, including comprehensive sexuality education," and to adopt measures to prevent all types of exploitation and abuse against them.

The conference followed four similar global conferences, in Bangkok in 2006, Strasbourg in 2004, Ottawa in 2002 and Addis Ababa in 2009.

Members of parliament meeting at the fifth International Parliamentarians Conference on Population and Development (ICPD) - held in Istanbul - agreed the economic crunch is no reason for governments to relax their commitment to women's reproductive rights and health, made 18 years ago.

Babatunde Osotimehin, executive director of the United Nations Population Fund (UNFPA) said 250 million women around the world do not have access to much-needed family planning services. "It is not acceptable because every life is worth more than the money that we talk about." he said.

"We have what it takes to make a difference," Osotimehin said, referring to the advances in global communications and medical science since 1994, when the world adopted the ICPD Programme of Action to empower women to claim their reproductive rights.

The conference aims at building on past commitments made in the first ICPD conference held in Cairo, Egypt in 1994. The Programme of Action adopted nearly two decades ago set a target of reducing maternal mortality by 75% by 2015; which is also one of the most urgent targets of the Millennium Development Goals (MDGs).

The good news is that maternal mortality has been reduced by 47% since 1990; still, governments are not doing enough to make reproductive health services widely available to women and young girls.

"Our work is not done," he said, "until we are able to reach out to that little girl out there drawing water five miles away from her house, who, when she has her regular menstrual period, is sent out of the house because it is unacceptable in (her) culture to be the house." Such girls are denied the opportunity to realise their full potential.

Safiye Cagar, of UNFPA, said reproductive health services, which are considered "soft issues" and therefore tend to be the first on the budgetary chopping blocks, unlike roads and schools. But building infrastructure will have little impact unless it is done in tandem with building a healthy population. "Full implementation of the Programme is not optional, it is essential, not just because of human rights but because so many other aspects of economic development hinge on its success."

She called for governments to allocate 10% of their national budgets to ICPD programmes.

Gita Sen, adjunct professor of global health and population at the Harvard School of Public Health, pointed out that the ICPD Programme is itself an unfinished agenda - the ICPD adopted in Cairo had talked about a comprehensive sexual and reproductive health package bolstered by a set of laws and regulations that would protect and promote the reproductive health rights of women, but family planning is still not integrated into issues like maternal mortality, and youth-specific sexual health needs are not being adequately addressed.

The best example of this fragmentation is the global HIV epidemic, which in most places is a "vertical silo sitting by itself" or, at best, running parallel to the rest of the health system. If a woman contracts HIV, she could simultaneously be suffering from domestic violence, she may well have a maternity problem and, most likely, her children will be in dire need of support, according to Sen. A woman probably has neither the time nor the capacity to go to different places to receive treatment, she said.

All the different sexual and reproductive health services need to be integrated as one package, which should give priority to family planning.

As far as youth are concerned, the work being done on the ground to protect and preserve their rights is "next to nothing", Sen said.

By Suzanne Ehlers, President, Population Action International

Next week, the 45th session of the Commission on Population and Development (CPD) will be held at the United Nations in New York. The Commission's work is to "monitor, review and assess the implementation of the ICPD Programme of Action at the national, regional and international levels."

The 2012 CPD outcome document will serve as a foundation for major upcoming international negotiations on sustainable development and population and this year's theme is "Adolescents and Youth."

The number of adolescents and young people in the world today is at an all-time high. Along with food, water and safe shelter, this huge share of the world's population needs access to contraception and a range of sexual and reproductive health services.

Many at the CPD will deny that young people are sexually active. They equate access to comprehensive sexuality education with a rise in sexual activity, when sex ed actually delays sexual initiation.

These deniers also conflate the basic tenets of good health care -- such as privacy, confidentiality, and informed consent -- with undermining cultural, religious and familial values. But young people are sophisticated enough to explore and define their values, and make informed decisions that help safeguard their well-being.

The lives of young people around the world literally depend on the success of our efforts at CPD 2012. We will seek to advance a visionary agenda for the full realization of young people's sexual and reproductive health and rights.

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."

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.

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.

In Morocco there has been a 60% decline in the numbers of women who die during pregnancy or childbirth and a rapid increase in modern contraceptive use by both rural and urban women and for relatively low levels of "unmet need" for family planning - defined as the share of women who wish to delay or avoid pregnancy but are not using contraception.

Morocco's maternal death rate is now closer to the average for Central America (90 per 100,000) than the average for the North African region (270 per 100,000) or Africa as a whole (590 per 100,000).

The share of married women ages 15 to 49 who want to postpone or avoid pregnancy was about 60% in 2004 and 80% by 2011, when 67% were using contraception.

Farzaneh Roudi-Fahimi, Middle East and North Africa program director at the Population Reference Bureau said, "When a woman wants a smaller family and uses contraception effectively, she can have fewer pregnancies—reducing her lifetime risk of disability and death from complications during pregnancy and childbirth."

The nation is poised to to be on track to achieve the United Nations Millennium Development Goal 5 - reducing maternal mortality by 75% between 1990 and 2015. Morocco has made safe motherhood a priority and invested in increased availability of voluntary family planning services, expanded and improved maternal health care, and ensured access to obstetric care (including Caesarian birth) in part by eliminating fees.

The Moroccan government has been by focusing on household-based delivery of family planning services, making modern contraceptives available to low-income and rural women who would otherwise not have access to private-sector services.

57% of Moroccan married women of reproductive age were using a modern contraceptive method in 2011, an increase from 36% since 1992. 10% were using traditional family planning methods, compared with about 6% in 1992.

While 44% of all Moroccan women ages 15 and older are literate, 72% of young women - ages 15 to 24 - are literate, according to 2009 UN data.

A 2011 PAPFAM survey found that Moroccan women were having 2.6 children on average in 2011. The change has been particularly dramatic among women living in rural areas, whose fertility declined from 6.6 births in 1980 to 3.2 births on average in 2011.

Modern contraceptive use among married women in the poorest quintile rose from 18% to 55% - not far behind that of women in the richest quintile. Unmet need for family planning among the poorest women was cut by more than half during that time.

The 2011 PAPFAM survey results also reflect dramatic increases in health care during pregnancy and childbirth, which research has linked to improved survival of both mothers and children. These changes are partly the result of policies that increased the number of trained midwives and removed the barriers that prevented rural women from accessing health care during pregnancy and delivery, including transportation.

Between 1992 and 2011, the share of births delivered at home declined from 95 percent to 61 percent for women in the poorest fifth of the population and from 73 percent to 14 percent for women with incomes in the middle fifth.

72% of women practicing family planning rely on the pill and 16 percent rely on traditional methods. Morocco's family planning program would benefit from expanding services to include more contraceptive choices, including condoms that prevent both pregnancy and HIV.

Moroccan family planning and maternal health services tend to focus on the needs of married women and these programs should be expanded to serve unmarried couples who are sexually active. "The number of couples in such relationships is not high, but the fact that women in such relationships find it difficult to access family planning counseling and services puts their health and well-being in danger, particularly if they are young," Roudi-Fahimi said.

Remote rural communities in developing countries typically face the related challenges of extreme poverty, poor health, and environmental degradation. And population growth often exacerbates these challenges. In communities that face environmental challenges along with high fertility and high maternal and child mortality, health programs that include family planing can have great benefits for the health and well-being of women and families, with positive influences on the local environment. Meeting the reproductive health needs of women and ensuring environmental sustainability by connecting family planning with environment programs has proven to be a "win-win" strategy. Yet this connection has often been seen as controversial or irrelevant to environmental policymaking.

Developing countries, with their faster rates of population growth, are contributing a growing share of CO2 emissions, due to rapid deforestation which releases large amounts of carbon dioxide into the atmosphere.

The UNDP says that developing countries face a double burden of being more vulnerable to wider environmental challenges such as climate change but also having to cope with immediate environmental problems such as resource depletion and poor water quality.

Family planning is a response to an existing need, and it gives women autonomy and equity. A 2008 study found that unintended pregnancy accounts for up to 41% of all births worldwide and over 200 million women worldwide have an unmet need for family planning. Family planning is "the factor in population growth most amenable to program and policy interventions," according to the UNFPA.

Researchers estimate that the demand for contraception will grow by 40% over the next 15 years. The context of family planning has shifted from population control decades ago to individual rights. And the impetus for programs is coming from local communities and developing countries.

In Democratic Republic of Congo, the World Wildlife Fund, through partnerships with local nongovernmental organizations and the Ministry of Health in the Democratic Republic of Congo, is working to improve access to family planning in rural areas with existing conservation programs to give women more autonomy to limit their births and improve maternal and under-5 mortality.

The family planning projects began with women reporting no access to family planning services in remote areas. The closest health center to either give birth or access other health services is up to 30 kilometers away and has few personnel, very limited equipment, and often no medicines. Because of this challenge, the programs focus on training community-based health workers who distribute contraceptives and provide guidance and counseling in rural villages. Public awareness campaigns, based on face-to-face dialogue, focuses on the benefits of family planning on women's health and income and how these benefits extend to children, families, and the entire community. Women with access to family planning services will know how to space births, have the time to recover from childbirth, and have the strength to work in their own businesses or in agriculture, leading to more income.

Women also participate in land management training. With access to reproductive health, women are healthier to participate in conservation activities, decreasing the population pressure on the environment.

Madagascar, off the coast of Eastern Africa, is home to 5% of global biodiversity and 80% of its flora and fauna are found nowhere else in the world. With a per capita GDP of only US$438, it is a "least developed country," . Its population of 21 million is projected to reach 29 million by 2025. Maternal mortality is extremely high, and only 29% of married women are using modern contraception.

In a coastal area that depends on fishing, women average six to seven children each, the closest facility that provides reproductive health care is 50 kilometers away through a desert, and high fertility and unmet need for family planning is stressing the environment. The number of fishermen in some areas has almost tripled from 535 to 1,510 in 20 years. And in 2011, 60% of the fish caught were juveniles, a trend that points to unsustainable fishing practices.

On the other hand, Blue Ventures, a UK-based marine conservation organization dedicated to conservation, education, and sustainable development in tropical coastal communities, started the Velondriake marine conservation program in a remote area on Madagascar to support sustainable resource use and in 2007, and opened regional family planning clinics serving 40 villages by 2011. The clinics focus on peer-led education campaigns, group discussions, educational films, and community events such as theater, sports, and cultural activities. The contraceptive prevalence has risen from under 10% in January 2007 to almost 35% by January 2011, and the fertility rate has fallen by about one-third since the start of the project.

Pathfinder tells the story of Georgette, a mother in the Democratic Republic of Congo had been pregnant 20 times and lost 7 of her babies to starvation. Then she met a Pathfinder-trained community health worker. Empowered with information about family planning, Georgette was finally able to make decisions about her body and her future. She told one of Pathfinder's staff, "family planning saved my life."

In the first six months of 2011, Pathfinder was able to provide much-needed services through more than 9.4 million visits and contacts with Pathfinder-supported health providers.

Pathfinder says: your generous support and continued involvement - whether by signing a petition, sharing a video, attending an event, or following us on Facebook - means a lot.

Representatives from 12 developing countries at a United Nations meeting declared today that voluntary family planning, secured by a steady supply of contraceptives, is a national priority for saving women's lives. The UN Population Fund (UNFPA) launched Global Programme to Enhance Reproductive Health Commodity Security in 2007 to support national efforts to ensure a reliable supply of reproductive health essentials. The 12 countries are: Burkina Faso, Haiti, Ethiopia, Laos, Mali, Madagascar, Mongolia, Mozambique, Nicaragua, Niger, Nigeria and Sierra Leone. They are the ‘Stream One' countries in the Global Programme.

More than 215 million women in developing countries want to avoid or space pregnancies but are not using modern methods of contraception, according to UNFPA.

"As of 31 October, the world will have 7 billion people, of which 1.8 billion are young people, and 90% of them live in developing countries. That implies that 1 billion young women are actively seeking the information and service we are talking about here," UNFPA Executive Director Babatunde Osotimehin said in opening remarks to the meeting in New York.

Participating countries have shown dramatic increases in the use of modern methods of contraception. In Niger, the contraceptive rate increased from 5% in 2006 to 21% in 2010. In Madagascar, it rose by 11% points from 2004 to 2009, up to 29.2%.

Supplies are reaching more people in the right place at the right time. In Burkina Faso, the number of health clinics reporting no shortfalls or stock-outs increased from 29% in 2009 to 81% in 2010. In Nicaragua, the percentage of service delivery points offering at least three modern methods of contraception increased from 66.6% in 2008 to 99.5% in 2010. In Ethiopia, the increase was from 60%in 2006 to 98% last year.

Dr. Osotimehin called on the 12 countries to put resources in their budget to meet the needs of their women and girls.

The First Lady of Sierra Leone, Sia Nyama Koroma, noted that support through the programme has increased the uptake of family planning and other reproductive health programmes, such as fistula activities and the screening of patients for breast cancer.

'Collectively, we are changing the face of maternal and child mortality in Sierra Leone,' she said.

In Malawi one in 36 women will die in childbirth. As Dorothy Ngoma, head of Malawi's Safe Motherhood Initiative, puts it, "being pregnant is described as having one foot in the grave".

Ngoma set up Malawi's first health workers' union at a time when there were more Malawian nurses in the UK than in Malawi. They campaigned for higher wages, better training and safer working conditions and reversed that trend. Ngoma was joined Joyce Banda, the country's first female president, and together they set up the Safe Motherhood Initiative.

Traditionally women in Malawi give birth at home, aided by "traditional birth attendants", and often hours or even days away from a medical centre. 75% live below the poverty line, 11% are HIV-positive, and malnutrition and disease are rife. All contribute to a much greater risk of a difficult delivery.

Banda has recruited a council of chiefs -- who dictate life in remote, rural villages where 85% of the population live -- to challenge tradition.

But the government has to convince pregnant women hospitals are where they want to be. Bwaila Hospital in Lilongwe used to be known as a place women came to die, a massively under-resourced central hospital to which only serious cases were referred, often too late.

There is a new labour ward, and women give birth in private rooms; but now Bwaila suffers from chronic drug and equipment shortages which have a profound effect on morale. Drugs hadn't been procured since 2009.

Because of the economic crisis Banda has had to enact harsh austerity measures, which hit wage-earners hard, causing a mass strike in the civil service.

“The biggest thing I try and teach is that what we do makes a difference and that's also the hardest thing," says MacLeod. “If a woman needs medication or blood and you don't have it, it doesn't matter how good a midwife you are. She is not going to make it."

Many of the nurses and midwives she works with are supporting their entire extended family as unemployment and culture in Malawi dictate. Often they work long hours for extra pay and suffer from exhaustion.
. . . more at Irish Times

A Guttmacher study - "Trends in Contraceptive Need and Use in Developing Countries in 2003, 2008, 2012" - finds that, from 2003 to 2012, the number of women wanting to avoid pregnancy and in need of contraception increased from 716 million to 867 million, with the biggest growth concentrated in the 69 poorest countries where modern method use was already very low.

73% of the 222 million women in developing countries who want to avoid a pregnancy but are not using a modern method now live in the poorest countries, compared with 67% in 2003. These women in the poorest countries who want to avoid pregnancy are one-third as likely to be using a modern method as those living in higher-income developing countries.

Notable progress in contraceptive use was made in Eastern Africa (31% to 46%), Southern Africa (75% to 83%), Southeast Asia (64% to 72%), Central America (71% to 77%) and South America (73% to 79%). However, in most subregions modern contraceptive use grew more slowly between 2008 and 2012 than between 2003 and 2008.

Population growth and the growing desire for smaller families will increase the number and proportion of women with unmet need especially in the 69 poorest countries.

Between 2003 and 2012, the use of sterilization declined from 47% to 38% of all modern method use in developing countries, and toward methods with higher failure rates, namely barrier methods (increasing from 7% to 13%) and injectables (from 6% to 9%). This demonstrates the need for services that help women use reversible contraceptive methods consistently and correctly.

Study author Susheela Singh concluded: "Improving the quality of services must become a priority." ... "This includes providing adequate follow-up care, facilitating informed choice among methods, increasing public education and addressing the needs of young people for quality information and services."

Girls in India have obstacles to getting an education. If a girl is pestered by a boy on the walk to or from school, her parents will likely to take her out of school, worried about the effect on their "honour" if she is sexually assaulted, and get her married quickly. Schools can be crowded, teachers can be unreliable, the water at the school is undrinkable, or the toilets are filthy.

Even though the World Bank upgraded India from a "poor" country to a middle-income one, and the UK announced it would end aid to India from 2015, and the country has a space program, 48 billionaires and its own aid budget, the quality of education is poor. A free and compulsory education is guaranteed for all children aged between six and 14, and primary school enrollment is at 98%. Within government schools pupils face numerous challenges, according to Oxfam India.

An additional 1.2 million teachers were needed and only 5% of government schools complied with all the basic standards for infrastructure set by the act. Some 40% of primaries had more than 30 students per classroom, and 60% didn't have electricity. 21% of teachers aren't professionally trained.

More than half of children in standard five - aged around 10 - unable to read a standard two-level text. 2.3 to 8 million of primary age children are not in school.

It is girls are often left behind after primary school, 62% were forced to drop out to help with work at home or get married. Two-thirds of those not in school were from those lowest in the caste system, tribal groups and Muslim communities, despite those historically oppressed groups making up only 43% of India's children. Private schools serving low-income families are unregulated, and can lack trained teachers and proper infrastructure.

The Global Campaign for Education (GCE), a coalition of 26 NGOs and teaching unions, wants all nations to allocate at least 6% of GDP to education. India has been promising that since 1968, but the figure has never topped 4%, and it is currently 3.7%.

Iran leaders are concerned that its low population growth rate, estimated at 1% by the United Nations in 2011, will foster an aging population with potentially disastrous consequences for its workforce, public health infrastructure and social security network. Their goal is to return to traditionally large Iranian families while ensuring a robust workforce in the next half-century.

However, young Iranian adults are concerned with unemployment, high inflation, a plummeting currency and the possibility of war with Israel. Iran's per capita gross domestic product is only about $6,400, according to the International Monetary Fund.

An example is Somayeh who insisted that she and her husband wait to have a child until they could move out of their rundown flat, with intermittent electricity and leaky ceilings, in a dangerous part of Tehran.

Another woman, Firoozeh, estimated the cost of giving birth, including doctor and hospital fees, at about $3,000 USD. "The costs of having a child are so high that I'm ready to use any method in order to not have children right now,"she said, adding: "My husband and I love children and are working as hard as we can to improve our situation so we can have them."

Young Iranian women now have greater independence and choices. About 60% of Iranian college students are women, and experts say rising career and educational aspirations for women in the last three decades have contributed to the sharp fall in fertility. Firoozeh waited until she turned 31 to get married.

Iran's fertility rate is 1.7. The UN predicts the median age will be 40 by 2030

Advocates of the new population growth policies say the aim is to return to traditionally large Iranian families while ensuring a robust workforce in the next half-century. Iran should eventually have 150 million people, double the current population, they say.

Gerhard Heilig, a population trends expert at the United Nations, said "The decline in fertility, when it's so low, has really nothing to do with official policies usually," he said. "This is a lifestyle choice and once people have made this lifestyle choice it's very difficult to reverse it."

The government's current strategy is comprised of stopping the population control programs and increasing financial incentives to get married and have children. A parliamentary committee is considering measures such as free medical treatment for pregnant women and increasing maternity leave. Loans, gold coins and cheap housing could be considered for families who have more children.

Djavad Salehi-Isfahani, an economist at Virginia Tech University in the United States, said the new policies may make a difference for poorer families, for whom the cost of birth control is a more significant part of their budget or for whom financial incentives might be more important.

He predicted the measures were not likely to work with the wider population, however, citing the failure of initiatives like the promise of payment in 2010 for each newborn of one million tomans, at the time worth about $1,000. "A million tomans is nothing for a family to change their behavior," he said.

In Malawi, more women are asking for female condoms, which give them options to protect themselves from HIV, and plan their families. They wouldn't have to rely on their partners to initiate condom use. They could have the opportunity to protect their own health.

Unfortunately, many decision makers are stuck on the pervasive myth that no one wants female condoms, and therefore there is not an adequate supply.

The Hunger Project-Malawi (THP-Malawi) began female condom distribution using peer educators. They distribute 30,000 female condoms every three months in the handful of communities they serve. They added male peer educators once they realized that almost half the people asking for female condoms were men. In Zimbabwe, one organization sold 2 million female condoms in 2009. In Nigeria, 1.4 million female condoms were distributed in 2011, approximately eight times the number distributed just two years earlier.

Despite all this proof of demand, advocates find they must still fight to convince donors and governments to invest in female condoms.

Female condoms are more than an HIV prevention and family planning method. They give women something they may have never had before -- a tool to exercise their human right to protect their health.

The Fiscal Year 2013 Country Operational Plan (COP) Guidance states in no uncertain terms that "PEPFAR funds may not be used to purchase family planning commodities". PEPFAR is the President's Emergency Plan for AIDS Relief. PEPFAR will continue to pay for male and female condoms, even though condoms prevent both HIV and unintended pregnancies.

The 2008 law contains no prohibition on the use of PEPFAR funds for contraceptive commodities; in fact it is totally silent on the integration of HIV/AIDS and family planning/reproductive health services.

Instead of reflecting the best public health practices of the day, it reflects the worst politics of the day. Standing on the side of science, good public health, and women is the right thing to do. If we don't, we undermine our ability to achieve an AIDS-free generation and our credibility as a leader on HIV/AIDS and global health.

When Secretary Clinton provided this vision at July's International AIDS Conference, she said "Every woman should be able to decide when and whether to have children. This is true whether she is HIV-positive or not."

Allowing country teams and program experts to decide to use PEPFAR funds for contraception based on the nature of their country's epidemic and funding landscape for HIV/AIDS and FP/RH is consistent with the goal of delivering health care services that are integrated, country-driven, and centered on women, girls and gender equality.

World Health Organization (WHO) guidelines identify contraception as one of four essential components of programs that prevent mother-to-child transmission ( PMTCT), known as "prong 2" —preventing unintended pregnancies among HIV-positive women. The U.S.-supported Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive (Global Plan) also includes contraception as part of the comprehensive package of HIV prevention and treatment interventions and services. It also reinforces the centrality of "prong 2" and sets the ambitious goal of reducing unmet need for family planning to zero by 2015.

As cited in PEPFAR's Technical Considerations, of the 22 high burden countries targeted in the Global Plan, rates of unmet need for family planning vary between 13% and 38%. Of the 26 countries receiving FY2011 PEPFAR PMTCT funding, 11 reported contraceptive stock-outs of various methods that year (Kenya, DRC, Madagascar, Ethiopia, Mozambique, Malawi, Nigeria, Tanzania, Uganda, Zambia, and Dominican Republic).

If PEPFAR continues to refuse to allow PEPFAR funds to be used to pay for contraceptive commodities where needed to advance HIV prevention and PMTCT goals, then U.S. funding for family planning and reproductive health programs must be significantly increased. Current funding ($610 million annually), falls far short of what it is needed to address the needs of the 222 million women in the developing world who want to avoid a pregnancy but are not using an effective method of contraception. U.S. advocates have been calling for at least $1 billion annually.

While there is an assumption that indigenous populations are disappearing, many Tsimane "groups' population growth is actually astronomical." notes Lisa McAllister, a doctoral student in integrative anthropological sciences at the University of California, Santa Barbara.

In Bolivia some Tsimane populations have annual growth rates of 3% to 5%, which calculates to populations doubling in size in as few as 14 to 23 years.

"This is a problem, given their limited land and resources, and the fact that much of the land is already overused," McAllister says. "Many Tsimane already acknowledge the conservation issues that overpopulation is causing. For example, Tsimane commonly complain that they need to go farther and deeper into the forest to find animals to hunt; and close to town, farmland is in short supply."

And yet, despite having better access to education and contraception, fertility rates among Tsimane women remain, on average, nine births over a woman's lifetime.

"It's great to encourage education," says McAllister. "But it may be naïve to assume that education or economic prosperity will automatically lead to reduced fertility."

The rest of Bolivia follow the classic "Demographic Transition" pattern where drops in mortality are accompanied by drops in birthrates, while "Tsimane mortality has dropped over the past several decades, but fertility has not," co-author Michael Gurven, professor of anthropology, said.

When women don't have access to a different life, or to alternative life paths usually associated with greater education, they have no incentive to delay fertility, the researchers say. When jobs are only available to men, there is nothing women can do with their education. "There currently isn't a lot of economic value for women or men to have an education."

While Tsimane women say they want fewer children," if you ask them who they consider to be the most influential women, the answer will be those who have the most children," McAllister says. Social status is rooted more in having large families and kin networks, than in attempts to lead a more modern lifestyle.

In addition, women living close to the nearest major town have more children than their counterparts away from towns. "All else equal, women in better condition should be better able to conceive, carry a baby to term, and provide for an infant," McAllister says. "It is not surprising that women in the best condition have higher fertility."

"Maybe making education valuable by improving job prospects for Tsimane who are not used to marketing themselves might be a better way to spend money than sending people to a village and having them talk about IUDs the reproductive system, and the value of family planning," she said.

Each year in the United States an estimated 11,300 babies die on the day they are born, according to Save the Children. This is the highest first-day death rate in the industrialized world. Investing in and expanding the reach of programs like Medicaid and Title X would make affordable pregnancy-related care and family planning services available to millions of women otherwise unable to obtain such care and would result in fewer first day deaths.

Contributing factors include preterm, unplanned and teen births. One in eight U.S. babies are born prematurely and U.S. preterm births rank second only to Cyprus in the industrialized world. Half of all U.S. pregnancies are unintended and the U.S. adolescent birth rate is the highest among industrialized countries -- with teenage mothers tending to be poorer, less educated and receiving less prenatal care than older mothers.

Comprehensive efforts are needed to reduce pervasive economic, social and health disparities, including improving access to high-quality, affordable maternity care for all women and making effective family planning available to every woman who needs it. These interventions are proven to offer direct and positive effects on newborns' and mothers' health.

Studies show there is a causal link between proper birth spacing and low birth weight, preterm birth and small size for gestational age. There is also an association between pregnancy intention and delayed initiation of prenatal care; women are less likely to recognize a pregnancy early if it is unplanned and therefore have fewer prenatal care visits. Children born from unintended pregnancies are less likely to be breast-fed at all or for a long duration.

Contraception has played a major roll in the drop of the U.S. teen birth rate, which has declined for nearly two decades and the 2010 rate represents a 44% drop from the 1991 rate.

Medicaid, Title X and other public programs help women avoid 1.94 million unintended pregnancies each year, which would otherwise result in 860,000 unplanned births and 810,000 abortions. Without these programs, levels of unintended pregnancy would be nearly two-thirds higher among U.S. women overall and among teens -- and close to twice as high among poor women. Ideological and fiscal attacks against these programs are not only counterproductive, but threaten to worsen what is already a severe crisis for U.S. women and newborns.

The organization Catholics for Choice has made a movie called "The Secret History of Sex, Choice and Catholics." Jon O'Brien, who was the one who decided to make the movie, explained that he was talking to a stranger who felt uncomfortable with many of the positions taken by Catholics for Choice, and O'brian told the gentleman that his work in support of reproductive rights was not despite his Catholic faith, but because of it.

The Catholic "social justice tradition wouldn't let me turn my back on people in need; nor would it allow me to ignore the importance of conscience in moral decision-making. Both issues relate directly to reproductive health: women are in the best place to make the decisions that affect their health, and deserve all the support necessary when life's challenges threaten their well-being, their health, or even their very lives. Those who are rich will always have the means to bypass the obstacles in their way, legal or otherwise, whereas the poor and needy are always the ones who suffer."

O'Brian asked the gentleman "Why do you deny the truth about all the affirming messages in Catholic theology about women, choice, and sexuality in general?" and was told: "Those issues are too hot to handle." He would have been denied mainstream acceptance and positions if he'd tackled issues like reproductive rights. Rather than pick that fight, he had chosen, as many others do, to keep his head down Apparently those whose understanding and interpretation of core Catholic teachings is a little different the standard teaching are slighted and attacked for raising legitimate points of view about church teaching.

There is a reason why people like Bishop Kevin Dowling, who tells the truth about Catholics and condoms in the shanty towns of South Africa, do not attain the trappings of power, position, and influence that have been lavished upon so many ultra-conservative American clergymen of late.

"Telling the truth about Catholic theology really matters. It matters for reasons of self-respect, and it matters for so many who think they have to choose between their faith and how they live their lives. For me, working with theologians and so many marvelous thinkers in the church who are not afraid to stand up and speak out has been an amazing experience. It is truly liberating when you see that it is possible to be both true to yourself and authentically Catholic at the same time."

And so, after talking to a filmmaker, the "The Secret History of Sex, Choice and Catholics" was born.

The "secret" is that there is more than one magisterium -- in addition to the hierarchy, there is also the magisterium of the theologians and that of the people. This means that any of us can be called to teach, and for many this can mean doing what the theologians and thinkers in the film have done: bravely speak out. Their paths often lead straight into confrontation with established authority.

The first day we released the movie, thousands of people worldwide -- from the Philippines to South Africa, from the US to Eastern Europe -- watched the film online. There is clearly a genuine hunger for this message.

Non-Catholics have learned from the film what the majority of Catholics actually believe. And the story told by "The Secret History" isn't just for Catholics. It gets to the heart of how we all make moral decisions and seek compassionate answers.

There has been controversy in the Philippines as representatives of the Roman Catholic Church and President Benigno Aquino III clash over a proposed reproductive-health bill designed to bring down the country's unusually high birthrate.

With a population of 104 million people and a birthrate of 25 births per 1,000 every year (compared to 13.7 per 1,000 in the U.S.) economists have suggested that the problems the Philippines has experienced in terms of poverty, pressure on natural resources and overburdened infrastructure will continue to cause hardship unless something is done. Affluent couples in the country have fewer than three children on average but the country's low-income mothers have nearly six.

The proposed bill, which is being debated in the Philippines House of Representatives, would require the government to make contraceptives available. It would also require officials to provide information on family-planning methods and provide classes on reproductive health and sexuality in schools.

With the results of a vote from the Philippines House of Representatives expected any day now the Catholic Church has been leading widespread protests, with an estimated 10,000 people protesting the bill in Manila in one day alone. Archbishop Socrates Villegas of Pangasinan province attended the rally and was quoted as saying "Contraception is corruption", "The use of government and taxpayer money to promote contraception is tantamount to corruption." He also expressed concerns that contraception made sex "cheap without responsibility".

Despite support for the bill from the United Nations, the bill would not only have to pass the vote in the House of Representatives, it would require support from the senate, which analysts say will be difficult.

Despite these difficulties, President Aquino seems determined to reduce poverty and improve the economy, and has met with some success in this regard. The GDP grew by 6.4% in the first quarter compared with last year (the fastest increase in six quarters) and country has experienced a series of credit rating upgrades.

In spite of these economic improvements the Catholic Church maintains its opposition, with the belief that economic development does not outweigh their moral concerns.

PEPFAR (President's Emergency Plan for AIDS Relief) should ensure that a HIV-positive woman who wants to prevent unintended pregnancy can receive family planning services at any PEPFAR location. The ability to meet the immediate needs of a woman and provide comprehensive prevention of mother-to- child transmission (PMTCT) programs should not be contingent on the presence of another program or funding stream.

In PEPFAR's annual Country Operational Plan (COP) guidance to the field, the Obama administration in principle continues to support an integrated, women and girl-centered approach to health services, but fails to provide implementers with the tools and guidance needed to make that a reality. This is a surprising development as it is the first COP released after the announcement of the Global Health Initiative (GHI) Plus Countries, and yet is out of step with public statements made by high-level officials touting the women and girl-centered, integrated approach to global health.

As the COP process, GHI and PEPFAR implementation and additional guidance continue to evolve, we encourage partners in the field to communicate with staff at their mission and in the Office of the Global AIDS Coordinator about what is working and what is not in order to inform their future decisions.

The FY11 COP guidance says that:

Any family planning services, including the provision of contraceptives for PMTCT, that are integrated with HIV services, must continue to be funded out of separate accounts. While these integrated activities are encouraged, the family planning commodities must be funded using non-PEPFAR funds.

"Field teams are expected to prioritize opportunities to link PEPFAR-funded activities with those funded from separate accounts supporting reproductive health and family planning."

PEPFAR programs are encouraged to provide referrals to family planning programs and to co-locate services. While this is a positive development, it does not address the family planning needs of women living in countries without family planning funding or programs. One-third of the 33 countries required to submit an FY11 COP do not receive any family planning/reproductive health (FP/RH) assistance from USAID.

Historically the U.S. has underfunded FP/RH programs and even recent important funding increases still leave FP/RH funding nearly 25% below their peak levels in 1995 (when adjusted for inflation) and below the U.S. fair share of addressing the needs of the 215 million women who want to avoid pregnancy, but do not have access to modern contraception.

Without significant scale up of funding for FP/RH, meaningful integration of these services will not occur using the referral and co-location model articulated in the COP.

The COP rightly identifies PMTCT programs as an ideal platform to deliver other essential health services, including family planning, but again misses an opportunity to maximize the improved health outcomes through fully supporting the tools needed to prevent mother-to-child transmission.

The World Health Organization (WHO) has long identified family planning as one of four essential components of PMTCT programs and many countries have both high HIV prevalence rates and high unmet need for family planning.

While it was encouraging to see that PEPFAR funds could support much-needed PMTCT training for health workers that includes MCH (Mother and Child Health), family planning and reproductive health services for women living with HIV, the impact of having a trained work force and increased demand for these critical interventions is limited if the commodities needed to deliver the services remain unavailable. By issuing a COP that does not account for the increased demand for contraceptives that will likely result from training and community mobilization, PEPFAR falls short of ensuring that HIV positive women will be able to prevent unintended pregnancy and plan the timing and spacing of their pregnancies.

Demographic change is closely associated with greenhouse gas emissions, and that population dynamics will play a key role in attempts to mitigate and adapt to the effects of changes in the climate system in the future. according to the strong evidence that exists.

By looking at only population size as the demographic variable in climate models, the contribution of "population" to climate change has been underestimated. Understanding fertility, population growth, urbanization, migration from environmentally depleted areas, household size and composition, and growing population density in marginal and vulnerable areas, is also crucial for the world to adapt to and cope with the adverse impacts of current and projected climate change.

Climate change threatens to cause the greatest and widest ranging market failure ever seen, Sir Nicholas Stern warned in 2006. One percent of global GDP must be invested in order to mitigate climate change, and that failure to do so could risk a recession worth up to 20% of global GDP.

Climate change poses a grave challenge for the whole world and has wide ranging implications for human well-being as well as for security, including the risk of armed conflict over resources and large-scale migrations of population within nations and across national borders. 150 million environmental refugees will exist in 2050, says the International Panel on Climate Change (IPPC), due mainly to the effects of coastal flooding, shoreline erosion and agricultural disruption.

Population policies and programs that promote universal access to voluntary contraception, when linked with broader efforts to address a range of demographic factors and meet development and poverty reduction objectives, such as the MDGs, particularly investments in family planning and reproductive health, girls education, economic opportunities and empowering of women, and in youth. These would help least developed and developing countries to speed up their demographic transition, enabling them to achieve demographic windows of opportunity which may contribute to economic growth and a greater capacity to cope with climate change impacts.

In the Philippines, more than half of the 3.4 million yearly pregnancies in the country are unplanned, resulting in high costs to women, their families and the national health care system. This very high rate of unintended pregnancy is impeding the Philippine’s development goals.

Unintended pregnancies are highly preventable if women have access to voluntary family planning information and services, particularly modern methods of contraception. Investing in contraception significantly improves public health, while also saving money and bolstering national economies.

Researcher by the University of the Philippines Population Institute and the New York City-based Guttmacher Institute found that expanding access to modern contraceptive methods as well as natural family planning in the Philippines would result in 800,000 fewer unplanned births, 500,000 fewer induced abortions and 200,000 fewer miscarriages each year. It would prevent the deaths of 2,100 women—nearly half of all deaths from pregnancy related causes—and prevent the cumulative loss of 120,000 healthy years of women’s lives that are currently shortened or impaired as a result of unintended pregnancies.

The 35% of Filipino women aged 15-49 who are poor account for more than half (53%) of the unmet need for contraception.

WHile providing modern contraceptive services to all women at risk of unintended pregnancy would raise annual family planning costs from P1.9 billion to P4 billion, on the other hand, the medical costs associated with unintended pregnancy, including treating the consequences of unsafe abortion, would fall dramatically—from P3.5 billion to P600 million—resulting in a reduction of P2.9 billion in these costs and a net savings of P0.8 billion.

These savings could then be used to improve and expand a range of health and social services, making it much more possible for the Philippines to achieve its development goals.

The reason to invest in voluntary family planning is to let women decide when to become pregnant and how many children to have. If we succeed in this goal, the payoff will be great for Filipino women, their families, their communities and society overall.

Multilateral development banks (MDBs) that lend to poor nations have spent little money on sexual health, and, in some cases, have followed policies that impeded women's empowerment.

The study examines the quantity and quality of funding for reproductive health from 2003 to 2006.

It records a decline in World Bank spending and a shortage of support for reproductive health and HIV/AIDS. This occurred although these banks have pledged to help countries meet the MDGs.

The World Bank was the largest funder from 2003-2006 approving a total of 7.5 billion dollars but funding declined from 2.7 billion dollars for such projects in 2003 to only 1.5 billion in 2006.

This comes after the bank was criticized for attempts to water down bank policy on reproductive health.

The African Development Bank Tunisia-based lender gave 44 million dollars for HIV/AIDS projects from 2003-2006 and 108 million dollars for reproductive health during the same time period. The Asian Development Bank's investments in reproductive health and HIV/AIDS from 2003 to 2006 totaled 47.4 million dollars. Last year, the bank lent 8.5 billion dollars for various projects.

The Inter-American Development Bank provided three million dollars in loans and grants for reproductive health and HIV/AIDS during the same four years. MDBs initiatives often lack gender rights projects.

Compounding lack of gender sensitivity is their unsustainability caused by project shortcomings including short-term duration and lack of funding for recurrent expenditures.

The IMF was faulted for loan and policy advice that force most borrowing governments to place limits on public sector wages and reduce the number of doctors and nurses. Development banks have introduced systems to monitor progress on gender equality policies and there has been modest progress.

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."

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.

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.

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.

Until recently the subject of family planning in Niger was taboo, but commissioner Kristalina Georgieva, the European Union's top humanitarian-aid official, was pleasantly surprised this time to see a project teaching women about contraception and the importance of spacing births.

The local Imam where she visited "was quoting the Koran saying there's a verse that says there has to be time between the birth of children so the children and mother can recover and be strong."

The support of the local religious leaders at the health centre she visited in Bambey, in western Niger, was crucial for bringing down the high rate of population growth, she said. The growth was putting a strain on a country that is among the poorest in the world, that struggles with a harsh climate and is vulnerable to the effects of climate change.

Since independence in 1960, Niger's population has risen from less than 2 million to 15 million plus.

Now there is "remarkable openness to address family planning". "At the level of the president, prime minister, ministers and cabinet there's an openness to discussing family planning. There's an openness that 3.3-percent population growth is not sustainable," she added.

"There are already activities on the ground (for) family planning in a very community-based and respectful manner … The topic is not taboo anymore."

Mothers need to space their children to avoid back-to-back pregnancies which contribute to malnutrition and keep mothers weak. "That's where there is potential to work hand in hand with community leaders and religious leaders. It has to be culturally acceptable to work."

The annual hungry season in Africa's Sahel countries is expected to begin in late February or early March - several months earlier than usual. Aid agencies say between five and nine million people are at risk.

Talking about population growth in relation to food shortages is a sensitive issue, partly because large families are considered important in many cultures, particularly where people rely on their children to help on the land and to support them in old age.

Many argue that the real causes of food shortages are political and economic. Georgieva says a food crisis is looming in the Sahel due to poor rains, bad harvests, food-price hikes and the return of migrants from Libya, among other factors.

But she also argues more generally that it is time for the world to pay more attention to managing population growth in fragile environments. When she visited Kenya last year she realised that in 1963 it had more or less the same population as her own country Bulgaria - well below 10 million. Today Bulgaria is at 7.5 million whereas Kenya's has soared to 40 million.

The populations of other affected countries had also grown five times and this meant that when there were droughts the impact was all the more severe.

For a very readable look at some of the arguments on why population growth is not the cause of famine, take a look at this article published by Al Jazeera: Famine in the Horn of Africa: Malthus beware. http://www.aljazeera.com/indepth/opinion/2011/08/20118178844125460.html

Facing severe budget shortfalls at home, many donor countries are cutting back their foreign aid programs, including support for crucial international family planning programs. The United States, the global leader in supporting contraceptive services in the world?s poorest countries, recently reduced its 2011 international family planning and reproductive health assistance by $33 million.

Uganda must step up its own funding for family planning. The time to act is now. The country has experienced strong economic growth in recent years, but we should remember that social and economic progress is linked to improved access to quality family planning services. Such services save women's lives, save the country money, and create a healthier, more productive society. Failure to support these services now will only end up costing more down the line.

Low levels of contraceptive use are already taking a toll. 70% women who want to avoid pregnancy are not using an effective contraceptive method. More than half of all pregnancies are unintended.

In rural areas, where 85% of the population lives and where family planning services are scarce, the poorest women now have two more children, on average, than they want, increasing economic hardship among the most vulnerable families, leaving them with fewer resources to invest in education, health care and other basic needs.

Unintended pregnancy is also a serious threat to the health and survival of women and newborns, often resulting in high-risk births occurring too soon after a previous delivery or when a woman is too young. This reality is starkly reflected in Uganda's high rates of maternal and newborn deaths.

Melinda Gates, philanthropist, talked with new mothers in Korogocho, a large slum in Nairobi, Kenya. She asked them "Why do you want to plan the number and spacing of your children?"

One woman said she wanted to be able to feed all her children.

Another woman added, "Where am I going to keep them? Under the bed?" It was funny until she explained she had only a single room in which to raise her children. "Our houses are toilets," she said. "Why bring so many kids into a toilet?" It was impossible for her to raise her children in a safe and healthy environment.

One woman said if she had too many children, her husband would leave her.

Finally a woman summed the whole conversation up in one sentence. "I want to bring every good thing to one before I have another," she said.

"As different as many of their experiences are from mine -- fighting their husbands for the right to plan, struggling to put food on the table -- there is something universal in motherhood that unites us. We all want to bring every good thing to our children," Gates said.

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.

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."

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.

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.

Ministers of health and high-level representatives from 22 countries will met in January in Dubai to agree approaches to saving the lives of mothers and children: accelerating progress towards achieving MDGs 4 and 5 (reduction of infant mortality and improvement of maternal health respectively) in the Eastern Mediterranean Region.

The event was co-organized by the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), and the UN Population Fund (UNFPA).

In 2010, five years away from the MDG deadline, countries around the world rallied around the UN Secretary-General's Strategy for Women's and Children's Health. The strategy aims to accelerate progress on the health MDGs, - goals on which progress had been slowest.

Some Member States in the Eastern Mediterranean Region have made impressive achievements, but in others too many mothers and children continue to die. Between 1990 and 2010, maternal mortality was reduced by 2.6% annually, and under-five mortality fell by just 2% per year. The vast majority of these deaths can be prevented with proven, cost-effective solutions.

The Dubai meeting paid particular attention to the situation in ten priority high burden countries identified under the United Nations Secretary General's Global Strategy for Women's and Children's Health: Afghanistan, Djibouti, Egypt, Iraq, Morocco, Pakistan, Somalia, South Sudan, Sudan and Yemen.

The federal Centers for Disease Control and Prevention have reported a 75% increase in severe complications from childbirth, such as cardiac arrest, respiratory distress and kidney failure, in the decade ending in 2009.

Severe complications affect a total of about 52,000 women a year.

A big reason for the increase is the number of pregnant women who are older, obese, or have chronic conditions such as diabetes and kidney disease that put them at higher risk. But healthy women, too, can experience major complications such as severe bleeding, or hemorrhage, which is the most common cause of death after childbirth. A nearly 60% increase in the rate of Caesarean-section delivery since 1996 is associated with a sharp increase in a condition known as placenta accreta, in which the placenta grows into the uterine wall through a surgical scar, and can cause severe hemorrhage after delivery.

Obstetrics-related complications account for $17.4 billion in annual U.S. hospital costs, according to the federal Agency for Healthcare Research and Quality. Complications have recently led to several malpractice payouts of more than $20 million each, and obstetrics can account for 25% or more of a hospital's total for all malpractice claims resolved by payment, according to Premier Inc., a hospital purchasing alliance.

Premier's Perinatal Safety Initiative has been working with hospitals, including Aurora West, in 12 states since 2006, training medical teams to follow protocols to prevent harm to mother and infant and respond rapidly in a delivery emergency. The training includes a military communication strategy known as SBAR, for situation-background-assessment-recommendation—to quickly get everyone on the team the same information about a patient's condition and the planned response. Since the project's inception, the rate of liability claims filed at participating hospitals has dropped by 39%, says Susan DeVore, Premier's chief executive.

Many of the most common causes of death such as hemorrhage and pulmonary embolism can also take place in the first few days after delivery to seemingly low-risk patients, so it is important that hospitals follow standardized prevention measures, says Mary D'Alton, head of obstetrics and gynecology at New York's Columbia University Medical Center. To prevent blood clots, for example, Columbia gives the blood thinner heparin to all patients after a Caesarean delivery and asks them to get up and walk after 12 hours.

Vivian von Gruenigen, system medical director for women's health services at Summa Health System says "People think pregnancy is benign in nature but that isn't always the case, and women need to be their own advocates."

The United States spends $98 billion annually on hospitalization for pregnancy and childbirth, but the US maternal mortality rate has doubled in the past 25 years. The U.S. ranks 50th in the world for maternal mortality, meaning 49 countries were better at keeping new mothers alive. Why the decline despite the high investment?

A study from researchers at the University of California, San Francisco found that Title X -funded clinics in California are more likely to offer services during evenings or weekends; to provide outreach to hard-to-reach populations, such as males, teens and individuals with limited English proficiency; and to use advanced technologies, such as electronic medical records and online appointment scheduling, to streamline clinic operations.

The data came from surveys of more than 1,000 public- and private-sector Family PACT clinicians in 2010. They found that Title X-funded clinics have implemented a greater array of infrastructure enhancements that promote access to and improve the quality of services for underserved populations than have other providers.

The authors suggest that Title X-funded clinics can serve as a model and recommend that nationwide health care reform build on the California model to improve infrastructure and the quality of care as family planning providers increasingly serve marginalized populations.

Recently, the UNFPA's State of World Population 2012 report declared, "the use of modern methods of family planning has increased in recent years in Eastern Africa, particularly Ethiopia, Malawi and Rwanda but there has been no increase in use of modern methods in Central and Western Africa."

Arthur Asiimwe of the Rwanda Biomedical Centre/Health Communication Centre, claimed Rwanda's success was due to increased rollout of family planning tools across the country which are freely accessible at all healthy facilities and the use of community health workers to mobilize and sensitize mothers towards family planning. The Centre also came up with new measures like vasectomy. Rwanda decline in pregnancies among adolescents was due to intensified sexual reproduction education within schools, said Asiimwe.

The UN report said that failure to meet sexual and reproductive health needs of adolescents and young people contributed to high rates of unintended pregnancy and HIV. It also reported that births among adolescents were declining in most regions but the rate of decline has slowed in some parts of the world. In sub-Saharan Africa, over half of young women give birth before age, and adolescent fertility in most countries in sub-Saharan Africa has shown little decline since 1990.

The report points out that making voluntary family planning methods available to everyone in developing countries would reduce costs for maternal and newborn healthcare by $11.3 billion annually.

The UNFPA Executive Director, Dr. Babatunde Osotimehin said "Family planning is not a privilege, but a right. Yet, too many women-and men-are denied this human right."

Despite the the global decline in maternal mortality rates, mothers in India continue to die from preventable causes at alarming rates. In India in 2010 one out of every 140 women - one every 5 minutes - die from pregnancy or childbirth-related causes.

However, using a conditional cash transfer program, Janani Suraksha Yojana (JSY), launched in 2005, the Indian government is working to ensure that no woman dies while giving life. The progam provides pregnant women with cash incentives for giving birth in hospitals and using health facilities.

Maternal deaths for women with high-risk pregnancies are largely caused by a delay in the decision to seek professional care, or in reaching the appropriate health facility, or in receiving care after arriving at a hospital. Because such women need access to skilled care to treat potentially life-threatening complications such as sepsis, hemorrhage, eclampsia, and obstructed labor, programs that focus on affordable and accessible health care are critical.

Researchers found that from 2005-2008, private facility births increased from 39% to 51%, and public facility births increased from 20% to 39%. An evaluation commissioned by UNFPA shows that JSY has seen an increase in beneficiaries from 739,000 in 2005 to approximately 8,380,000 in 2009, with about 71% women in five states reporting an increased awareness of all-hours government facilities for delivery.

This program will be one of the primary ways to help India reach its goal of decreasing maternal mortality rates down to 100 deaths per 100, 000 live births by 2015.

A study titled "The Health Systems Cost of Post-Abortion Care in Ethiopia," by Michael Vlassoff of the Guttmacher Institute, estimated the cost to the health system of providing post-abortion care (PAC), based on research conducted in 2008. PAC consumes a large portion of the total expenditure in reproductive health in Ethiopia. Investing more resources in family planning programs to prevent unwanted pregnancies would be cost-beneficial to the health system.

Ethiopia spent US$7.6 million in 2008 to provide care for post-abortion care complications, an average of $36 per woman treated. The study also found that every dollar spent on family planning services would save $6 in post-abortion care services.

The treatment of incomplete abortions is both the most common and the least costly post-abortion care procedure in Ethiopia, costing an average of $24 per procedure. Treatment of shock and sepsis costs approximately $40, while treating the most serious complications, such as uterine perforation and related illnesses, costs almost $153 per intervention. Women suffering from complications that arise from unsafe abortion pay more than 75% of the total cost of their treatment, a much higher proportion than they pay for other reproductive health services.

While the study only looked at the direct costs of post-abortion care, such as drugs, supplies, personnel and hospitalization fees, the authors noted that including indirect costs, such as capital and overhead, which were not investigated in the study, would bring the national total cost of pos-tabortion care provision to at least $11.5 million.

Of the estimated 382,000 abortions in Ethiopia in 2008, about 75% were carried out under unsafe conditions. The researchers found that 58% of women who had had an abortion experienced complications that required medical treatment. However, many of these women did not receive the medical care they required, indicating that current service provision is insufficient. Also, despite growing modern contraceptive use in Ethiopia, about 1.7 million unintended pregnancies occur every year, largely due to unmet need for contraception.

A special supplement was published in the September 2012 issue of the International Journal of Gynecology and Obstetrics. It was edited by Susheela Singh, vice president for research at the Guttmacher Institute, and members of the International Union for the Scientific Study of Population panel on abortion research. The supplement examines morbidity and mortality; costs to health systems, women and families; and the social consequences of unsafe abortion.

The unsafe abortion rate in developing countries has remained stagnant since 2003 at 16 abortions per 1,000 women aged 15-44. Developing countries account for 98% of all unsafe abortions.

Between 1992 and 2008, there were large increases in Colombian women's use of misoprostol to induce abortion. This has reduced the health risks previously associated with clandestine abortion procedures, such as those performed by traditional midwives. By 2009, half of women who obtained an abortion in Colombia used misoprostol. Furthermore, because of impressive gains in general health care coverage among Colombian women between 1992 and 2008, the proportion of women in need of postabortion care who did not receive required medical attention fell from 46% to 21%.

However, over the same time period, the proportion of women experiencing abortion complications increased from 29% to 33%, and the rate of hospitalization for the treatment of abortion complications rose by 26%—two trends that are due, in part, to an increase in ineffective and incorrect misoprostol use. The authors emphasize that health care providers, pharmacists and pregnant women themselves need better information on the correct use of the drug.

To read more, including stories of Brazil and Ethiopia, http .

A project based on deployment of mobile phones and focused on improving maternal and child health in Nigeria's Ondo State has seen a 30% reduction in maternal mortality since its launch two years ago, says Ondo State Commissioner for Health, Dr. Dayo Adeyanju.

The Abiye Safe Motherhood Project and the Mother & Child Hospital initiatives enable communication between the nursing or expectant mothers with their health service providers. An earlier study had shown that the number of women who attend and ‘deliver' at the basic health centres were appalling.

Free mobile phones were distributed to the registered expectant women to keep them connected to their health service providers in case they experienced contractions so they could get back to the facility.

The use of the mobiles phones are expected to further reduce maternal mortality rate by 75% by 2015. The project saw nearly 1220 babies delivered in a single year with one maternal death reported. That would mean a maternal mortality rate of only 100 per 100,000 live births compared to Nigeria's current maternal mortality ratio of 545 in 100,000 live births.

According to our analysis, access to reproductive health and family planning can help to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, and ensure environmental sustainability - the first three are defined by Millennium Development Goals 1, 2, and 3.

Controlled trials in Matlab, Bangladesh, and Navrongo, Ghana, have shown that increasing access to family planning services reduces fertility and improves birth spacing. In the Matlab study, findings from long-term follow-up showed that women's earnings, assets, and body-mass indexes, and children's schooling and body-mass indexes, substantially improved in areas with improved access to family planning services compared with outcomes in control areas. At the macroeconomic level, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour.

According to the Malthusian argument, population growth puts pressure on scarce resources, leading to hunger and high mortality. However, population increase resulting from health improvements and increasing life expectancy can have very different economic consequences from population growth resulting from high fertility or immigration; therefore, the source of population growth needs to be known to predict its social and economic effects.

*Family planning programmes can reduce fertility in resource-poor settings such as rural Bangladesh and Ghana.

* Fertility declines are associated with an increase in women's health, earnings, and participation in paid employment.

* The children of women who have had frequent home access to family planning and health services are healthier and better educated children than are those of women without such access.

* Reduced fertility and child mortality lead to an increased proportion of working-age people within the population, with positive outcomes for economic growth.

* Household-level behavioural effects on the female labour supply, child health, and education can lead to large macroeconomic demographic benefits.

Although fertility decline is driven mainly by reductions in desired fertility, reproductive health and family planning interventions can help families to achieve their fertility goals. A reproductive health, child health, and family planning intervention in Matlab, Bangladesh, and a similar intervention in Navrongo, Ghana, both led to reduction in total fertility of about one child per woman compared with control areas. Reproductive health and family planning services can thus be effective even in resource-poor settings.

Improved control of fertility and health of women and children will give women more opportunity to acquire skills that could raise lifetime earnings. Additionally, a reduction in total fertility might lead parents to accumulate more physical assets than they would have otherwise done, particularly if the assets are a partial substitute for the support and care they expect from a child. Moreover, human capital investments parents make in each of their children's health and schooling might rise as a result of reproductive health programmes that provide information and access to family planning.

Theoretically, when those children reach working age, there will be fewer young adults competing in the job market possibly causing wages to rise.

Increases in women's health and productivity would give families more resources for their children than they would have in areas without a family planning and reproductive health programme, and the resulting investments in child health and education should increase prospects for the next generation, alleviating poverty by boosting labour productivity and capital accumulation, which adds to aggregate economic growth.

In the Matlab program in Bangladesh, outreach family planning programmes were set up in 71 villages from 1977 to 1996. Community health workers visited the homes of all married women of childbearing age every 2 weeks to offer them various contraceptives and child and maternal health services and supplies. 19 years after the program started, child-to-woman ratios were 16% lower in villages with an outreach program than in those that had access only to standard government family planning clinic services. The child-to-woman ratio declined by 39% in the control villages compared with 55% in the intervention villages.

In terms of the programme's benefits for women, the average body-mass index (BMI) of women aged 25 - 54 years was more than 1 kg/m2 higher in the outreach program area than in comparison areas. Another study of Matlab reported that a 1 kg/m2 improvement in BMI in women was associated with a 17% decrease in the hazard rate of mortality. Women in villages with an outreach programme reported monthly earnings in 1996 that were 40% higher than were earnings in comparison villages. Married women in programme villages reported 25% more physical assets per adult in their household than did those in control areas, and the composition of household assets in programme villages had shifted away from livestock, which depends on the availability of child labour, towards housing and financial assets, consumer durables, and jewellery.

Children aged 7 - 14 years in the outreach programme villages had completed significantly more years of schooling than had those in the comparison areas, and their average BMI was higher in the treatment programme villages. These were found to be indirect benefits that are linked to improved health and productivity of women, increased household assets per adult, and some increased health and schooling of the children of the women.

However, wages of men and young women (aged 15—24 years) were not affected by the intervention, as would be conjectured from Malthusian population pressures in this rural setting where agricultural production depends on a fixed amount of land.

An intervention in Navrongo in northern Ghana, studied four different community groups: those that received home visits from female nurses who provided married women with contraceptive and health services; those in which a leadership network known as zurugelu, designed to involve men in health and reproductive issues through group discussions and to enroll community health volunteers to provide services; both interventions; or no intervention (the control group).

Analysis of subsequent data from Navrongo has shown a 9% decrease in the number of children ever born to women living in communities with both interventions compared with the number born to women in control areas, which suggests that birth spacing might lead to smaller completed families. Most of the effect of the zurugelu treatment on fertility is, however, restricted to a small group of educated women. Although these results have shown that a family planning intervention can lower fertility in a very poor rural area of Africa, and that visits by nurses reduced infant mortality, long-term follow-up studies of the health and economic effects of the interventions are still to be completed.

In theory, the effects of family planning interventions at the household level should add up to measurable effects on national income at the aggregate level, although interactions between effects might influence the final outcome, and some effects might occur only at the aggregate level. However, population growth could put pressure on food and land prices, which affects everyone, not just families with many children. The interventions in Navrongo and Matlab were regional and captured aggregate effects in these areas, but population change might have indirectly affected other regions as well—eg, by migration.

Mortality decline tends to occur before fertility decline, so initially, rapid population growth takes place. This increase in total population leads to rapid urbanisation as births begin to exceed deaths in urban areas and as people migrate from rural areas where population growth and a rising labour supply have eroded rural wages.

Most developing countries have large numbers of children and few working-age adults. This situation is exacerbated when child mortality declines. A decline in fertility expands the working-age share of the population, and raising national income per person. However, when fertility drops to less than the replacement level (about two children per woman), further fertility declines can contribute to a high old-age dependency rate.

Fertility declines are likely to have little effect on the female labour supply in the poorest developing countries, since almost all women in these countries already work, usually at home - which might be why the family planning programme in rural Matlab had only a small effect on female labour market participation.

Improvements in child survival mean that households can achieve their desired number of children with lower fertility than before. A simulation model to examine the association between a reduction in total fertility rate of one child per woman in Nigeria. showed a 13·2% increase in gross domestic product per person above baseline forecasts after 20 years, rising to a 25·4% increase after 50 years when long-term effects are realised. Findings from empirical studies of economic growth have shown that reductions in the youth dependency ratio and rises in the working-age share of the population are associated with rapid economic growth, which partly explains the economic take-off in India and China (gross domestic product per person is rising by 1·0% per year in China and 0·7 % per year in India).

Up to now, productivity gains in agriculture have overcome the problem of land scarcity. However, several severe Malthusian challenges caused by a scarcity of global fixed resources might emerge in the future. One challenge is depletion of traded commodities such as fossil fuels. As the supply of these traded goods decreases, price rises are expected to encourage innovation that will increase efficiency of use and development of substitutes. Large-scale environmental degradation of forests, fisheries, water tables, and the atmosphere, particularly damage caused by emissions that lead to global warming, is a more worrying development than depletion of traded commodities because the absence of price mechanisms means there is no automatic market incentive to respond. In this case in particular, reduced fertility and slowed population growth might have benefits, although rising income per person, which accompanies reductions in fertility, might well generate its own environmental pressures.

Meeting the need for contraception services could reduce maternal mortality by 20%.

The new annual report of the UNFPA says "If women had the power to make decisions about sexual activity and its consequences," ... "they could avoid many of the 80 million unwanted pregnancies each year, 20 million unsafe abortions, some 750,000 maternal deaths and many times that number of infections and injuries." And: "They could also avoid many of the 333 million sexually transmitted infections contracted each year."

Melinda Gates, of the Bill and Melinda Gates Foundation, told people that she wanted to help put contraceptives back on top of the global health and development agenda. But then, she acknowledged what was missing from her agenda were the women across the world who have told her over and over again that having access to birth-control methods that work for them would change their futures.

Now she tells people that she wants to help put women at the center of global health and development work, and better contraceptives are one of their top priorities.

She said that, at the health clinics she visited in African countries there are always plenty of free condoms available, but most African women can't rely on condoms for birth control because their husbands refuse to use them. African women favor contraceptive injections over condoms. But because of supply constraints, supply-chain problems, and outdated public policies, these injections are frequently out of stock. In one large Nigerian city, there were 226 days last year when not a single public health clinic had injections available.

If your goal is helping women build the lives they want for themselves and their families, then their needs cannot be met just by stockpiling injections, like you can condoms.

In the United States this election year, when contraceptives and public policy overlapped, contraception seemed to get wrapped up with abortion or the meaning of religious freedom. The fact is, 99% of women in the United States who have had sex use birth control at some point in their lives.

What our behavior (if not our rhetoric) tells me is that contraceptives matter to us. "They certainly mattered to me. I was able to go to college and business school. I was able to have a rewarding career at Microsoft. And then Bill and I were able to decide how many children to have (three) and when to have them (each three years apart), which I believe made us better parents," Gates said.

For some of the same reasons contraceptives matter to women in developing countries. They want their children to grow up healthy and go to school. Contraceptives are a single link in a long chain that includes proper nutrition, vaccines, clean water, productive farms, and high-quality public schools. But they are the first link, and they give parents a much better opportunity to complete the chain.

The study in Bangladesh that has been ongoing for the past 35 years, proves that people who have access to and education about contraceptives are healthier, less likely to die in childbirth, and less likely to have children who die. They are better educated, with sons and daughters who have more schooling. And they are more prosperous. Economists have argued convincingly that the so-called East Asian economic miracle of the 1980s was due in large part to parents in the region deciding to have fewer children.

Contraceptives unlock one of the most dormant but potentially powerful assets in development: women as decision-makers. When women have the power to make choices about their families, they invest in the long-term human capital of their families. They don't do it because they're worried about GDP; they do it because they're worried about their children's futures.

November 6th was a happy occasion for pro-choicers, but we still need to get the message across: Reproductive coercion is wrong. When women aren't allowed to choose the number and timing of their children, they're being treated more like breeding stock and less like human beings.

But many women around the world -- and even in the United States -- don't have that choice.

Both pro-choice and anti-choice (like Republican Rep. Chris Smith, R-N.J.) can agree: China's coercive policy limiting many women to having one child infringes upon human rights. Any government that forces women to undergo unwanted abortions and sterilizations is immoral.

But people like Smith will carry on about coercion in China, but they never consider the fact that their own policies are just as coercive. Enlisting the government to force women to give birth to babies they don't want is also immoral, and it's happening across our nation:

Montana just passed a bill that requires teenagers to notify a parent before obtaining an abortion. It included language saying that "A parent, a guardian, or any other person may not coerce a minor to have an abortion." Coercing a 13-year-old to give birth, however, is just fine.

Nebraska's next senator will be Deb Fischer, who believes that rape and incest survivors should be forced to bear their rapists' children.

Rep. Chris Smith was the sponsor of a 2011 bill that said only survivors of "forcible rape" would have been eligible for taxpayer funding for an abortion .

A Missouri law lets bosses block contraception coverage from employees' health plans. In fact, the state actually fined insurance company Aetna $1.5 million for offering coverage of birth control!

The Guttmacher Institute found that, in 2011, more than 1,100 state bills were introduced that would affect reproductive health and rights. 135 of those bills were passed into law. 68% of these new laws restrict abortion. Five states began requiring women to have ultrasounds before abortions, even if their doctors say it's not necessary.

So yes: Forcing woman to undergo unwanted sterilizations or abortions is coercive. But so is mandatory motherhood. Only when every woman has the right to choose for herself - free of government interference, will we truly be equal.

Access to safe abortion remains the neglected taboo in discussions about reproductive health and family planning.

In Ireland, which has restrictive abortion laws, Savita Halappanavar was denied a termination of pregnancy during a threatened miscarriage and subsequently died of sepsis in the hospital in October 2012. Her death sent an outcry throughout the developed world. While maternal deaths are now rare in developed countries, any such death is usually avoidable. The Irish Government should thoroughly review and reassess its ambiguous abortion law.

In the developing world, of about 350,000 maternal deaths all but about a 1000 happened in developing countries, the majority in Africa, according to 2008 figures. The leading causes are post-partum haemorrhage, hypertensive disorders, sepsis, obstructed labour, and complications from unsafe abortions.

Of an estimated 43.8 million abortions per year, 49% are classified as unsafe and nearly all (97%) in Africa are unsafe. About 47,000 women each year die from unsafe abortion and another 5 million women suffer disabilities related to unsafe abortions. Without access to legal and safe abortions, many women will continue to die needlessly.

The best way to reduce the number of abortions is to give women choice over when and how to plan their families and avoid unwanted pregnancies in the first place. Through access to contraceptives almost 300,000 maternal deaths were averted in 2008. Yet, there are still about 222 million adolescent girls and women worldwide who lack access to family planning.

At the London Summit on Family Planning in July, US $2.6 billion in new donor money was pledged to give an additional 120 million adolescent girls and women access to contraceptives by 2020. However $4.1 billion is required to reach everyone who has unmet needs.

A UNFPA report that came out in November estimates that making voluntary family planning available to everyone in developing countries would reduce costs of health care for women and newborn babies by $11.3 billion annually. The report makes a strong case that family planning delivers immeasurable rewards to women, families, and communities. Women must be allowed to take part in society beyond reproduction. Adolescent girls' lives should not be restricted by early childbirth, lack of education, and poverty. Deaths and disability from childbirth and unsafe abortions should become a scourge of the past.

The 2014 Cairo International Conference on Population and Development (ICPD) and the 2015 post-Millennium Development Goals project will give us the opportunity to make the strongest effort possible to give every woman in every country the right and choice to decide when and how to plan a family. Sustainable development requires the full participation of women in society worldwide.

Note: I don't like to see it called 'population control', but, as you can see, the article is about voluntary family planning.

There has been some concern that the population of Kenyan has increased to the point of adversely affecting the ever dwindling natural resources, and if it continues to grow any further, the existing resources will not be able to sustain the high population numbers.

Parents cannot cope with the cost of bringing up children in healthy environments, hence the vicious cycle of poverty.

For these reasons the government is seeking to control the population growth. On the other hand, if the control is not properly and professionally done, Kenya could end up like some developed countries, which despite the abundant resources don't have enough labour and workforce to exploit these resources.

An effective population control policy needs to balance the population growth and control.

The millennium development goals provide for sustainable population growth and sustainable economic growth. There needs to be a balance between population growth and economic growth.

In order to ensure that it provides for its people good and reasonable standards of living, the government must strike a balance between population growth and the existing economic and natural resources. A very high population will be catastrophic to the economy and quality of life.

This has to be done carefully so as not to violate social, family and human rights of individuals. Each and every person has a right to live their lives freely, and to make personal decisions on the direction their lives should take. The government should therefore employ measures that are acceptable and that will not affect the lives of people.

All population control policies or mechanisms should work in such a way that the family rights are not offended. No one should feel micro-managed by population control policies or any legislation that a nation enacts.

Governments should embrace persuasive ways of controlling the population, in that it is up to the person to decide and weigh if s/he thinks having fewer children is beneficial or not. Getting children should not be criminalised; it should be voluntary.

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.

At the Family Planning Summit held in London in July 2012, participants pledged $2.6 billion dollars in additional funding to provide 120 million new women who have 'unmet need' with family planning products and services by 2020 in 69 of the world's poorest countries. This goal has been dubbed 'FP2020.'

However, there may not be 120 million new users to be found in the 69 of the world's poorest countries,

Christopher Purdy, Executive vice president, DKT International found, using UN estimates, that there are 144 million women with unmet need, 73% of them in 20 countries, which include lower-middle and upper-middle income countries such as India, the Philippines, and Algeria. Using the same UN estimates, if we consider only the 69 priority countries of FP2020, the number of all 15-49 year old women with unmet need drops to 109 million. However, if we include only those countries with per capita GNI (PPP adjusted) below $2,500, the number with unmet need drops to around 48 million.

Most of these countries are in Africa, the area where donors are understandably focusing a majority of their resources.

However, while most of the unmet need is where the people are, they are not necessarily where average income levels are lowest. Many of these countries are are lower-middle ($1,026 - $4,035) and upper middle-income ($4,036 - 12,475) countries. This includes countries like Indonesia, South Africa, and Mexico, where there are large pockets of poor people who need family planning. Of the 30 most populous countries - 72% of the world's population - only 12 of them fall below the $2,500 threshold, according to the UN Contraceptive Wall Chart.

Unless we invest in these countries, we will be hard-pressed to reach 120 million new women. For DKT, this meant opening up new programs in Pakistan and Nigeria (both lower-middle income countries) last year.

Allocation of human and financial resources is underway but needs to be aligned with the realities of where the greatest chance for success can be achieved. It would appear that some re-orientation may be required to avoid falling short of FP2020's ambitious target 7 years from now.

In the U.S. we spend 11 billion taxpayer dollars a year on unintended pregnancies, yet automatic cuts built into the sequester slashed $86 million from family planning and reproductive health care for poor women, and Congressional Republicans are trying to roll back the contraceptive mandate in AHC. You would think Republicans are more interested in ideology than balanced budgets.

Effective, affordable, accessible contraception dramatically drops the rate of unintended pregnancy and related public health costs, research has found. Of the 9,000 St. Louis youth and women who, in the study, were offered the free contraceptive of their choice, 75% chose an effective, long acting method - an implant or IUD. The result: two years later, the teen pregnancy rate was at 6 per 1,000 rather than the national average of 34 and the abortion rate fell to 80% below the national average.

When pregnancies are intended, family and community resources are strained, and maternal drinking or poor nutrition in the weeks right before and after conception may increase birth defects.

In 2006, Oregon spent $72 million on births from unintended pregnancies. In Washington State, during fiscal year 2012, Medicaid paid $700 million for prenatal, delivery and infant care. When asked by the state Department of Health, approximately half of the women who received this care said that they would have preferred to get pregnant later or not at all. The State of California saved an estimated $2.2 billion over a five-year period by increasing birth-control access for residents who fell below 200% of the federal poverty level.

Only 40% of the girls who give birth between ages 15 and 17 ever graduate high school, compared to 90% of their peers. Only 2% graduate from college by age 30. Their offspring are at higher risk to have mental health problems, health problems and academic problems. Male offspring are more likely to end up in the criminal justice system. Girls are more likely to end up pregnant as teens.

50% of pregnancies in the United States are unintended. For unmarried women under 30, that number is 70%. For teens, it is over 80%. Fatigue, forgetfulness, finances, domestic conflict, substance abuse and ambivalence can interfere with effective contraception usage. That is why long acting "fit and forget" methods like implants and IUDs are 10 to 50 times more effective than the pill, and why they are recommended by the National Campaign to Prevent Teen Pregnancy. One in 12 women relying on the pill gets pregnant each year. With condoms, that's one in eight; with no birth control, it's eight in ten. With an IUD or implant, that rate drops below one in 500.

Because teens are particularly unreliable at taking the pill, and are vulnerable to barriers including costs and delays, public health experts increasingly recommend bringing services to youth via the growing system of school-based health clinics. When Texas implemented parental notification requirements for teens seeking contraception and abortions, the teen birth rate went up, second trimester abortions went up, and state budgets took a hit to the tune of $40 million annually. When Texas cut funding for family services in 2011 as a way to kill Planned Parenthood, state budgets took another hit. Health officials projected last year that the $73 million in cuts would produce 24,000 additional unplanned births, costing the taxpayers $273 million. Now Texas Republicans are quietly proposing to restore the funding.

The Guttmacher Institute has reviewed scientific literature of 66 studies conducted over the past three decades and has determined that the ability to delay and space childbearing is crucial to women's societal and economic advancement. In other words, women's ability to obtain and effectively use contraceptives has a positive impact on their education and workforce participation, as well as on subsequent outcomes related to income, family stability, mental health and happiness, and the well-being of their children.

Adam Sonfield, lead author of the literature review. "Contraceptive use, and the ensuing ability to decide whether and when to have children, is linked to a host of benefits for themselves,... But the evidence also suggests that the most disadvantaged women in our society do not fully share in these benefits, which is why unintended pregnancy prevention efforts need to be grounded in broader antipoverty and social justice efforts."

Findings:

*The pill was a driving force behind significantly more young women participating in the labor force, including jobs requiring advanced education and training.

*Contraception significantly contributed to increasing women's earning power and to decreasing the gender pay gap.

*Contraception helped spark a trend toward later marriage, helping women and men to find stable, economically attractive matches; relationships are more likely to dissolve after an unplanned pregnancy or birth than after a planned one.

*Women and men who experience unintended pregnancy and unplanned childbirth are more likely than those who do not to experience depression, anxiety and lower reported levels of happiness.

*If the birth of a child is unplanned, individuals are particularly likely to start off unprepared to be parents and to develop a poor relationship with their children.

* Effective pregnancy planning and positive social and economic outcomes are intricately linked and mutually reinforcing—and not just for women but for their children as well.

"Policymakers should heed the evidence about the strong and widespread benefits of contraception and halt the archaic and harmful attacks on the programs and providers that make contraceptive services accessible and affordable for all women who need and want them."

A report released yesterday by the U.S. Centers for Disease Control and Prevention reported that from 2006 through 2010, 11% of sexually-active women between ages 15 and 44 had used emergency contraception (otherwise know as morning after pills), the report says, up from 4.2% in 2002, and less than 1% in 1995.

Young women were most likely to use them, with 25% of sexually-active women between 20 and 24 useemergency contraception. 50% of the women said they used the contraception because they had unprotected sex. The medical director of the Washington, D.C.-based Association of Reproductive Health Professionals, said that these emergency contraception pills should not be confused with "abortion pills." "Emergency contraception does not cause an abortion. You take emergency contraception pills to largely prevent ovulation from happening. This is pregnancy prevention," she said.

In Malawi women have an average of 5.8 children. 40 years ago the average was 7.2 children. A study by the African Institute for Development Policy and Population Action International noted that Malawi's population grew from 3 million in 1950 to 15 million in 2010, and is projected to reach 50 million by 2050. The study's authors warn that rapid population growth is increasing food insecurity, environmental degradation and poverty levels.

In addition, Malawi has one of the highest maternal mortality rates in the world, with 800 Malawian women dying every day from labour- or pregnancy-related problems, the Aspen Institute's Global Leaders Council for Reproductive Health (GLC) says.

Funding to developing countries for family planning, as a proportion of all overseas health development assistance, fell from 8.2% in 2000 to just 2.6% in 2009, according to GLC.

Despite this decrease in funding, a recent study by USAID found that the percentage of Malawian couples using contraception rose from 7% in 1992 to 42% in 2010. This was attributed to the combined efforts of the government, NGOs and international donors, which, besides increasing access to family planning services, have also helped create a "culture of acceptance" at the community level.

However the urban and rural areas see big differences in family planning services. Rural areas have long distances from health centers, traditional taboos, values that discourage family planning, and poverty to hinder women from accessing family planning services. Many women who are economically dependent on their husbands are unable to make their own decisions, even those relating to their reproductive health.

Most public sector clinics only offer hormonal injections (Depo-Provera), condoms and contraceptive pills, while NGOs provide more choices, such as Marie Stopes International, provides long-acting and permanent methods, including intrauterine devices, implants, tubal ligations and vasectomies, as well as mobile services. Some also offer emergency contraception.

One client says the pill is inconvenient as it has to be taken every day. She ruled out condoms because they are controlled by men. Married with one child, she is using hormonal injections to control the size of her family.

Another client has three children and has been using injections since 1998. "My dream is to bring up a family that I can take care of without over-burdening myself," she said.

Shippensburg University in Pennsylvania has a vending machine that dispenses emergency contraception to its students when they insert $25. The machine was installed after 85% of the student body said they thought Plan B should be available on campus grounds. Last year an uproar from anti-choice advocates prompted a review of the university's practices. The university added a feature to the vending machines that requires students to swipe their student ID to verify they attend the college and are above 17 years old. This additional feature has satisfied the FDA: under FDA guidelines, Plan B is already available to everyone over the age of 17 without a prescription.

Students are no longer forced to delay taking the pill by having to schedule an appointment. junior Chelsea Wehking said she has "heard some kids say they'd be too embarrassed" to make a trip into the surrounding small town to purchase Plan B.

After controversy over Obamacare's contraception mandate first erupted last year, fueled by the anti-choice community's myth that Plan B induces abortions, emergency contraception became more controversial. But the morning after pill (which is safer than aspirin) simply prevents pregnancy within the first 72 hours after intercourse.

Hispanic women in the United States are having fewer children, a 25.7% drop some demographers and sociologists attribute to changes in the views of many Hispanic women about motherhood. Both immigrant and native-born Latinas had steeper birthrate declines from 2007 to 2010 than other groups.

In 2011, the American birthrate hit a record low, with 63 births per 1,000 women ages 15 to 44. The U.S. birthrate is now about half what it was during the baby boom years, when it peaked in 1957 at 122.7.

The 25.7% decline in birthrates among Mexican-American women and women who immigrated from Mexico has reversed a trend in which immigrant mothers accounted for a rising share of births in the United States, according to a recent report by the Pew Research Center.

The decline, which coincided with the recession, suggests that attitudes have changed since the days when older generations of Latinos prized large families and more closely followed Roman Catholic teachings, which forbid artificial contraception.

The reasons for deciding to have fewer children are many, involving greater access to information about contraceptives and women's health, as well as higher education, surveys show.

Latinos suffered larger percentage declines in household wealth than other groups from 2005 to 2009, and, according to the Pew report. While birthrates do drop during recessions, a drop as large as Latinos have experienced is atypical, said William H. Frey, a sociologist and demographer at the Brookings Institution.

D'Vera Cohn, author of the Pew report, said that in past recessions, when overall fertility dipped, "it bounced back over time when the economy got better." But Mr. Frey says the decrease has signaled much about the aspirations of young Latinos to become full and permanent members of the upwardly mobile middle class, despite the challenges posed by the struggling economy.

But birth control is expensive. Birth control pills with health insurance can still take a $50 co-payment a month. IUDs, often not covered by health insurance, are unaffordable. Some are having to make do with condoms.

According to research by the National Latina Institute for Reproductive Health, the overwhelming majority of Latinas have used contraception at some point in their lives, but they face economic barriers to consistent use. As a consequence, Latinas still experience unintended pregnancy at a rate higher than non-Hispanic whites, according to the institute.

The highest share of births to teenage mothers in the U.S. is among native-born Hispanics.

Watch the following music video for 'Abet', the first Yegna single

A new radio drama, Yegna (pronounced YEN-ya, which means "ours"), that reflects and encourages the potential of Ethiopia's girls, recently started broadcasting to millions of people across Ethiopia.

It follows the story of five very different girls whose shared love of music creates an unlikely friendship that each character draws on as she faces different challenges. The girls go on to form a band, and each episode of the drama features a new song.

The deputy prime minister of Ethiopia, Demeke Mekonnen, said: "This will help to engage the talent of girls and create opportunities for them to be more active participants in school, society and in all economic and political aspects - which is the direct strategy of the Ethiopian government."

The drama is designed to tackle some of the real challenges facing many girls in Ethiopia, including early marriage, violence and the lack of access to education, as well as to encourage and facilitate friendship among girls. Research by the Population Council and others has shown that without social connections girls lack the support, advice and role models they need to reach their potential.

Each 30-minute weekly segment will be followed by a talk show to discuss the themes of the drama. The audience will be able to interact with the show via Facebook, call-in numbers and free SMS messaging. It is hoped the show will evoke conservations in Ethiopian households. The Yegna team is also piloting an approach to provide clubs based on the show, which will create a safe space for girls to come together and learn through games.

Yegna is being aired in the Amharic language, in the capital Addis Ababa and the Amhara region - home to a combined population of some 20 million people, including an estimated 2.5 million girls.

Billboards, bus signs, radio adverts, and national and local media coverage, as well as 500 university students recruited as Yegna ambassadors are spreading the word.

In December, more than 600 youth leaders who attended a UNFPA-backed global forum in Indonesia envisioned a world where the youth can actively participate in society and have access to quality education, health services and decent work opportunities.

Here are the proposals they would ask governments to fulfill:

Universal access to a high quality, affordable and comprehensive package of basic health, mental health, and sexual and reproductive health care services.

Universal access to free and quality education at all levels, backed by access to funds to support other needs related to education.

Eliminate traditional harmful practices, including early and forced marriage, forced circumcision and genital mutilation, and gender-based violence.

Guarantee work, social, domestic and learning environments that are free from physical, sexual and psychological abuses.

Ensure equal access to decent work opportunities and protection from discrimination, particularly for women, young single parents and marginalized groups.

Develop and strengthen a multistakeholder system of gathering and disseminating reliable and quality youth data to inform public policy and planning.

They also asked for the inclusion of safe and legal abortion.

Sierra Leone and Liberia have some of the highest maternal mortality rates in the world, with 15-24 year olds accounting for 40% of such deaths.

In a project called "Girls at Risk, by IPPF and FORWARD listened to hundreds of young teenage African girls talking about sexual and reproductive health and rights. The prime "risk" in question was teenage pregnancy: the risk of becoming pregnant; the risks associated with unsafe abortion; and those associated with poor maternal health provision.

Seri Wendoh, analyst of the project, talked of rape, incest, abuse and gender-based violence; of girls routinely pressured by parents into marriage, multiple relationships with "sugar daddy" partners, or sex work to secure the basics of survival; of the immense physical and psychological trauma caused by years of conflict and the use of rape as a weapon of war; of unsafe abortion resulting in sickness or death; of economic independence denied through forced removal from education.

If you want to know what these girls said, look at http://www.forwarduk.org.uk//download/235 A wonderful pamphlet with great pictures. This is elegant in the simplicity of its expression and the clarity of its message.

Just a few of the quotes from the pamphlet:

"Parents commonly put pressure on their daughters to get money from men. If you have a boyfriend and you talk to him your mother says ‘does he give you money?' If not, do not even talk to him. Find a man who will pay you. I know a family, the daughter is fifteen, her breasts are not yet full on her chest, they gave her to the man who is past 35- they gave her to him for money."

"Girls say there is unemployment for them in the community so that is the reason why they turn to prostitution so that they can be able to feed themselves."

“if their boyfriends do not beat them it means that they do not like them."

“Due to the use of condom, it prevents them getting pregnant which will prevent them winning the love of that men, and getting that man. So they neglect the use of condom. Especially if they have rivals, they don't want her to get pregnant and win the love before her."

Peer education has been effective in school level in a district of Nepal after the schools started class on sex and reproductive health. The students have developed their habit to speak openly in this issue. Earlier, students, especially the girls used to hesitate to talk to people on the sex related topics.

Students have learned many things about HIV- AIDS and sex related issues through the peer education. They take active participation in the group discussion on reproductive health and sex related issues.

Earlier, people used to feel shy and hide their health problems. "Such an attitude has changed. People openly inform health workers about their diseases," said a local teacher.

Estimates indicate that one in five young people survive on less than a dollar per day. Young people aged 15 to 24 are a quarter of the world's working population but half are unemployed.

This disparity is particularly pronounced in developing and least developed countries, where around 51 percent of the combined population is below the age of 25.

The U.N.'s MDGs set a global agenda to end extreme poverty, with a focus on lower income countries with large youth populations.

The main reason that developing countries cite for not having youth delegates is the costs of sending someone to New York for several weeks. Visa regulations are often an issue. In some cases, it is due to a distrust of youth.

Part of the U.N. Secretariat organises activities and assists the General Assembly in creating policies on youth development.

In 1981, the General Assembly adopted a resolution for the first time officially encouraging member states to include youth delegates in their national delegations. Priority issues include education, employment, hunger and poverty, health and environment.

More than 113 million children were denied access to primary education and more than 150 million had never completed it. Girls are particularly excluded from primary education.

Another 250 million children aged five to 14 in the developing world cannot go to school because they are forced to work.

Poverty is a global epidemic, and young people are at risk. But youth participate more effectively in UN deliberations on issues of sustainable development and are effective at lobbying governments for stronger commitments.

They are working at the grassroots level and contributing to the MDGs targets. "If we want the MDGs fulfilled everyone can make their contribution in some way and this is the message I would like to pass to young people."

The Youth Peer Education Network (Y-Peer) works in the areas of adolescent sexual and reproductive health in Oman, with the help of Oman's Scouts and Guides. After completion of this course and receiving his certificate of completion, Al Alawi was sent to Bosnia and Herzegovina for a 10-day workshop to prepare him as a Y-Peer focal point for Oman.

He then trained five male and six female participants in peer education. The workshop trained trainers to teach fellow youth community members the correct facts on reproductive health, HIV, and other health areas. The sessions at the workshop included team presentations on specific topics, theatrical representations of birth spacing, HIV, and learning how to say 'no'. Discussions followed all exercises with the trainer acting as the facilitator and encouraging debate.

There was a positive response from the participants. Most youth do not feel comfortable talking to their elders on the matter, or receiving the information out of shame or taboo. The Y-Peer network hopes to guide the youth from grassroots level, within the most vulnerable age groups, in all issues related to reproductive health.

HIV among young Congolese with no schooling is 5.4%. Sexually transmitted diseases (STDs) in Congo show a high HIV risk among young people. UNFPA said that half of all new cases of HIV is found among youths between 15 and 24.

The spread of DTD's among young women is faster than any other group and most do not even know they are infected, how HIV is transmitted or how to avoid it.

Someone must give the youths the training and information they need. It is important that the government concentrate their action on the youths.

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.

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

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.

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.

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."

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

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.

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.

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.

15 year-old Malala Yousafzai, the schoolgirl from Pakistan known as an impassioned advocate for education, was shot in the head by the Taliban in October because she believed girls should have the right to go to school.

She was transported to the Queen Elizabeth Hospital in Birmingham, England, and has undergone several surgeries. Recently she made a video statement.

"I can speak, I can see you, I can see everyone and today I can speak and I'm getting better day by day. It's just because of the prayers of people, and because of these prayers, God has given me this new life, and this is a second life. This is the new life and I want to serve the people."

Doctors expect that she will need anywhere from nine to 18 months to fully recover.

As Malala gains strength, so too does her cause. Malala's father, Ziauddin, said: "When she fell, Pakistan stood and the whole world stood and the world supported her."

In her statement released today, she announced the creation of a new charitable fund to support the cause she has championed. I want every girl, every child to be educated," she said in her video statement. "And for that reason, we have organized the Malala Fund."

Vital Voices - a global non-governmental organization advancing girls' and women's leadership through training and mentoring - established the fund on behalf of Malala and her family.

Click here https://salsa.democracyinaction.org/o/440/t/13433/shop/custom.jsp?donate_page_KEY'35 for information on the Malala Fund and how to donate.

November 25th was the International Day for the Elimination of Violence Against Women. The UN High Commissioner for Human Rights Navi Pillay said "Ensuring women's and girls' rights, eliminating discrimination and achieving gender equality lie at the heart of the international human rights system."

In October, 14-year-old Malala Yousufzai was shot in the head and the neck by the Pakistani Taliban on her way back from school in Pakistan. The Taliban threatened to kill anyone else, including women and children, holding views they disagree with.

"Malala was targeted for her prominent role in promoting the fundamental right of education for girls and for criticizing the Taliban for actions such as destroying girls' schools and threatening to kill girls who attend them. The fact that they tried to do just that to her brought into sharp focus the extreme intolerance and physical danger facing many girls who try to exercise their basic human right to education in many other countries," Pillay said.

"The sad truth is that Malala's case is not an exceptional one and, had she been less prominent, her attempted murder might have passed more or less unnoticed."

In nearby Afghanistan since the Taliban were removed from power in 2001, they have reverted to guerrilla tactics which have included - as a matter of policy -- attacks on girls and women, especially in relation to their attempts to receive education.

"In the first six months of 2012 alone, the United Nations Assistance Mission in Afghanistan (UNAMA) verified 34 attacks against schools, including cases of burnings of school buildings, targeted killings and intimidation of teachers and school officials, armed attacks against and occupation of schools, and closures of girls' schools in particular. Incredibly, there have even been at least three separate attempts this year to poison girls attending schools in Afghanistan, with over 100 girls affected on each occasion."

The long distance travelled to school was as a major factor in parents deciding not to send their daughters to school, with security concerns one of the main reasons.

Girls' education has been subjected to deliberate attacks in more than 30 countries because of religious, sectarian, political or other ideological reasons. Girls get less education because their parents fear for their safety, worry about sexual violence or simply -- because of traditional values or lack of education themselves -- value their daughters' education less than that of their sons.

"Malala's bravery in confronting such practices touched a chord internationally. The attack led to an unprecedented outpouring of popular anger and major protests in favor of girls' education in Pakistan itself and in a number of other countries in the region." Important Pakistani and international educational initiatives have been launched in her name.

On Tanzania's western boundary, the Nature Conservancy's Africa program has a project to conserve a vast forested area, including the rugged Mahale Mountain National Park. The area contains about 90% of the chimpanzees in the country and also a significant portion of the Lake Tanganyika coastline. Lake Tanganyika is a true freshwater biodiversity gem. It has not only some of the most spectacular fish diversity on the globe, it also holds - in one lake - nearly as much fresh water as all the U.S. Great Lakes combined. But to successfully conserve the fish and chimps, complex conservation issues must be addressed.

In this remote region, when people can't get enough food from the lake, they turn to the forest for hunting and to clear new land for farming. When there are too many people for the natural resource base, both the lake and the forest suffer. Nature Conservancy conducted a baseline socioeconomic survey of the 50,000 people who live in the area. The numbers were startling:

49% of the population is under the age of 15, among the highest in the world.

The average household size of 6.7 is 29% higher than the 2010 average of 5.2.

130 of every 1,000 children born lin the last half of 2006 did not survive to their 5th birthday, giving the villages an under-age-five mortality among the highest in the world.

The Nature Conservancy concluded: If we can't address rapid human population growth in the area, we will not succeed in conserving the lands and water on which all local life depends.

Rather than continue with the sole focus on more mouths needing more inputs, why not also adopt strategies that result in fewer mouths? South Korea, for example, went from half its population under the age of 15 and 6.3 children per woman in 1960 - much like where we work in Tanzania - to a much more sustainable teardrop shape, with a growth rate at replacement level 30 years later. Colombia, Morocco, and Bangladesh had similar demographic shifts in even less time. These examples of dramatic demographic change show that it is possible to take the fuse out of the population bomb.

A recent report from Lilli Sippel et al. from the Berlin Institute for Population and Development saw that education - in particular educating women - was one of the most significant factors for reducing population growth rates. Education was also found to be the key factor for greater economic development, which is a necessity for sustaining the benefits to an older population.

An analysis of 26 countries from Teresa Castro Martin and Fatima Juarez of over a half century of international development dove-tails with the Sippel findings. In sub-Saharan Africa, $1 invested in primary education returns $1.25 to $1.38 to the community economically. And, when poor women in developing countries earn income, they spend most of it on their families, creating a positive feedback loop that helps the next generation to be more educated and healthy.

One final and important finding: educating women about reproductive health and providing them with family planning options would do more for reducing greenhouse gas emissions than stopping all deforestation, according to the UN in 2009. Education reduces population growth rate, which reduces growth in consumption, which in turn reduces greenhouse gas emissions.

While remoteness in Mahale, Tanzania has helped to protect these special habitats from destructive human development, the people have also been virtually forgotten by government health and education programs.

In Mahale, The Nature Conservancy has a partnership with Pathfinder International, the leading human and reproductive health organization in Tanzania. Priority projects are promoted where population, health, and environment (PHE) actions are developed - collaboratively - from the beginning. Partnerships are important - they should bring knowledge of which strategies have worked best for the socioeconomic situation of each project.

It is also important to support government funding for primary and secondary education for women. Government relations efforts in countries where PHE projects are being advanced should support education in its broadest sense.

In the Persian Gulf oil monarchies the trend for child-brides has almost disappeared. The latest statistics reveal that Abu Dhabi's (UAE) inhabitants now marry after their twentieth birthday - men at an average age of 26.5, and women at 25.9. The rise in the marriage age is attributed to the improved economy arising from the discovery of oil, which allowed for investment in facilities and infrastructure as well as in education and in additional empowerment among residents. It is mainly attributed to the higher literacy rates among its citizens, with a higher attendance recorded in both secondary and university education, and for the sheikhs adopting a policy of inserting women in all productive spheres, both administrative and political . Nowadays, it's the women's father themselves who want an education and career for their daughters before seeing them married.

One third of girls in countries throughout the Middle East, Africa and Asia get married before reaching the legal age, according to the U.N. Among the Arab-Muslim countries, Yemen has the largest number of child-brides, with over 40% of women marrying before the eighteenth birthday. In Saudi Arabia mature men marrying girls as young as nine and ten years of age. This conservative tradition is being challenged by a growing number of citizens of Saudi Arabian countries, as well as by a number of international organizations.

There is a zone of human pain in the failed, and failing states along the Sahel on the edge of the Sahara desert, and across to Somalia, Yemen and Afghanistan, says Professor Malcolm Potts.

Rapid population growth, global warming, poor governance and a hideous mistreatment of women are combining in a perfect storm which could lead to unprecedented levels of environmental stress, starvation, escalating conflict and massive waves of migration. The scale of these problems goes beyond the usual response to a potential humanitarian disaster. Unless strong action is taken, the catastrophe now unfolding in the Sahel has the potential to kill as many tens of millions of people.

This is a global problem and it needs a global understanding and a global response. New international strategies need to be built about food security, family planning, gender equity and governance that have major geopolitical implications for the rest of the twenty-first century. A proper response will require billions of dollars , which would likely come primarily from the World Bank, regional development banks and other traditional donors.

Today's extremes of drought, caused by climate change, could become averages by 2050. Overgrazing, poor agricultural practices, lack of infrastructure and uneven governance could result in inefficient use of natural resources including soil, water and ecosystem-based services. Soil erosion and destruction of trees for firewood are about to collide with climate change turning serious problems into a catastrophe.

From October to May there is no rain and temperatures can exceed 120° Fahrenheit (49° C). Tremendous dust storms cover huge areas of the Sahel and Northern Nigeria. Climate change will make a bad situation worse. Droughts that used to occur every 10 years are already happening every five and they will be interspersed with torrential downpours leading to flash floods that wash away homes and crops.

Already agricultural output cannot keep pace with population growth. The UN Environment Programme sees the Sahel as "heading towards an environmental disaster" and feeding tens of millions of people as "mission impossible."

44% of children in Niger are stunted and face a life-long penalty in stunted growth and inhibited brain development if they survive.

The third largest city in Kenya, after Nairobi and Mombasa is now a refugee camp of drought victims in the north. It was built for 400,000 refugees, but every day an additional 1,500 women and children, fleeing from drought in Somalia and Ethiopia, arrive.

The worst drought in 60 years is hitting the Horn of Africa; 13 million people are already hungry. "750,000 could die in the next six months unless aid efforts were scaled up" says the New York Times. But this is just a sign of things to come. We must recognize the nature and the scale of the problem and focus on outcomes not process.

50 million people live in the Sahel. In Niger population is projected by the UN to rise from 16 million today to almost 60 million or possibly even higher in 2050 and an implausible 139 million by 2100 million, implausible since death rates may rise due to starvation or disease.

Burkina Faso is projected to go from 16 to almost 50 million people by 2050, Chad from 11 to almost 30 million. Mali is projected to more than double from 15 to 35 million and Somalia from under 10 to over 20 million.

Until recently, the UN's World Population estimates assumed that most countries would reach 2.05 children per women by 2050, and that least developed countries would fall to 2.41, but demographers have recently accepted that birth rates in the high fertility countries will not reach replacement level fertility any time soon. The highest world projection for the end of the century is now 15.8 billion ( the lowest 6.2 million) at the century's end. These few high fertility countries (averaging from 4 to over 7 children per woman) with a total population of 1.2 billion today, are projected to be the largest population block in the world by 2100.

Delay in raising the age of marriage and in instituting family planning will be as lethal in a country like Niger, as was the delay in instituting HIV prevention in Africa in the 1980s. Today in Niger, only one in 1000 women completes secondary education. In the Sahlel, few people are educated, making non-agricultural employment virtually impossible. Few girls enter secondary school and virtually none complete it.

Unless investments are made today in education, especially for girls, and in family planning in these high fertility regions then the world will become even more divided than it is today between rich and poor and between stable democratic nations and failed states. The Sahel presents the most immediate, and also the most easy to document, set of problems.

We must make family planning easy to obtain. In the case of family planning we have half a century of robust evidence of what works. We must meet the unmet need for family planning. Even failed states have markets than can be tapped into. We must knock down uninformed medical barriers to family planning. We must recognize how common misinformation is leading women to believe family planning is dangerous.

In Cambodia after the fall of Pol Pot, in refugee camps along the Thai border, neither UNICEF nor Doctors Without Borders were supplying contraception in the camps. But when this was done by another NGO, use of contraceptives jumped from zero to 52% of married women in one month.

Sahlel countries see a very high rate of child marriage. Increasing the age of marriage by five years reduces population growth by 15 to 20%, according to demographers. High fertility countries will not slow population growth rate until the average age of the first birth is raised. In Niger, the average age of marriage is under 16.

Under-age girls are married off to older men every day. Most child brides either never go to school, or drop out when they marry. Compared with mature women, these girls are twice as likely to be beaten by their husbands and five times as likely to die in childbirth.

Poor soils and unpredictable weather are outside human control. We don't know how to ameliorate corruption in contemporary governments. Subsidies to American farmers depress African markets unfairly, but they are unlikely to change soon. But addressing population through access to family planning, eliminating forced marriage for young girls and raising the age of the first birth have more promising solutions.

In a project involving a polygamous society on the border with Niger, where the average aged of marriage is 14.5, we found that a small educational grant of $196, spread over six years, had resulted in between 82% and 92% of girls remaining in school.

We need to apply funds to pilot projects, such as the success keeping girls in school, on a nation-wide scale. We may need careful, random control trials to show that cash transfers work.

While Bangladesh has one of the highest rates of child marriage in the world, its rate of birth registration is the among the lowest, which constrains legal protection against child marriages. Two-thirds of women marry before the legal age of 18 for girls, and one-third start childbearing before 20.

Girls are often married off early to avoid sex outside of marriage which would stain the family honor. Marrying at a young age puts girls at higher risk of sexual health problems, including HIV.

A strong taboo keeps young people from having access to adequate information about their sexual and reproductive health rights (SRHR) so most adolescents enter into marriage and pregnancy without any adequate preparation. The current national school curriculum contains only minimum information about SRHR.

Sylhet, in the north-east part of Bangladesh, has large tea plantations. A manager of the country's oldest tea plantation said of the worker families there: "Reducing the percentage of child marriages in the tea gardens is a problem. In Sylhet, the literacy rate is low, some 80% of tea garden people are illiterate."

HASAB, Bangladesh's leading NGO focusing on HIV/AIDS and STI-related issues, has been working with Sylhet youth groups on SRHR issues.

One of the girls in Sylhet told how her uncles wanted her to get married rather than get an education. But she wanted to get educated, to work, so she came to the youth group and talked to the peer leaders.

"The peer leaders and HASAB visited my mother and made her understand that even if I'm a daughter, I can feed myself, I can be independent, that I'm equal to my brother. I stood up for myself, I showed my mum our neighbours' daughters, some had died giving birth, and I told her: Do you want to lose your daughter, let your daughter live, give her a life. Now those other girls have two or three children already and have weak health. As I'm the only daughter my mother agreed as she didn't want to lose me.

“My life would have been doomed since the boys in the tea plantation estate are not well educated and some have problems with drugs and alcohol. I wouldn't have been able to cope with it. I'm not thinking about marriage right now, I want to graduate, go abroad, come back here and make a big school for the children. If you don't have knowledge, you're born here and die here only knowing one type of green, the colour of the tea plantation."

Roksh Vijaya, a Hindu priest at Rita's tea plantation said: “People here are very religious so at first they thought that talking about sexual health issues was wrong so I was very doubtful; now I see the progress, it's very good."

With a third of Bangladesh's population under the age of 14, empowering young people with the necessary knowledge to understand and be able to voice their rights is just one of many critical elements in the fight against child marriage.

Sierra Leone's 11 year civil war left a devastated health and social service infrastructure, life expectancy is just 47 years; only 7% of married women use modern contraception, compared to the global average of 57% worldwide; the average woman bears 5 children in her lifetime, which will result in a 27% increase in just 12 years.

But an innovative Population Media Center radio drama in Sierra Leone, called Saliwansai, is motivating men and women to visit family planning and reproductive health facilities resulting in the saving the lives of countless mothers and babies.

Character development and role modeling are used in the dramas to convey accurate information about the safety of contraception and family planning. HIV/AIDS and gender based violence are also addressed. Audiences learn from both the positive and negative role models in the drama.

The Sierra Leone writers of the drama were trained in ways to create the highly entertaining story lines and local actors and producers work in a recording studio built by PMC. 208 episodes are planned.

"The writers of Saliwansai have created an intricate storyline, with suspenseful plot twists that have captivated audiences across the country," says Bill Ryerson, president and founder of Population Media Center.

Interviews of clients visiting Ministry of Health family planning and reproductive health facilities show that, of all clients who cited radio programs as their source of family planning information, 82% named Saliwansai as the radio program that motivated their visit.

Initial results indicate that radio dramas can be effective in motivating men and women to visit family planning and reproductive health facilities.

In Egypt, 16 million - 20% - are between the ages of 15 and 24, according to the U.N.. By 2027, there will be 26 million more. Currently, young Egyptians receive little accurate information about sexuality and protecting their health, leaving them vulnerable to coercion, abuse, unintended pregnancy, and sexually transmitted infections, including HIV. Preparing them for the transition to adulthood, a time when sexuality and relationships are central, will be a challenge.

Sexuality and reproductive health (SRH) are among the most fundamental aspects of life. But sensitivities to traditional religious and family values, designed to protect young people, keep them from receiving enough attention in public policy discussions. There is the assumption that young people do not need to know about SRH issues until they are married.

Because the majority of adolescents are enrolled in school, providing SRH education in schools is cost-effective.

At the International Conference on Population and Development (ICPD) held in Cairo in 1994, governments from 179 countries, including Egypt, agreed that information and services should be made available to adolescents to help them understand their sexuality and protect their health. Recently the UN Commission on Population and Development, held in April 2012, reiterated this agreement and focused on adolescents and youth. Egyptian policymakers agreed with the reservation that they would implement the recommendations within the framework of Islamic laws, a position frequently taken by governments of Muslim countries.

While the ICPD Programme of Action clearly states that individual countries have the right to design their policies and programs in ways that conform to their laws, values, and cultures, these policies and programs should uphold individual rights and respond to the complex needs of adolescents - who are in the midst of a process of physical, cognitive, emotional, social, and moral maturation.

A number of NGOs in Egypt have taken pioneering steps in developing youth SRH programs,, and there are successful programs in other Muslim countries, but Egypt has yet to institute national SRH programs.

While in the U.S. generations of sixth-graders learned fundamentals of sex, in Pakistan, the subject is not taught in schools due to traditional cultural values in the Islam-based education system. Young people learn about sex from whispered conversations with their schoolyard friends, or by experience. The fact that parents are loath to give them the facts about reproduction leaves great room for misinformation, unsafe practices, uncontrolled family size, and abortion as a method of birth control.

Because the Koran strictly prohibits sex outside marriage, the very topic of sex is taboo with teachers, and even family physicians shy away from broaching the subject with patients (including married ones). However last month Dow University of Health Sciences, based in Karachi, announced that it will integrate reproductive health education into its curriculum beginning next academic year so that future doctors will be prepared to treat patients for sexual and reproductive-related problems.

The Dow University sex-ed program will be taught to male and female students every semester. The group also developed a reproductive health guide for faculty and students that comports with the country's cultural values.

The program is based on building clinical skills, and removes moral or religious judgments from teaching. "Health starts with reproductive health," said Sikander Sohani of the nonprofit organization Aahung, which collaborated with Dow University on developing the curriculum. "If sex is healthy, marriage is healthy, the relationship is healthy. They will make good and safe decisions regarding health and family planning. This will improve the economic health and social status of the country."

The FDA found that emergency contraception is safe enough for over-the-counter access to any woman or girl of childbearing age, but the Obama Administration overturned this ruling, resulting in a huge outcry. A New York City pilot program may change things.

The program, Connecting Adolescents to Comprehensive Healthcare (CATCH), operates on campus-based student centers to provide birth control pills and emergency contraception. The teens and their parents have been enthusiastic participants.

Only 1 or 2% of parents opted out of the program. They were allowed to select any or all of four types of reproductive services that they did not want their child to receive, including emergency contraception, birth control pills, pregnancy testing or condoms.

In the 2011-12 school year, 567 students received emergency contraception, known as Plan B, and 580 received the birth-control pill Reclipsen through the city program. These numbers do not reflect the many students who were referred out for services.

The private programs also offer morning-after pills and do not require parental consent. If a parent opted out of the city-run contraception program, his or her child could still go to any community clinic or a school-based health center operated by a private organization and receive the contraception.

It was too early to tell if the program was effective in reducing pregnancy or sexually transmitted infections, said health officials.

Other programs across the country have shown that increased access to birth control through school health facilities and more focus on teen pregnancy prevention has been key in reducing both unintended pregnancy and sexually transmitted disease, and even talk to students about all options, including abstinence.

"The key for us was that not only were we seeing high rates of teen pregnancies, we were also seeing high rates of STDs," said Shawn Grunwald, coordinator for the school-based health center there. "Students knew they could get contraceptives, but they could never get to the places that dispense them, and didn't know how to use them. This provides us an opportunity to provide them with some education."

In the U.S., nearly half of all pregnancies are unintended and teen pregnancy rates remain unacceptably high. It's clear that New York schools are doing the right thing to provide students with proven means of making responsible choices about their future. After all, isn't that what education is supposed to be about?

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.

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.

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.

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.

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.

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."

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.

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.

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."

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.

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.

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

Leymah Gbowee, a 2011 Nobel peace prize co-laureate and Liberian peace activist, called for recognition of the crucial role and valuable experience of women during times of conflict.

It is women who provide basic services, in the form of food and shelter, to those internally displaced by civil war. It is also women who negotiate and secure safe passage through checkpoints set up by rival factions. And, thirdly, women negotiate peace on behalf of their communities by identifying and validating those that are members of the community. Women carry out these roles in the face of the constant threats of kidnapping, rape and murder.

Yet it is a paradox that women find themselves empowered during times of conflict to the same degree that they are disempowered in times of peace. When conflicts end, women are dismissed as underqualified and so excluded from formal peace negotiations.

Gbowe's efforts as an activist involve encouraging female participation in elections. The fact that conflict affects men and women differently has only recently begun to influence the peacekeeping and development efforts of foreign governments and NGOs. The constant threat of rape directly inhibits the ability of women to carry out their peace-facilitating roles.

Gry Larsen, the Norwegian state secretary for Foreign Affairs, spoke of the importance of gender-appropriate post-conflict development and aid project strategies. It is often a simple considerations of logistics, management and communication. Placing food stores, medical tents and toilets, for example, closer to communities, along well-travelled routes or in open spaces significantly reduces the risk of rape. And information relating to when and where fresh aid supplies will be delivered allow women, who most often collect the aid, to arrange safe travel.

President Asif Ali Zardari, on the International Day for Women, signed the National Commission on Status of Women (NCSW) Bill 2012 into law. The NCSW Bill was unanimously approved by the National Assembly and Senate earlier this year.

Zardari said that the National Commission on the Status of Women has been made independent and autonomous. It has been empowered to protect the social, economic, political and legal rights of women, he said.

Protecting women from harassment at workplace, preventing acid attacks, discouraging anti women practices, creation of a Fund for women in distress and detention and legislation to punish several offenses against women including depriving them from inheritance and forced marriage were among the prominent measures taken by the Government, the President said.

Leymah Gbowee's father protected her and her four sisters from the secret cutting ritual that would serve to bind them to their village. FGM plagues over 100 million women and girls around the world..

"My upbringing defied what the typical African setting would say I went through," said Gbowee.

Growing up in a poor, middle-class - she calls it - village in Liberia, her upbringing was different, molding her into a feminist, an activist, a peace-builder and the 2011 Nobel Peace Prize laureate.

When a bloody civil war ravaged her country from 1980 to 2003, Gbowee realized it was women who would have to bear the greatest burden in ending the conflict. She began organizing Christian and Muslim women to demonstrate together, founding Liberian Mass Action for Peace. They used non-violent protests and a sex strike.

She wrote a book and held peace-building workshops in and around her country, teaching women to understand the great power they held - in both mind and body.

Pray the Devil Back to Hell is an inspiring documentary film about Gbowee's part in helping to oust Liberian president Charles Taylor. Gbowee is a single mother of six, including one adopted daughter, and is based in Accra, Ghana, where she is the executive director of the Women Peace and Security Network (WIPSEN-Africa).

\Women living in conflict regions of the world are victims of rape, sex trafficking, disease, infant mortality and other atrocities. Yet, these issues are many times swept under the proverbial rug as heads of state or humanitarian groups take great pains in dealing with other facets of a country's rehabilitation.

"Liberia has 994 deaths per every 100,000 births. Sierra Leone is even worse. 1200 to every 100,000. In this day and age, we shouldn't have these numbers," said Gbowee. "It was because when we started rehabilitating our countries, we did not make maternal health a priority."

"For us, the fight is to dignify what the African woman does, not to try to get her to do what the African man does," said Dr. Hildra Tadria of Uganda, co-founder of African Women's Development Fund.

Across Latin America fertility rates plummeted, even though abortion is illegal, the Catholic Church opposes birth control and government-run family planning is rare.

Migration to the cities, the expansion of the female workforce, better health care and the example of the small, affluent families portrayed on the region's popular soap operas have contributed to such a fast demographic shift that it caught social scientists by surprise. The number of children per woman when from 6 in 1960 to 2.3 by 2010.

Brazil has been particularly fascinating for demographers, it's fertility rate falling lower than in any other Latin American country except Cuba, which has state-sponsored family planning and legalized abortion. With a population of almost 200 million, there is a great gap between rich and poor, although millions have joined the middle class during Brazil's recent economic expansion.

The country's fertility rate has fallen from 6.15 children per woman in 1960 to less than 1.9 today. That is lower than the United States, which at 2 per woman is just enough for the population to replace itself.

Brazil's fertility rate took a big drop uniformly across the country. Suzana Cavenaghi, a Brazilian census bureau demographer. "We wouldn't expect that in a country that's so diverse, with a lot of poverty in so many places and so unequal, economically speaking."

Women were empowered by a pro-democracy movement that rose up against a 1970s-era military dictatorship. That dictatorship, which wanted to populate Brazil's remote areas, inadvertently contributed to fewer births by promoting industrialization. That led rural families to crowd into cities, where a brood of children could be a financial drain.

Women began to look for means of birth control, easily obtained without a prescription. Doctors in the public health service provided sterilizations, which became common, and women sought out pills that induced abortions long before those pills became the subject of controversy in the United States.

A report, "The Battle for Female Talent in Brazil," says that 59% of Brazilian women consider themselves “very ambitious" and that 80% of college-educated women aspire to upper-echelon positions. U.S. women are far less likely to give those responses.

The country's elaborate soaps, or telenovelas, have been an important factor in the drop in Brazilian fertility, researchers say. The protagonists inhabit an appealing, affluent, highflying world, whose distinguishing features include the small family.

The Colorado Children's Campaign has found that there is a wide and growing gulf between the state's affluent and its poor when it comes to how they choose to create and maintain families.

The poorest counties have the highest rates of teen pregnancy, while, in affluent counties, new moms are more likely to be in their 30s.

Many close to the issue are convinced that teenage pregnancy is less a matter of morals or sex education or access to birth control than it is a matter of a girl or boy feeling that they have a future. Or not. Girls with prospects do not have babies. Teen pregnancy is well established as a cause of poverty, but it may also be a result of poverty.

Lisa Piscopo, a Colorado Children's Campaign researcher, said "I believe girls choose to have babies when they don't have a vision of any other options."

The answer is neither handing out condoms nor preaching abstinence, but to offer more of a vision for other options. Debbie Channel made a grant-funded attempt to curtail teen pregnancies by convincing young girls that there was a big world out there and they could claim a place in it.

In Huerfano County the average annual income just over half the statewide average and an unemployment rate that rose to over 10% last year. It has the state's highest rate of births to girls ages 15 through 17, and 54% of babies born in Huerfano County were to unmarried women.

Nationwide five of the wealthiest states had the lowest teen pregnancy rates. But Louisiana, Arkansas, Mississippi, Tennessee, Kentucky, Oklahoma, Texas, New Mexico, Arizona and Nevada had the highest teen birth rates. All but Arizona and Nevada are among the poorest states.

In 2009, a University of Chicago study reported that by age 17, one-third of young women in foster care reported having been pregnant, and by age 19 the number was nearly half. As many as one third of girls interviewed for the study said they wanted to become pregnant, perhaps "to create the family they don't have or fill an emotional void."

The 55th session of the UN Commission on the Status of Women, the global policy-making body dedicated exclusively to gender equality and the advancement of women, was held from Feb. 22 to March 4 at the UN headquarters in New York.

Song Xiuyan, vice chair-person of the All China Women's Federation, said that the international community should continue to strengthen its efforts to enhance women's economic situation and political status, improve women's participation in society, education and labor market, eliminate violence against women, and guarantee women's rights and interests.

Song said the launching of UN Women, formally known as the UN Entity for Gender Equality and the Empowerment of Women, clearly indicates the great importance that different parties have attached to, and the broad consensus reached on women issues.

She proposed that the UN Women should be committed to the realization of women's full development, with more input being made to alleviate poverty among women and to improve their education and health.

Newsweek/The Daily Beast's third annual Women in the World summit showcased the stories of the globe's most fearless femalesState Hillary Clinton and Madeleine Albright, Nobel Peace Prize winner Leymah Gbowee, Oscar-winning actresses Meryl Streep and Angelina Jolie, House Minority Leader Nancy Pelosi, Facebook's Chief Operating Officer Sheryl Sandberg, legendary feminist Gloria Steinem, and IMF Chief Christine Lagarde, and sparked a rousing discussion on the urgent challenges and tremendous opportunities facing women today.

Other speakers included politicians, CEOs, philanthropists, educators, lawmakers, and activists from around the globe—including a provincial council member from Afghanistan, a Burmese democracy activist, a groundbreaking investigative journalist from Guatemala, and Egyptian veterans of Tahrir Square.

The summit produced a weekend of unforgettable discussions and deep connections between women of different generations and backgrounds, all bound by the conviction that "women's rights are human rights" and that women have a moral obligation to work on each other's behalf.

Leymah Gbowee recounted her life in Liberia during Charles Taylor's brutal reign and the events that led her to assemble the country's mothers to demand an end to civil war—culminating in a chain of women, arm in arm, taking a group of unmotivated negotiators hostage until they hammered out a peace accord. "If we want the rape to end, the violence to end, we have to stand up." .. "We have to be our own Gandhis. We have to be our own Kings. We have to be our own Mandelas," she said.

Gbowee also expressed shock that American women were not more outraged over the way certain politicians and pundits were trying to shut them out of the reproductive-rights debate.

Kah Walla, former presidential candidate of Cameroon's People's Party said "We cannot accept that having 19 percent of women in [the U.S.] Congress is OK." ... "It's politics that defines the economy; it's politics that defines social norms. And until we get political power, we are not going to be able to make giant strides."

16-year-old Suma Tharu from Nepal, opened the Women in the World summit with a poignant song about being sold into slavery by her parents—who were disappointed to have a daughter. Suma, when she grows up, wants to work for an organization that helps other women.

"We have a lot of work to do now of behalf of women in Egypt," said Dalia Ziada, Egypt director of the American Islamic Congress, who also said "There is no spring without flowers and there is no Arab Spring without women."

.. http to read the entire, very inspiring, story.

Seven per cent of married women from rural communities in Jordon's southern region were forced to get pregnant, while 46% had no say in the timing of their pregnancies.

The study targeted 918 women, 807 of whom filled out the questionnaire. Thirty seven per cent said they used at contraception with the intrauterine device and pills being the most common.

Ninety five per cent of the women agreed that family planning has positive health advantages, while 29% did not give high priority to their health and do not seek medical treatment when they get sick.

In light of these figures, there should be more focus when drawing up health policies to raise awareness and empower women. Strategies should provide education and training to enhance access to health centres and help them make appropriate decisions related to their reproductive health.

The southern governorates cover a vast area, so there should also be a focus on outreach programmes. Forty two per cent of the respondents believe that married women's work was confined to their households.

More than 30% said they were psychologically abused, being cursed for example, while 20% reported being physically abused and subjected to some form of economic and social abuse.

A project is designed to improve women's reproductive health by enhancing health services in health centres, and also seeks to empower local communities as well as increasing awareness among men, women and young people on issues related to reproductive health.

The Philippine is making headway in addressing gender issues and laws promoting participation of women in productive and income-generating activities and laws addressing violence against women and children.

A Gender and Development (GAD) Budget Policy provides allocation of 5% of national and local government budgets for gender and development. The Philippine government is dedicated to addressing all forms of discrimination against women and is taking initiative in addressing violence against women, reducing women's vulnerability to trafficking and unsafe migration, accelerating women's participation, particularly Muslim and indigenous, in political life and decision, addressing high unemployment rate, enhancing access to health care and capability building and providing access to resources and security. All institutions may nominate any person who embodies all the qualifications of the proposed champion. The first MDG champion will be awarded an Orlina glass sculpture, scholarship grant, study tour abroad to United Nations General Headquarters (UNGH) in New York, United States and Geneva, Switzerland, free travel around the Philippines and designation by 2015 as Ambassador of Goodwill.

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."

The topics of contraception and sexual education are largely avoided in many Muslim countries. And many countries in the Middle East have laws against the purchase of oral contraceptive pills.

However, the Holy Quran does permit contraception as long as both partners consent, it's not permanent, and it doesn't cause bodily harm. Education is needed in order to change the perception of policy makers, and this education needs to be respectful of their traditional values while reassuring them of the benefits of making contraception available to young people.

Middle Eastern traditions and Shariah (Islamic) law dictate that pre-marital sex (even between consenting adults above the age of 18) is punishable by law. This often brands all contraceptive methods as instruments for having sex out of marriage. The uses, risks, and contraindications are not discussed and are unknown to adult women. The general view is that these topics promote sexual behavior among unmarried men and women.

Doctors are an exception and can provide contraceptive advice to married couples. Unmarried men and women have no access to contraceptive knowledge and are at risk of unwanted pregnancies and STDs. Unmarried pregnant women may even attempt suicide when they feel they have no options.

Also, emergency contraception is not widely available, which has led to an alarming rise in cases of fake and often dangerous pills that are purchased online.

Progress in introducing the topics of contraception and sex education may be slow, but every step forward is significant.The significance of providing contraception and improving overall healthcare must be linked. Experts will impart knowledge and train peer educators, to construct policies and to negotiate with government agencies.

Basic awareness-raising can begin through the Friday Islamic congregational prayer and the sermons, while keeping the Islamic law according to the Quran and Hadith in the forefront.

Peer educators also need to be selected on the basis of sex, nationality, language, and communication skills so they can be specifically tailored for specific groups, particularly with the men and women separately.

Feedback from participants is also important to help educators improve their teaching, answer the relevant questions, and dispel the common myths and misconceptions about contraception. Social media and the internet can also serve this purpose.

Information must be freely available to empower youth about making responsible decisions to avoid unwanted pregnancies.

The London Summit on Family Planning held in July harvested commitments from organisations and nations which enabled it to easily overshoot that $2.3 billion target. The Summary of Commitments from the UK Department of International Development reported that commitments came from 10 donor countries, 6 foundations, 19 developing countries, 21 civil society groups, 3 multi-lateral partnerships, and 1 private sector company.

The goal of the summit was to raise sufficient donor funds to meet the unmet need for contraception of 120 million women worldwide by 2020. This would require an extra $4.3 billion injected into family planning programs over the next 8 years. Of that $4.3 billion, $2.3 billion would be provided by donors.

In summary, the world is putting its money where its mouth is, taking Sexual and Reproductive Health seriously, and placing it at the center of the development agenda.

The Summary of Commitments incorporates International Planned Parenthood Federation's (IPPF) own commitment to treble the number of women's and girls' lives saved each year by 2020.

With increased capacity, increased funding, and strengthened service delivery systems, IPPF aims to save the lives of 54,000 women and girls, avert 46 million unintended pregnancies, and prevent 12.4 million unsafe abortions by 2020. The federation will also triple its services to young people by 2020, and make commodities more affordable.

Speech by H. E. Yoweri Kaguta Museveni, President of the Republic of Uganda at the London Summit, July 11, 2012

The issue of population in Africa must be put in a proper context. Africa is the origin of man (five million years ago) and is also the cradle of civilization (Egypt). About 100,000 years ago, the population in Africa was one million people while that out of Africa was just a few hundreds. However, by 1500 the out of Africa population was 300 million people while the population in Africa was only 47 million people.

Africa is a huge continent of 11 million square miles of land. You can fit the US, China, India, Brazil and the whole of Western Europe in Africa - with some space to spare.

Today the population of Africa is one billion people, less than the population of India which, in land area, is a mere 1/11 of the area of Africa.

Some of the African countries such as DRC, CAR, Congo Brazzaville, Gabon, Zambia, Angola and many others seem to suffer from under population rather than over population.

Africa's population is now about 70 million people. Therefore, the problem is not population per se. The problems are under-development and lack of socio-economic transformation on the one hand and child spacing for the good health of the babies to be born and for the health of the mother.

Africa needs to metamorphose from a pre-capitalist, quasi-feudal society to a middle class, skilled working class society. That social metamorphosis will, inevitably, bring down the population growth rate. Middle class societies and industrial working class societies do not have time or space (in urban areas) to generate children.

The economy of Uganda has been growing at the rate of 6.5% per annum for the last 25 years in spite of inadequate supply of electricity and high transport costs.

This summit gives us the chance to reflect on our efforts to improve adolescents' and women's needs in order to empower them, improve their health and welfare. Young people should be better able to make informed choices for healthy sexual and reproductive health lifestyles.

Uganda has reduced poverty and promoted universal primary and secondary education for both girls and boys thereby increasing literacy rate. Life expectancy in Uganda has increased to 52 years. We have promoted women involvement in all spheres of our national development.

Infant mortality in Uganda has reduced very considerably. However, our progress on MDG 5, improving maternal health, is still not on target.

In developing countries, women continue to die during pregnancy and childbirth. Yet the causes are well known and largely preventable. The use of relatively cheap and available technologies will lead to significant improvement in the living conditions of women. With women lacking access to family planning facilities, concerted efforts must be made to ensure their access, equitable distribution and affordability.

Natural methods should also not be forgotten taking advantage of the fact that days for ovulation are limited in the monthly cycle of a woman.

Nobody should administer family control drugs to rural illiterate women without explaining fully the implications of such an act. Family planning should be out of informed choice not out of manipulation.

In Uganda, we have scaled reproductive health, including antenatal care, youth-friendly services, emergency obstetric care as well as family planning particularly encouraging birth spacing.

Government will increase the government allocation for Family Planning supplies from $3.3m per year currently to $5m per year for the next 5 years and will mobilise an additional $5m from external partners.

Khumbo Kachali, vice president-Malawi - The Malawi government declared its commitment to raise Malawi's Contraceptive Prevalence Rate) to 60% by 2020 with a targeted increase in young people aged 15 to 24 years. It pledged to raise the legal age of marriage to 18 and strengthen institutional arrangements to deliver effective policy leadership for population and family planning.

Nigeria Health minister, Muhammad Ali Pate - His country targeted a Contraceptive Prevalence Rate of 36% by 2018 to avert 31,000 maternal deaths.

Senegal promised to more than double the number of women using contraception to 27% by 2015. The government will also increase its spending on procurement of reproductive health supplies by 100%, and double the budget for its family planning programme, investing in awareness campaigns. The country's minister of health claimed the support of the religious leaders.

Tanzania's president Jakaya Kikwete also pledged to double the Contraceptive Prevalence Rate to 60% by 2015.

Ethiopia recognized that early childbearing is a major contributor to maternal mortality, and put emphasis is on adolescent girls who have the highest unmet need for family planning.

The Zambian government committed to expand its budget for family planning by 100% as well as reaching out to religious leaders opposing contraception initiatives, said Joseph Katema, Zambia's minister of community development and mother and child health.

President of the United States Barack Obama signed an executive order on August 10 recognizing that gender-based violence undermines not only the safety, dignity, and human rights of the millions of individuals who experience it, but also the public health, economic stability, and security of nations; and making gender equality and women's empowerment a core focus of US foreign policy.

Evidence demonstrates that women's empowerment is critical to building stable, democratic societies; to supporting open and accountable governance; to furthering international peace and security; to growing vibrant market economies; and to addressing pressing health and education challenges.

Such violence significantly hinders the ability of individuals to fully participate in, and contribute to, their communities -- economically, politically, and socially. It is a human rights violation or abuse; a public health challenge; and a barrier to civic, social, political, and economic participation. It is associated with adverse health outcomes, limited access to education, increased costs relating to medical and legal services, lost household productivity, and reduced income, and there is evidence it is exacerbated in times of crisis, such as emergencies, natural disasters, and violent conflicts.

There is established an Interagency Working Group (Working Group) to address gender-based violence, which shall be co-chaired by the Secretary of State and the Administrator of the United States Agency for International Development (Co-Chairs).

The U.S. government's international HIV/AIDS program, PEPFAR, has $1.5 billion of its funds which have remained unspent for more than a year and a half. PEPFAR has said it will spend it on commodities (condoms, HIV rapid test kits and voluntary medical male circumcision kits), systems and institutions, and program strengthening.

Condoms play an important role, but a focus on broader voluntary family planning methods would help reduce the spread of HIV, especially mother-to-child. It is critical in the fight against HIV/AIDS and for the health and well-being of women and girls. Voluntary contraception has been called "the best kept secret in HIV prevention" and has a proven evidence-base.

New World Health Organization guidelines on couples HIV testing and counseling include family planning as part of the package of information and linked services offered in counseling sessions. Both PMTCT and counseling and testing are listed as priority areas for this money.

This is also a matter of rights. All women, including those living with HIV, have a right to decide whether and when to have children, and how many to have. Right now, there are 215 million women who want access to modern contraception but do not have it. Moreover, women in their childbearing years are also those most likely to be living with HIV in PEPFAR countries.

The Global Health Initiative's aim is a more integrated, women-centered and country driven global health program. Where needed, funding for family planning activities should be made available as part of the laudable, U.S.-endorsed, goals of creating an AIDS-free generation and eliminating mother-to-child transmission of HIV.

Eighteen past winners of the Blue Planet prize - the unofficial Nobel for the environment - warn that, in the face of an "absolutely unprecedented emergency" civilisation is faced with a perfect storm of ecological and social problems driven by overpopulation, overconsumption and environmentally malign technologies. Society has "no choice but to take dramatic action to avert a collapse of civilisation. Either we will change our ways and build an entirely new kind of global society, or they will be changed for us".

The group includes Sir Bob Watson, the government's chief scientific adviser on environmental issues, US climate scientist James Hansen, Prof José Goldemberg, Brazil's secretary of environment during the Rio Earth summit in 1992, and Stanford University Prof Paul Ehrlich. The paper was published on the 40th anniversary of the foundation of the UN environment programme (UNEP). The paper, which was commissioned by UNEP will feed into the Rio +20 earth summit conference in June.

"The rapidly deteriorating biophysical situation is more than bad enough, but it is barely recognised by a global society infected by the irrational belief that physical economies can grow forever and disregarding the facts that the rich in developed and developing countries get richer and the poor are left behind.

"The perpetual growth myth ... promotes the impossible idea that indiscriminate economic growth is the cure for all the world's problems, while it is actually the disease that is at the root cause of our unsustainable global practices", they say.

The group urges politicians to listen and learn from how poor communities all over the world see the problems of energy, water, food and livelihoods as interdependent and integrated as part of a living ecosystem.

"Community-based groups in the poorer most inaccessible rural areas around the world have demonstrated the power of grassroot action to change policy at regional and national levels... There is an urgency now to bring them into mainstream thinking, convey the belief all is not lost, and the planet can still be saved."

"The problems of corruption, wastage of funds, poor technology choices and absent transparency or accountability are social problems for which they are innovative solutions are emerging from the grassroots."

"Delay is dangerous and would be a profound mistake. The ratchet effect and technological lock-in increase the risks of dangerous climate change: delay could make stabilisation of concentrations at acceptable levels very difficult. If we act strongly and science is wrong, then we will still have new technologies, greater efficiency and more forests. If fail to act and the science is right, then humanity is in deep trouble and it will be very difficult to extricate ourselves.

The paper urges governments to: replace GDP as a measure of wealth with metrics for natural, built, human and social capital - and how they intersect; eliminate subsidies in sectors such as energy, transport and agriculture that create environmental and social costs; tackle overconsumption in the rich world, and address population pressure by empowering women, improving education and making contraception accessible to all; transform decision-making processes to empower marginalised groups, and integrate economic, social and environmental policies instead of having them compete; conserve and value biodiversity and ecosystem services, and create markets for them that can form the basis of green economies.

.. http the source document

About two-thirds of Oklahoma women who became pregnant between 2000 and 2003 did not intend to, and many Oklahoma women and men aren't getting family planning information. Attitudes and social restraints keep too many from getting it. Two-thirds of the unintended pregnancies were paid for using tax money.

37% of women surveyed during that three-year span did not want to become pregnant. 38% indicated their pregnancies were simply "mistimed."

But women in both categories are at higher risk for poor pregnancy outcomes, because they are less likely to get prenatal care, more likely to use alcohol, drugs or tobacco, and more likely to become victims of violence.

Only 35% said they intended to get pregnant.

Teenagers reported the highest rate of unintended pregnancies, with nearly 64%. Rates of unintended pregnancies were also high among African-Americans, at more than 55% and American Indians, at nearly 45%.

Women with lower levels of education and those living in poverty reported higher rates of unintended pregnancy.

The survey recommends: expansion of adolescent health services, especially in low-income communities; routine counseling; awareness of family planning available to low-income women; better access to more effective contraceptive methods; a focus on men's roles in family planning.

Advocates argue there should be more emphasis on the male role in preventing unwanted pregnancies.

Research shows that women who carry unintended pregnancies to term are less likely to pursue more education and to get good jobs. They also tend to have more health problems. Taxpayers usually foot the bill for the pregnancy. For every $1 invested in publicly funded planning services, $3 in Medicaid are saved.

In the last legislative session, measures did not even generate debate.

County health departments and family-planning contractors provide education and outreach.

An average of 10 families lose a parent daily, or more than 4,000 families yearly.

Most maternal deaths are due to prolonged labor, hemorrhage or excessive bleeding, hypertension, and complications from infection, obstructed labor, and complications from abortion. These causes are preventable with proper nutrition, adequate prenatal care, and access to services by trained physicians or midwives.

The cost effective solution is responsible parenthood that means not having more children than you can afford to support. If you cannot afford nutritious food and prenatal care for the pregnant mother, then it is the height of irresponsibility to indulge in sex that will lead to pregnancy.

There are natural and artificial methods to help couples avoid unplanned and unwanted pregnancies. They have to consult their doctors in government or private clinics for the best method. When a woman gets pregnant and she and her husband are financially unprepared, then the possibility of dying during childbirth becomes very high due to malnutrition and lack of prenatal care.

India has dropped a plan to bar politicians with more than two children from running in elections for parliament or state legislatures, saying it does not want to use force to control the population. The thinking in the government is that family planning should be voluntary.

The infant mortality rate in New York City jumped to 8% in 2003 after several years of declining and was caused by a rise in deaths in New York's poorest communities. The overall infant mortality rate is 6.5 deaths for every 1,000 newborns, below the national average of 7 per 1,000. Some neighborhoods are worse than others: the Tremont section of the Bronx averaged 10.2 for every 1,000 children. Other neighborhoods with poor ratios included Fort Greene, Brooklyn, and Jamaica East, Queens. Manhattan had the lowest rate, 4.8, while the Bronx had the highest, 8.6. Factors including the use of alcohol or tobacco during pregnancy, access to medical care and the mother's economic status. The increase was due in part to the number of babies born prematurely and weighing very little. The overall rate is based on the deaths of 807 infants and 124,345 live births in 2003. City health officials aim to reduce the infant mortality rate to 5.0 by 2008. The Health Department is urging women to control their reproductive health and educating women about the methods of birth control. The campaign concentrates on the city's poorer communities and will include ads in the subways and on buses. Teenage pregnancy in New York has dropped in recent years but is still well above the national average. However, the majority of pregnancies in the city, of any age group, were unplanned.

A conference in Nairobi is focussing on improving girls' education in sub-Saharan Africa especially to provide for the girl-child to go back to school after pregnancy. In Zambia 2,230 girls had dropped out of school last year because they became pregnant. Only a handful of countries in Africa have laws that make it compulsory for schools to re-admit young mothers. Where such laws exist, authorities must make sure they are enforced. Of the 42 million children who do not attend school in Africa, about 60% are girls. Sub-Saharan Africa is the only region which is in danger of not fulfilling a target to eliminating gender disparities in education by 2015. Poverty prompts parents to keep children at home to assist with chores or be sent out to earn money. More than 200 million children are engaged in child labour, 68 million in Africa. When money is available it is the sons who receive preference. Parents believe daughters are destined for marriage and have no need of education. The provision of free primary education has traditionally been viewed as the best way of overcoming this hurdle. But delegates to the conference warned once again that simply passing the relevant legislation would not do the trick. Free education needs monitoring to ensure that girls enroll. Although Kenya introduced free primary education last year, 1.5 million children remain out of school including many disabled children. A study found that poor sanitation facilities discouraged attendance by girls who had started menstruating and led to them dropping out of school. Under a new project, girls are provided with sanitary towels, while teachers have been trained to discuss menstruation and related issues. An effort had been made to improve sanitation and build separate toilets for girls and boys. This has increased the retention of girls in school.

A US evangelical group will recruite British teenagers to its campaign against sex before marriage. The abstinence campaign has received $700,000 from George Bush, to replace sex education with Victorian values. Teenage pregnancies are concentrated at the bottom of the social scale. Women born into poverty are more likely to be unemployed, depressed and become dependent on alcohol or drugs. Teenage pregnancy and venereal disease is generally blamed on lax morals and a permissive welfare state. Teenagers are in trouble conservatives insist, because of the sexual liberation and the state support of single mothers. The US is the only rich nation with 53 births per 1,000 teenagers - worse than India, the Philippines and Rwanda. The UK comes next with 20. Germany and Norway produce 11 babies per 1,000 teenagers, Finland 8, Sweden and Denmark 7 and the Netherlands 5. Sweden, changed its sex education policies in 1975 when abstinence and sex only within marriage were dropped, contraceptive education was explicit, and youth clinics established to provide advice and free contraceptives. Sweden saw its teenage birth rate fall by 80% and sexually transmitted diseases declined by 40%. The Dutch experience concluded that the success has been from a society with open attitudes towards sex and sex education. Contraceptives are not associated with shame or embarrassment. America and the UK have an atmosphere of embarrassment and secrecy. The UK has a higher teenage pregnancy rate because of lower rates of contraceptive use. The catastrophe afflicting so teenagers in Britain and America has been caused by those who campaign against sex education. Abstinence campaigns such as the Silver Ring Thing delay sexual activity, but participants are one-third less likely to use contraceptives as they are not "prepared for an experience that they have promised to forgo".

Abstinence programmes are associated with an increase in pregnancies among partners of young males.

Despite increasing contraceptive use and declining fertility, unintended pregnancy and abortion remain common in Vietnam. 40% of pregnancies during 1994-97 have been unintended. With concealed pregnancies ending in induced abortions, the unintended pregnancy rate approaches levels found in developing countries. Unintended pregnancy was associated with age, early marriage, spousal age difference, number of living sons, past unintended pregnancy, geographic region, contraceptive use, and family planning. The findings suggest that broadening the method mix at the community level, targeting high-risk and underserved groups, and expanding postabortion counseling are likely to have an impact on the unintended pregnancy rate in Vietnam.

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

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.

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.

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.

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.

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.

Reproductive health programmmes have focused almost exclusively on women. Involvement of men implies responsible parenthood, family planning; prenatal, maternal and child health; prevention of sexually transmitted diseases, including HIV; prevention of unwanted and high risk pregnancies; shared control and contribution of family income and empowerment of women.

In Bangladesh, men are not involved, but could do much to ensure the success of population and reproductive health programs, gender equity, girls' education, sharing of household chores and child-rearing. In Bangladesh, family planning is woman-focused and, it does not address the reproductive health problems of men. Most men need to know more about preventing pregnancy, HIV/AIDS, and other STIs.

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.

In 1978, women made up only 24.2% of the student population at Chinese colleges and universities. By 2009, that number rose to nearly half, according to the National Bureau of Statistics.

In contrast, women in India make up 37.6% of those enrolled at institutes of higher education, according to government statistics.

Since 1979, China's family planning rules have barred nearly all urban families from having a second child in a bid to stem population growth. With no male heir competing for resources, parents have spent more on their daughters' education and well-being, a groundbreaking shift after centuries of discrimination.

"They've basically gotten everything that used to only go to the boys," said Vanessa Fong, a Harvard University professor and expert on China's family planning policy.

"In the past, girls were raised to be good wives and mothers," said Vanessa Fong, a Harvard University professor and expert on China's family planning policy. "They were going to marry out anyway, so it wasn't a big deal if they didn't want to study."

Today's urban Chinese parents "perceive their daughters as the family's sole hope for the future," and try to help them to outperform their classmates, regardless of gender.

Some demographers argue that China's fertility rate would have fallen sharply even without the one-child policy because economic growth tends to reduce family size. In that scenario, Chinese girls may have gotten more access to education anyway, though the gains may have been more gradual.

Crediting the one-child policy with improving the lives of women is jarring, given its history and how it's harmed women in other ways. Facing pressure to stay under population quotas, overzealous family planning officials have resorted to forced sterilizations and late-term abortions, sometimes within weeks of delivery, although such practices are illegal.

When sonogram technology arrived in the 1980's, some families were able to engineer a male heir by terminating pregnancies when the fetus was a girl. Chinese traditionally prefer boys because they carry on the family name and are considered better earners. 43 million girls have "disappeared" in China due to gender-selective abortion as well as neglect and inadequate access to health care and nutrition, according to a recent UN report.

"It is gendercide," said Therese Hesketh, a University College London professor who has studied China's skewed sex ratio. To combat the problem, China allows families in rural areas, where son preference is strongest, to have a second child if their first is a girl. The government has also launched education campaigns promoting girls and gives cash subsidies to rural families with daughters.

Beijing-based population expert Yang Juhua has determined that single children in China tend to be the best educated, while those with elder brothers get shortchanged. China has many loopholes to the one-child rule, including a few cities that have experimented with a two-child policy for decades.

While women have reached gender parity in education, they remain woefully underrepresented in government, have higher suicide rates than males, often face domestic violence and workplace discrimination and by law must retire at a younger age than men.

It remains to be seen whether the new generation of degree-wielding women can alter the balance outside the classroom.

If one goes by the sex ratio of six out of the 10 most populous countries in the world, gender imbalance seems to be becoming a worldwide phenomenon.

The 2011 global sex ratio is 984 females against 1,000 males. India's is lower, at 940 females to 1,000 males, and China, Indonesia, Nigeria and even the USA have all shown a decline in the sex ratio in 2011.

Despite all its prosperity, better living and educational standards, the USA has failed to sensitize the society towards the girl child.

The decline has been particularly sharp in Nigeria and Indonesia.

On the other hand, the sex ratio in Japan, Brazil and the Russian Federation has increased impressively in 2011, while the population of these countries (except Russian Federation where it has declined) accounting for nearly three-fifth of the world population, has grown over the last decade.

India (940), Pakistan (943), Bangladesh (978) and Afghanistan (931) all show a preference for sons, although showing a light increase. All these countries have banned pre-natal tests.

Affluent urban couples in China are starting to think about having a second baby, hoping it is a girl.

Some are concerned that their first child will move away when he grows up, and a daughter can stay and take care of them.

An example given of such a couple are a woman and her husband who own a software company in Beijing that earns the couple about 500,000 yuan (74,828 U.S. dollars) a year - enough to afford circumventing the one-child policy. Under this policy, couples need to pay a fine, based on families' annual income, that has been reported to range from 45,000 dollars to more than 100,000 dollars.

The couple thought it was too expensive to raise a boy, especially in big cities like Beijing and Shanghai. "We have to buy him an apartment at least. Otherwise it will be difficult for him to find a girlfriend."

In China, where a historical preference for boys has led to a dramatic gender imbalance, attitudes about having girls are beginning to change in urban areas. According to a 2009 survey of 3,500 prospective parents in Shanghai, 15 percent of those interviewed wanted a baby daughter compared to 12 percent who wanted a baby boy. The rest had no preference.

China's gender imbalance has reached dangerous levels. The attitude that girls cannot accomplish as much as boys is becoming outdated. "Girls can also inherit a family business." "They can be as able as men."

A booming economy in the last decade has created more opportunities for woman, particularly in the cities. Rising incomes have rendered moot the traditional reasons for wanting a boy - namely that a boy will earn more money to support his parents in old age.

In 2005, the last year for which data is available, there were 119 boys born for every 100 girls. In some areas, the ratio was as high as 130 males for every 100 females.

In rural areas preference for boys has led to a number of selective abortion, prostitution and human trafficking. China has a surplus of some 32 million boys.

South Korea has had a shift in gender preference in the last 20 years. In 2006, Korea's gender ratio was 107.4 boys born for every 100 girls, down from a peak of 116.5 boys to every 100 girls in 1990, according to a 2007 World Bank study. (Demographers consider a 105 to 100 ratio normal).

Major shifts in Korea's economy created opportunities for women in the work force, changing long- held attitudes toward women?s role in society.

A study in 2010 by the government-supported Chinese Academy of Social Sciences named the gender imbalance among newborns - not overpopulation - the country's most serious demographic problem.

The study attributed the gender imbalance to China's three-decade-old one-child policy and to a poor social security system.

"The chance of getting married will be rare if a man is more than 40 years old in the countryside. They will be more dependent on social security as they age and have fewer household resources to rely on," another researcher said. Abductions and trafficking of women were "rampant" in areas with too many men.

China has made great strides in terms of gender equality. There are a growing number of women in government administrative positions, legislation on gender equality continues to rise and there are more women receiving education at high levels.

When you survey young women in developing countries, and ask them how many children would they like to have, often the answer is: "two". However, when the answer is "two children", but where there is sufficient male preference that a woman will keep trying until she has a son, then the average fertility rate of that area is 3.0.

Male preference can slow, or even freeze, gains in fertility reduction until women establish a higher standing. This can be done with education, women's empowerment, jobs for women, and others, but these all take time.

Birth spacing, menstrual regulation, and popular soap operas are three quicker ways that may help nudge fertility reduction towards faster progress.

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.

China has 32 million more young men than young women which could lead to increasing crime, because parents face birth limits and abort female fetuses to have a son.

The imbalance is expected to worsen over the next two decades and could trigger a spike in crime by men unable to find female partners. Males under 20 exceeded females by 32 million.

The biggest boy-girl gaps are in the 1 to 4-year-old group. China imposed birth controls to limit growth of its population, noting that resources were strained and changes were needed in its new push to modernize. The controls have prevented an additional 400 million births.

But families cling to traditional preferences for a male heir, and infanticide of baby girls became a problem. In response, some parts of China allow couples to have a second child if the first is a girl.

The prevalence of sonograms has allowed parents to learn the gender of their fetus about 20 weeks into pregnancy, leading to a rise in abortions based on sex. China bans tests to determine the gender for non-medical reasons but they are still commonly done. China's laws do not prohibit or define late-term termination.

Some families hide the births of daughters, so they can legally try for a son.

Sex-selective abortion does contribute to these high sex ratios, but so do other things such as non-reporting of girl births, abandonment, infanticide.

China has launched subsidy programs and education campaigns encouraging families to have girls, but with limited impact.

Enforcing the existing ban on sex-selective abortion could lead to normalization of the ratios.

The UN's 2013 human development t index (HDI) from the UN Development Programme has been released. Its figures and rankings include life expectancy, education and income.

Afghanistan, Timor-Leste, Burma and seven sub-Saharan African countries had the fastest average growth in human development over the past 12 years.

Norway was on top again, while Burkina Faso, Chad, Mozambique, the Democratic Republic of the Congo and Niger were at the bottom.

But the report also includes a table on trends in the HDI over the past three decades - which makes more favourable reading for poorer African nations.

In terms of annual average HDI growth in the 2000s, sub-Saharan Africa (1.47%) surprisingly outstripped the Arab states (1.07%), east Asia (1.43%), Europe and central Asia (0.77%), and Latin America (0.74%).

And although Niger has the lowest human development score in the world, it had the 10th fastest average human development growth between 2000 and 2012 (2.2%), behind Afghanistan (3.91%), Sierra Leone (3.29%), Ethiopia (3.09%), Rwanda (2.73%), Timor-Leste (2.71%), Angola (2.56%), Mozambique (2.37%), Burundi (2.31%) and Burma (2.23%).

North Korea, Somalia, and South Sudan were not included in the HDI scores.

The inequality HDI (IHDI) measures the level of human development of people, taking into account inequality.

The US fell 13 places in the UN's human development index (HDI) once inequality was taken into account, South Korea fell furthest in the rankings, while the US fell 13 places, and Latin America made up most of the rest of the worst performers.

The countries that climbed the most once inequality is taken into account were mostly former communist states.

Then there is the gender inequality index (GII), which seeks to expose differences in the distribution of achievements between women and men - in areas such as health, empowerment and the labour market.

The Netherlands ranked top, followed by Sweden, Switzerland, Denmark and Norway. Yemen scored lowest on the GII, followed by Afghanistan, Niger, Saudi Arabia and the Democratic Republic of the Congo.

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.

Kenya is on the verge of a major demographic transition and rapid urbanisation.

The World Bank, in its report Turning the Tide in Turbulent Times, says this must be well managed for the country to attain middle income status within this decade. 30% of Kenyans live in cities; by 2030 this proportion may reach 48%.

"Economic activities in urban areas have a much higher yield than those in rural areas. No country has transitioned into middle income status by remaining predominantly rural," said the World Bank country director. In Kenya, for example, Nairobi and Mombasa have only 10% of the country's population, but 40% of wage earnings.

The working age population - age 15 to 64 - is bigger than the rest of the population, which depends on them. 55% of Kenya's population is of working age and is expected to reach 63% by 2030. As families become smaller, and life expectancy grows, this economically vital group drives the economy by working, saving and investing.

However massive investment is needed to support the pressure of an increasing population - in housing and infrastructure, job creation, and crime prevention - to reap the benefits of this urban transition.

The building of new homes is not keeping up with the demand, with only one-fifth to one-third of the necessary houses being built - even as the population grows by one million a year. Only 25% of those born today will have access to quality housing in the next two decades as they reach adulthood and start family life.

Electric power is the biggest infrastructure constraint on Kenyan firms, with transport coming a close second.

The World Bank report suggests that if Kenya's infrastructure could be improved to the level of continent-leader Mauritius, annual per capita growth rates would be 3.3% higher than they are currently.

Addressing Kenya's infrastructure deficit will require spending 21% of GDP.

The World Bank is optimistic that, with the right kind of focused investment and urban policy, Kenya can still achieve middle income status of $1,000 per capita by 2019. In 2010, growth was higher than expected at 5.6%.

34% of Africans (313 million) spend between $2 and $20 a day, putting them in the category of middle class, a rising group of consumers to rival those of China and India, according to the African Development Bank.

Record numbers of people in Africa own houses and cars, use mobile phones and the internet and send their children to private schools and foreign universities. The findings should challenge long-held perceptions of Africa as a continent of famine, poverty and hopelessness.

Mthuli Ncube, the bank's chief economist, said "There is a middle class that is driven by specific factors such as education and we should change our view and work with this group to create a new Africa and make sure Africa realises its full potential."

Africa's middle class rose from around 111 million (26%) in 1980 and 196 million (27%) in 2000. Tunisia, Morocco and Egypt had proportionately the biggest middle classes in Africa, while Liberia, Burundi and Rwanda had the smallest.

The African middle classes own cars and are more likely to have salaried jobs or own small businesses. They tend not to rely entirely on public health services, seeking more expensive medical care. They tend to have fewer children and spend more on their nutrition and schooling.

The middle class was responsible for at least half of Africa's GDP of $1.6tn.

Bangladesh is going through a social and economic transformation. The concept of sustainable development requires integrating objectives. The future of sustainable development lies in the evolution of the character of governance. We are to find how to pursue economic development without degrading environment and ecosystem resources. We are also have to turn disaster risk reduction into sustainable development policies.

Addressing emerging needs require inclusive and pro-poor growth with equity and justice. Integration of environmental priorities into national strategies for poverty eradication and sustainable development needs special attention. We are remove barriers toward strengthening capacities at individual, and institutional level to implement national policies and programmes toward sustainable development.

It is also relevant to implement the national programs - such as National Water Management Plan, Land Use Policy, Fisheries & Livestock and Agriculture Policy - to achieve sustainable development in Bangladesh. The PRSP Phase II provides us an opportunity to integrate these policies with poverty-environment in Bangladesh. How can we build partnerships for learning to ensure more effective ways to implement those policies and plans.

Over the last 15 years Bangladesh has made gains in human development indicators. In the 2007 UNDP Human Development Report, Bangladesh is ranked 138 among 177 countries with an HDI score of 0.509, which places it among countries considered to have achieved medium human development.

Despite impressive gains Bangladesh faces challenges. Achieving the MDGs within the next decade will require more ambitious and effective strategies. Urban poverty has risen accompanied by lack of decent work and adequate shelter. The critical challenges of attaining environmental sustainability (MDG Goal 7) are still inadequately addressed. This is further deteriorated by absence of land zoning and weak environmental governance. Climate change has led to serious deterioration of ecosystems.

There is a growing consent that democratic governance creates the conditions for sustainable development and poverty reduction. Local governments can play a major role. Improvement in the dialogue between the state, citizens and their communities, is also a requisite.

Local and regional development strategy involves building partnerships between national and local authorities, community organisations, civil society, and the private sector. However, there is a need for a technical advisory body for the services to be provided. Other strategies needed are: strengthening the capacities of local governments in sustainable development; supporting central governments to formulate policies promoting decentralisation to foster natural resource management, and strengthen local development; and empowering women's associations and users of natural resources.

Sustainable development is vital in both poverty alleviation and sustainable environmental management. In Bangladesh where competition for resources is intense and the carrying capacity is under severe strain, the concept of eco-system restoration and regeneration, has immense potential to relieve social tension and improve public well being.

A pico-hydro power plant for lighting in a remote and village in Nepal shows what can be achieved with rural electrification.

Nepal is a developing country, 138th of 177 countries using the Human Development Index. Some 80% of the population live in rural areas that are difficult to access. Nepal ranks among the lowest of the word's economies at 197th out of 225.

Biomass fuel consumption in Nepal represents 93% of usage nationwide, and 100% in remote mountain areas.

Humla is 17 days walk away from the nearest road. Compared to developed nations infant mortality ranges from 86 to 53 per 1000 live births for the poorest and richest 20% respectively. A Holistic Community Development (HCD) approach for the communities living in the impoverished Karnali region of Humla has been developed.

Various needs cannot be addressed using a single approach. Primary health needs have to be addressed in a multi-pronged approach. Installing small scale electricity benefits health through the reduction of pollution from open fire cooking, heating and lighting. They also benefit education, with light for evening classes for mothers and out-of school children, and the environment through the reduction of biomass.

Other critical needs can be neglected, such as a lack of a sewage system, and contaminated drinking water. Villagers define their most urgent needs as, electric light, a smokeless stove, a toilet nearby, and clean drinking water. These four demands are installed, as a group, into each home, and includes a smokeless metal stove, solar lighting, a pit latrine, and access to safe drinking water. Experience shows that a single-pronged approach is neither sustainable nor beneficial in the long-term.

The communities in Humla need to tap their available renewable energy resources. In the target village, water flowing year-round in a nearby stream, plus an average of 5'6 kWh/m2 per day of sunshine, provide significant resources suitable for providing minimal indoor lighting services. In Humla, all families use a resin-rich wooden stick to light indoor living spaces. The amount of equipment and machinery that would need to be air lifted into the village makes such a project difficult. Initial project costs and the ongoing maintenance costs would be far beyond the local community's economic capacity.

Project planners, in collaboration with local people, have to understand and openly discuss the local cultural attitudes toward change. The step-by-step approach begins small, it also means that misuse of the system has a relatively small and easily addressed set of consequences. Villagers learn new skills and competencies, and develop a strong sense of ownership for the new technology. That allows a seamless transfer of the project to the local community, which is prepared and able to run and maintain the system.

A typical project generates 1.1 kW at a maximal water flow. The project, developed white light emitting diode lamps, with the unit consuming just over 1 W. These lamps are almost unbreakable, and last more than 20 years if used for 7 hours a day.

The entire power plant was built with locally available materials provided by villagers as part of their contribution to the project. In addition individuals from every household contributed labour to the building and installation process.

Buy-in, participation and local sense of ownership were prioritized. At the completion of the project, villagers were proud of their achievement. The generator's 225 V AC is transformed to 615 V AC, travels via an underground cable to the village, and transformed to 225V AC. The system was modified so that 850 W or more can be diverted full-time to a water heater that heats water in a 500 litre plastic tank that is insulated with pine needles and nestles within a larger, 1000 litre plastic tank.

The warm/hot water is used for showering, to prepare meals. The integrated long-term approach has been shown to be a significant step in the right direction. With time, those offering assistance and those receiving it will experience the mutually beneficial, benefits. However, this will most likely unfold over the course of two generations of living and working with the people who are being helped to escape the vicious circle of poverty and hopelessness.

Even in her early childhood, Vandana Shiva, born in 1952 in a small village at the foot of the Himalayas, wanted to be a scientist. After living in Canada she left with a doctorate, but confronted with poverty, injustice and environmental destruction, she saw herself as an environmentalist and human rights advocate. The alternative Nobel prize winner studied the multitude of tree species, forest plants and traditional agriculture of her homeland.

The illiterate peasant women from the high Himalayas taught her to recognise the value of nature and the urgency of defending it. The peasant women have bred seeds which are optimal for the soil condition and environment, and have, through exchange and cross-breeding, developed an astonishing agricultural biodiversity. For many years Vandana Shiva has worked for the rights of small peasants in India, who are losing control over their own seeds. Her campaigning led her to directly criticize international industry and trade circles.

The WTO agreement on trade-related aspects of intellectual property (TRIPs) criminalises the storage of a portion of a harvest for planting the next year as well as the millenia-old practice of exchanging seeds between farmers". In addition, the agricultural agreement legalises the with genetically modified food crops and criminalises the protection of biological and cultural diversity, on which the variety of nutritional systems depends.

Shiva's understanding of democracy reclaims the freedom of development for individual life-forms and the sovereignty of peoples over water resources, food and quality of clothing. Vandana highlights alternatives to the monopolisation of life and natural resources. She counters the centralised power of multinational corporations with decentralised structures based on peaceful co-existence.

She transfers insights from quantum theory to human ecological actions. In the end everything is connected with everything else, says the environmentalist.

Lack of educational opportunities for girls is fueling the Ethiopia's high level of early marriage, according to Annabel Erulkar, of the Population Council in Ethiopia. Of the 20-24-year-old women that she studied, 79% of those who had married before age 15 had never been to school and only 3% had attained any secondary schooling. Unschooled women had 9 times the risk of marrying before age 15 as women who had some degree of formal education and five times the risk of marrying at ages 15-17.

Of those married before age 15, 97% had a mother with no education and 91% had a father with no education, compared to those who had not married during adolescence, 76% and 64%.

89% of girls married before age 15 had arranged marriages, compared with 52% of those married at ages 18-19. 71% of girls younger than 15 had not met their spouse until the wedding day. and only 33% had known about the marriage beforehand, and just 31% wanted to be married at the time.

Those who had married before age 15 were far less likely to have wanted to have sex than were those who had married at ages 18-19 (49% vs. 85%). The youngest brides were more likely than older brides to have recently experienced intimate partner violence at the hands of their husbands.

Girls in rural areas - with high rates of poverty and where cultural beliefs and social norms uphold the practice - were found to be four times as likely as urban girls to marry before the age of 15. In the Amhara region, the median age at marriage among females is 14.4.

Community-based programs that get girls into school and keep them there may be more effective at combating early child marriage than strategies that address girls already in school or seek to change community attitudes toward early marriage.

Fifty-eight million girls in developing countries were child brides in the last decade. This PRB ENGAGE Mini-Presentation highlights the consequences that early marriage can have for girls, such as poor health outcomes and lost opportunities for education and empowerment. But effective strategies to address early marriage do exist and can help millions of girls fulfill their potential and contribute to the development of their families and communities.

The idea that girls should get the same education as boys seems to be gaining acceptance. However, in the developing world, there are impediments to keeping girls in school, the biggest being the stubborn persistence of child marriage.

About 10 million marriages occur worldwide each year in which at least one spouse, usually the female, is younger than 18. In 16 countries, half of girls marry by that age. West Africa has the highest incidence of child marriage. In Niger, 36% of girls are wed before turning 15.

High child-marriage rates are associated with weak indicators in maternal health, education, poverty, food security and HIV incidence, since badly informed and weakly connected mothers make poor decisions for themselves and their families.

In the developing world, a baby born to a mother under 20 is 50% more likely to be stillborn or die in the first month than one born to a mother 20 to 29. Pregnant girls younger than 15 are five times more likely to die giving birth than women over 20 are.

Often the birth canal is not large enough, causing obstructed labor, which results in obstetric fistula, a condition where there is constant leakage of urine or feces due to the damage of prolonged obstructed labor; such girls are often cast out of society.

Girls who marry young also typically leave school. Their children are more likely than those of older brides to be undereducated and malnourished.

Often the wife is much younger and her husband, which translates to a power imbalance that often leads to spousal abuse.

While several countries have increased the legal marital age to 18 to comply with international conventions defining marriage as an agreement between consenting adults, legal change alone has made little difference. The prevalence of child marriage is decreasing -- but very slowly. Some countries even want to reverse the law and lower the marriage age.

Parents often see educating a daughter as a waste of resources and think of early marriage as a way to eliminate an economic burden. But there are programs that seek to reverse this economic dynamic and have successfully reduced child marriages. In a rural area of Ethiopia, for example, parents of girls 10 to 14 were given $6 to pay for their daughter's school supplies plus a goat worth $25 if she remained enrolled for two years. As a result, girls in the program were one-tenth as likely to be married and three times as likely to be in school as their peers. Similar programs in Malawi and Bangladesh have also reduced child-marriage rates.

When parents can afford to keep a daughter at home, they tend to see their daughters as children who will later give them a a return on investment in education for jobs. And schooling gives girls the skills, social networks and confidence to better negotiate their futures.

But these interventions need to be expanded beyond the pilot stage. Funding is needed and governments need to make them part of national education policy. In Ethiopia, for example, the local authorities partnered with the Population Council, which received funding from the Nike Foundation, the United Nations and the U.S. Agency for International Development.

In the poverty-stricken, deeply conservative northern districts of Bangladesh, children defer to elders. So when 13-year-old Rehana was faced with the consequences of early marriage - an end to school, isolation from her friends and a life of hard work at her in-laws, she knew outright rebellion was out of the question. Fortunately she knew exactly who to call: the district's "wedding busters", a movement consisting of 11 groups of around 20 youngsters, campaigning against child marriage.

Rehana's mother argued. "Who will help us find a nice boy when she gets older?" ... "And who will protect Rehana on her way to school?" Antara, 16, one of the leaders of the child protection group could not argue. "All we can do is show them that child marriage is a curse."

The intervention of such groups is a key reason why all of the areas' unions or local councils have been able to declare their respective localities "child marriage-free zones" - in a country where almost one -third the children is married off by age 15.

Myrna Evora, country director of Plan Bangladesh, a children's charity that campaigns against early marriage said: "Early and forced marriage often drives girls into a cycle of poverty and powerlessness. They tend to miss out on an education, suffer from poor health and give birth to children who are also weak and malnourished."

Shamsul Haq, a local council chairman, said "You can't defeat something like this with heavy-handed law enforcement." Although Bangladesh in 1984 made it illegal for males under 21 and females under 18 to marry, enforcement remains lax.

There is widespread ignorance about the health consequences of early marriage. Child brides become part of a vicious cycle of chronic malnutrition and are at high risk of death during childbirth. Unicef's State of the World's Children 2011 report tells us that girls who become pregnant before the age of 16 are three to four times likelier to die giving birth than women in their 20s.

Dr Mahbub Hasan, a surgeon, said "Because their bodies are not fully formed, they're at risk of prolonged or obstructed labour. This threatens the lives of both mother and child. Early marriage is hampering our efforts to bring down maternal and child mortality."

In Bangladesh's entrenched and illegal dowry system - where a bride's family pays significant sums to the groom - encourages the marriage of adolescent girls, because younger brides typically require smaller dowries.

The government, with support from the World Bank, has been giving small cash transfers or stipends to encourage girls to stay in school. According to a World Bank study, the overall proportion of females who married in stipend project areas declined between 1992 and 1995, from 29% to 14% for 13 to 15-year-olds, and from 72% to 64% for 16- to 19-year-olds.

The wedding busters go from village to village, holding courtyard meetings and staging amateur plays. They can call on the aid of the local council chairperson and even the police chief. "The kids can stop 50% of child marriages by themselves. In the rest of the cases, we get involved," said Ehsan Chanu, former chairman of Mirganj local council.

51% of Niger children are stunted. One of three children die of hunger. Their graves dot the landscape.

One of every three girls in Niger marries before age 15, one of the highest birth-rates in the world. By marrying off their daughters at such young age, it's one less mouth to feed and it brings in a dowry from the groom's family, money desperately needed to feed the mouths of the many other hungry souls.

In the small hamlet of Hawkantaki (pop. 200), between the harvest of last year and this spring's planting, 9 of 10 girls between the ages of 11 & 15 were married or engaged.

Kadiatu was forced into marriage at age 12 and had a baby a year later. The baby's father left 6 months after she was married and she had no help from her mother or any other relative. She had her second child at age 18.

Her father had died when she was 6 and she had to quit school and go live with her uncle, whose wife treated her like a servant while her other children were allowed to go to school. She was forced into the bondo society, a group that practices female genital cutting. She did not want to. She wanted to go to school, but her mother told her that she couldn't afford to pay school fees, even though she could afford to spend a lot of money on the initiation process. Once initiated, she was forced into marriage.

Kadiatu supports herself and her children by selling wood, potato and cassava leaves. She doesn't want this kind of life for her daughters. "I want them to be free to get an education, and to not be worried about marrying too young or experiencing violence. I want them to grow up to be strong young women who can make their own choices, go to school, own land and control their own lives."

Kadiatu says some of the main challenges faced by women are are: sexual assault and harassment, teenage pregnancy, gender based violence, lack of parental or family support, lack of finances to help support them on their day to day activities, and lack of access to land for farming and agricultural activities.

She would like to see leaders promise to help tackle issues on poverty, teenage pregnancy and early marriage, HIV & AIDS; provide standardized free medical health services for all children and women; provide improved agricultural activities and revised land tenure systems for our community for suckling mothers to have easy access to backyard farming; and microfinance opportunities for women.

She also wants to see help from world leaders in the areas of free education for girls at all levels; corruption, youth employment, and background information.

About 34% of women aged 15 to 19 have either already had a baby or are pregnant. This also often leads to interrupted education, reduced earning potential, poor marital outcomes and reduced health outcomes for surviving children.

In Sierra Leone about one-third of urban and one-sixth of rural 20- to 24-year-olds are out of work, and more than 17% of the urban populations aged 15 to 35 years are unemployed.

Find out more at one.org/africanvoices. Restless Development is an agency that places young people at the forefront of change and development. It works in Africa and Asia to empower young people to take their lives into their own hand and trains, educates and inspires young people to be part of the solution. Find out more at www.restlessdevelopment.org

In the U.K., Muslim clerics have been performing sharia marriages involving child brides as young as 12, an investigation found. Two imams have admitted they would be prepared to officiate at the wedding of an underage girl to a man in his twenties, despite fears the pair would later have sex.

It is believed that 1,000 of the 8,000 forced marriages of Britons each year involve girls of 15 or under. In one case last year allegedly involved a girl of five.

One Iman told an undercover reporter: ‘Tell people it is an engagement but it will be a marriage,' ... ‘In Islam, once the girl reaches puberty the father has the right, the parents have the right, but under the laws of this country if the girl complains and says her marriage has been arranged and she wasn't of marriageable age, then the person who performed the marriage will be jailed as well as the mother and father.'

Islamic law allows a couple to have sex after marriage but, as the legal age of consent is 16, a husband can be prosecuted for rape if he has sex with an underage girl.

Farooq Murad, of the Muslim Council of Britain, said: ‘We are strongly opposed to it on the basis that it is illegal under the law of the land where we are living and even under sharia it is highly debatable.'

The Home Office said: ‘Child marriage is totally unacceptable and illegal. Perceived cultural sensitivities and political correctness cannot and will not get in the way of preventing and uncovering such abuse.'

"A hungry people listens not to reason nor cares for justice, nor is bent by
any prayers" said Roman philosopher Seneca, 2,000 years ago, . There is
little use in preaching ecology and inter-generational equity to the nearly
billion children, women and men who will go to bed partially hungry tonight.
Agricultural scientist Dr. M. S. Swaminathan advocates a four-point action
plan to provide a community-led food security program that protects the
ecological foundations essential for sustainable food and water security.
The world's population was only 940 million in 1798 when Thomas Malthus
expressed his apprehensions about human ability to produce food to match the
needs of increasing human numbers. At that time, Marquis de Condorcet, a
French mathematician, remarked that the population will stabilise itself if
children are born not for mere existence, but for "happiness", meaning
social, economic, educational and ecological "happiness". Even though the
global population has now reached over six billion, Malthusian fears were
not realized because of tehnological advances which kept the growth rate of
food production above population growth rates. It has become apparent,
however, that the very progress in agriculture has, in several areas of the
world, eroded water security, owing to the unsustainable exploitation of
groundwater and inadequate efforts in storing rainwater. In addition, food
security challenge shifted from physical to economic access to food at the
end of the 20th century. Due to a famine of jobs, at least 300 million in
India suffer from poverty induced hunger and every third child born is
underweight (below 2.5 kg) due to maternal and foetal undernutrition. Such
low birth weight children suffer from handicaps in brain development, an
irony since this century has been christened as "Knowledge and Innovations
Century". Today in the developing world, annual imports less exports of
cereal grains amounts to 88 million tonnes at a cost of US$14.5 billion, and
the demand is expected to increase at least by 40% in the next twenty years.
Milk and meat have been imported in large amounts since the early 1970s and
this is expected to increase eight fold between 1995 and 2020. In the
meantime, per capita arable land and irrigation water availability is
shrinking while biotic and abiotic stresses are increasing. Food imports by
countries have the same impact as importing poverty and unemployment. Modern
industry promotes jobless economic growth. On the other hand, agriculture,
agro-processing and agri-business foster job-led economic growth. The
population supporting capacity of major ecosystems has already been exceeded
in most developing countries. Population pressures are particularly high
near megabiodiversity regions where land, water, flora, fauna and atmosphere
support systems are all in distress. The challenges during this century will
be both economic and ecological access to food. Swaminathan's four point
action plan for food security includes an 1) Integrated Natural Resources
Management (INM) through local level socio-demographic charters at the
grassroots (village) level, 2) Integrated Gene Management, 3) Community Food
and Water Security System, and 4) Restructuring global institutions. INM:
The major purpose of a village level socio-demographic charter is to
sensitise the local community on the population supporting capacity of their
ecosystem, with components including a) Environment management to prevent
loss of top soil, depletion of ground water, pollution of lakes and rivers,
deforestation, loss of grazing lands, conversion of forests into
agricultural land and air pollution, with water harvesting, watershed
management and the efficient and economic use of water to receive highest
priority; b) Hygiene and housing: safe disposal and recycling of garbage,
sewage and human waste; c) Health security, which would include reproductive
health issues like maternal and child health care services, reproductive
health education, tuberculosis and AIDS prevention and care, provision of
safe and affordable contraception, prevention of infant mortality; d)
Education: higher enrolment in primary schools, and more education of the
girl child; e) Nutrition security: balanced diets and safe drinking water.,
including nutritional supplementation of pregnant mothers and children under
five and to eliminating micro-nutrient deficiencies. f) Gender code: to end
gender inequity and discrimination including adverse sex ratios, inequitable
property rights, dowry, female foeticide and infanticide, higher female
mortality and morbidity, higher female illiteracy, feminisation of poverty
and food insecurity for women. The role of women in the conservation and
improvement of agrobio-diversity will be given explicit recognition. India's
national bio-diversity legislation, the Plant Variety Protection and
Farmers' Rights Act, now before Parliament, provide for recognising and
rewarding the contributions of tribal and rural families to genetic
resources conservation (biodiversity) and improvement. Community seed banks,
supported by microcredit, and grain banks operated by a self-help groups
need to be established. In the re-negotiated World Trade Agreement,
industrialised countries should make provision for recognising and rewarding
primary conservers of bio-diversity and holders of traditional knowledge,
mostly found in developing countries and indigenous communities. Breeders'
and farmers' rights should be protected with intellectual property laws

The economic crisis threatens to reverse progress in poverty reduction and governments must do what they can to ensure those gains are not lost.

The target year is (2015) for accomplishing the eight MDGs. Asia has made strong progress to cutting extreme poverty in half by 2015. However, the economic crisis threatens to slow the pace of further reduction.

GDP growth in 2009 for developing Asia will be 6% lower than in 2007 and 3% lower than in 2008. As a result, around 60 million people will be stuck below the US$1.25 poverty line.

Prospects for the achievement of non-poverty related development goals look increasingly bleak. Many countries remain off-track on primary school completion rates, and access to water.

Questions have been raised whether infrastructure alone can cushion the harsh economic impacts of the crisis. Social service programs such as health care and education, should not be crowded out by infrastructure programs.

Bangladesh has been a success story in population and reproductive health, but it still has to go a long way. People are not getting the right contraceptive at the right time. Bangladesh is the most densely populated country in the world and its population will stabilise in 2050 when there will be nearly 24 crore (crore = 10 million) people.

The country has made progress but the maternal mortality rate is still high with 12,000 women dying from complications of pregnancy and childbirth annually.

Bangladesh has to target the poor because they are voiceless and have a higher total fertility rate (TFR), maternal mortality and higher incidence of malnutrition. The TFR among the poor has been double that of the rich. Women get married at an early age due to low income and lack of security. Half of the population lives below poverty line. Close links between poverty and reproductive health exist that keep the poor in persistent poverty. Infant mortality among the poor has come down to 65 per 1,000 in 2004. Contraceptive prevalence increased to 58% in 2004 from 8.5% in mid 70s. A growing concern in Bangladesh is the persistence of health inequality, linked to birth attended by skilled health personnel.

More than 45% in the highest income group has access to safe delivery whereas in the lowest income less than 4% get this service. The first round of success was the reduction of fertility to 3% in 2004 from 6% in the mid 70s.

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.

Among the 5 million people affected by the tsunami, there are at least 150,000 pregnant women who may be facing complications of pregnancy, and need urgent medical aid. Over 50,000 women will give birth in the next three months and the damage to health facilities has jeopardized their chances of safe delivery. Many midwives who provide home-based delivery support have been displaced and no longer have basic supplies. Women who experience birthing complications will require assistance to ensure the survival of their babies. Women and girls have particular hygiene needs which must be considered if they are to be able to carry on their daily lives, yet these are often overlooked. In some communities women have lost everything and do not have even the most basic clothing. Yet they assume the burden of caring for other family members. UNFPA has made available $3 million for the provision of the most basic maternity and hygiene support for women throughout the region. The Fund is asking donors for funds to support the reestablishment of basic reproductive health care in affected communities.

HIV poses a serious threat to agricultural production in Ethiopia. An increasing number of the rural population are being affected by the pandemic. A large part of the Ethiopian population relies on donor handouts for survival because of frequent droughts and crop failures. This year at least 5 million people require emergency food assistance because they could not raise their own crops. The agricultural professionals union is planning an information network that will assist rural communities to get better understanding of the disease and how it spreads. Provision of appropriate information as well as care and support for the affected people could mitigate the pandemic. Life expectancy in Ethiopia is already falling and the epidemic is undermining the nation`s efforts to reduce poverty. It is estimated that 2.5 million Ethiopians live with the AIDS virus. Life expectancy is currently 45.5 years. According to statistics the prevalence rate of the virus in the country`s population of 72 million is around 6.6%. The primary mode of transmission is unprotected sexual practices, high frequency of casual partners and harmful traditional practices.

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.

At the conference called Women 2000: Gender, Equality, Development and Peace for the 21st Century, Secretary of State Madeleine Albright called for a global effort to eliminate trafficking in women, which, she said was "distorting economies, degrading societies, endangering neighborhoods and robbing millions, mostly women and children, of their dreams." 200,000 Bangladeshi women have been sent to Pakistan during the past 10 years. The Center for the Study of Intelligence estimated that 45,000 to 50,000 women and children enter the U.S. annually as slave laborers or sweatshop workers. 50,000 women from the Dominican Republic work in the sex trade in Latin America and Europe, according to estimates from the International Organization for Migration. Women are sent from Ethiopia illegally to neighboring countries and to Middle Eastern nations such as Lebanon. Ethiopia passed a law in 1998 forbidding this practice, but enforcement has been difficult. Once the women get there, their passports are taken away from them, and they can't get back home. 5,000 to 7,000 Nepalese women are sent to India annually, mostly as prostitutes. An estimated 220,000 Nepalese women are living in India as a result of trafficking. Other women at the conference decried female genital mutilation and circumcision, which persist in Ethiopia and other African countries. An estimated 2 million women and girls undergo genital mutilation each year, and about 132 million have been mutilated in 28 African countries, according to the World Health Organization.

In the U.S. from 100,000 to 300,000 girls are subject to sexual trafficking every year, and few cases of child rape are ever prosecuted, according to Malika Saada Saar, the founder of the Rebecca Project for Human Rights. Girls between ages 11 and 14 are particularly at risk, and more American-born than foreign-born children are being bought and sold for sex in the U.S. The U.S. Department of Justice estimates that "about 293,000 American youth are currently at risk of becoming victims of commercial exploitation."

Actor Ashley Judd spoke of a 14-year-old girl she knows who was separated from her family in the Atlanta airport. She was picked up by a man and forced to have sex with men 15 times a day.

Saar said "We don't put the trafficker or the pimp behind bars. When you go and talk to survivors of trafficking, they talk about how they are the ones who were arrested."

U.S. laws are being rewritten to make them tougher on traffickers and the people who pay for sex. A new law in Georgia imposes a 25-year minimum prison sentence for those found to have coerced someone under 18. But Saar said new laws aren't necessary to address the problem. "There are statutory rape laws," she said.

The trafficking of men women and children for labor and commercial sex is a "serious" problem in the U.S., the State Department said in its 10th annual report, published in June 2010, which grades 175 nations on their efforts to fight trafficking.

The nightclubs of Addis Ababa, reveal a thriving sex industry.

Extreme poverty has forced many girls into the sex trade which in Addis is linked to restaurants, bars, hotels and nightclubs frequented by wealthy expatriates or local businessmen, but the city also has residential houses that function as unlicensed brothels.

8,134 establishment-based sex workers were identified in the capital, 60% between 15 and 24.

Clients are increasingly targeting young people with the perception that these groups are less likely to have HIV. Condom use by sex workers is very high. In 2005, the state-run Addis Ababa HIV Prevention and Control Office launched a condom campaign to promote condom use.

But clients are often reluctant to use condoms. HIV prevalence among sex workers is over 20% and as high as 50% in some towns.

MSDA, a local NGO, is trying to give sex workers the opportunity to earn a safer, legitimate living by offering training and gives them capital to start a small business.

Almost half of Ethiopia's 71 million people survive on less than US$1 a day, and the government estimates that 1.2 million are living with the HIV virus. Most sex workers say they started doing it for economic reasons.

MSDA is currently training 72 commercial sex workers and 120 sex workers' mothers. Training them in income-generating activities, their mothers too, because if the mothers do not have money they will force their daughters to go back to their life as sex workers, or practice prostitution themselves.

A report says that although most women voluntarily seek work in the richer countries, they toil in intolerable conditions, or are held in virtual captivity in which they are physically and psychologically abused.

In the Middle East, a system called kafala, in which the employer holds the worker's passport and other official documents until the date of departure, ensures that the worker is dependent on the "master."

If domestic workers break their contract they are often forced to forfeit their pay cheques.

Although workers are likely to be abused sexually, they lack access to health facilities. Saudi Arabia requires that a pregnant domestic worker be attended to only if accompanied by the expected child's father.

In Sri Lanka, where migrants undergo AIDS testing, half of all reported HIV cases occur among domestic workers who have returned from the Middle East. Human trafficking in Africa is the third most lucrative illegal business after arms and drugs.

Trafficked people across the world are estimated at more than 3 million, with 80% women and girls and up to 50% children.

Millions of women working overseas send remittances back home to improve the lives of those they left behind.

Somebody must do the low-paying jobs that the locals are unwilling to do, it says.

Migrants' earnings sent back home are the reason experts give for supporting international migration.

The World Bank estimates that remittances are larger than the value of official development assistance. Apart from claims of gobbling up jobs at the expense of the locals the migrants are accused of being HIV bearers. A study which claims that 66% cent of all heterosexually transmitted HIV infections diagnosed in the EU are in people from high-prevalence countries.

While the brides are dependent for their legal status on the groom-to-be, they are being used as a ploy to recruit women.

The US passed a law authorising consulates to share information with would-be brides regarding their husbands-to-be.

In 2004, the second largest category of work permit applications from foreign women were for entertainment and leisure. Japan admitted nearly 65,000 women on entertainment visas. The boundary between entertainment and sex work is often blurred.

Pregnancy-related problems among migrants are a major issue throughout the EU. Migrants receive inadequate or no antenatal care, and have higher levels of still birth or infant mortality. Domestic violence against immigrant groups is high.

About 20,000 persons are being trafficked every year from Bangladesh and those working in the Middle East sent home 72% of their earnings on average.

Bangladesh is one of the nine largest manpower-exporting countries along with China, India, Indonesia, Myanmar, Pakistan, Sri Lanka and Thailand. These countries contribute between one half and two thirds of all documented immigrations and refugees.

One third of labour migrants within the region are women, the majority in domestic services or entertainment often not covered by the labour laws. Many also ended up in the sex industry fueled by poverty, discrimination and unemployment in Asia.

Bangladesh data indicated that less than 1% of the immigrants between 1991 and 2003 were women. There are about 10,000 to 15,000 women employed in Dubai. Restrictions were enforced on female migration by countries like Bangladesh, Nepal and Pakistan in order to protect women. Bangladesh lifted the ban in 2005.

One third of the global trafficking in women and children occurs in the South East Asia.

An estimated 1,800 children become infected with HIV every day because of exploitation and discrimination.

Many young people were not able to choose safe sexual behaviour while 2.3 million children under 15 are living with HIV and many have no access to treatment.

Plan has called for the education of children and adolescents to prevent the spread of Aids, prevention of parent-to-child transmission, and to support vulnerable children, including orphans.

In the West African Republic of Benin, girls are harassed on their way to, from, and even in school. They are often pressured into having unprotected sex. Many more are so desperate they are forced to sell sex for the price of a meal.

There are millions of sexually exploited children; girls whose older husbands are infected, or boys who are under pressure to practice unsafe sex.

UNICEF said: "More must be done to reach the most vulnerable groups. Girls who are at risk of being trafficked are at particular risk of HIV infection. Education equips children with better negotiating skills.

"Over 50 million children have lost their parents in sub-Saharan Africa. Many will likely be forced into child labour or the commercial sex trade."

Plan wanted to ensure universal birth registration for all children orphaned by or living with AIDS, protection of inheritance, property rights for AIDS orphans and basic health care.

The international community must address poverty and the denial of human rights.

Almost 70% of all the women killed in a year in Peru died at the hands of their husbands, partners, lovers or boyfriends. More than 300 women have been murdered in Ciudad Ju'rez, Mexico, in the last 11 years. In Guatemala, 500 women were killed in the 2000-2004 period. But the biggest danger is not out on the street. According to a study in Peru femicide in this country takes the shape of domestic violence.

The press tends to describe them as "crimes of passion," because the perpetrators usually claim to have committed them in a fit of jealousy. These cases become invisible when the newspapers lump them together as 'crimes of passion,' and official reports do not discriminate between them at all. There was no official government monitoring of killings of women. The figures for January to March of this year confirm that three-quarters of the killers were cohabiting partners, boyfriends, husbands, ex-partners or ex-boyfriends of the victims. And the crime was nearly always committed in a place the couple shared. Perpetrators usually argue that they killed their partners out of jealousy, or because of alleged infidelity, in an attempt to mitigate their responsibility. In 2005, 58% claimed infidelity or jealousy as their motive.

In a police report obtained by IPS, Juan Jos' Galiano, 36, confessed that on Apr. 2 he strangled his partner, Rosa Trujillo, 38, because he suspected her of carrying another man's child.

Mar'a Elena Salas, a lawyer and researcher for the non-governmental organisation Demus, said the nationwide average was 12 cases of femicide a month.

According to the monitoring of news items, 52% of murdered women are between 16 and 35. One out of three women is killed by being strangled, throttled or knifed. Only one out of two is killed with a firearm.

Many perpetrators of femicide tell the judge their violence was due to their sense of outraged honour, because of an infidelity that is very hard to prove.

In over half the cases, the woman was murdered after several previous instances of violence, and in some cases the victims had reported their partners to the police.

The State does not prevent violence against women, much less do anything to eradicate it. The perpetrators of these crimes have a record of violence against their partners. Peru has signed the Inter-American Convention on the Prevention, Punishment and Eradication of Violence Against Women, but Peruvian law has not been reformed to ensure that those responsible for the murders of Peruvian women are sentenced appropriately.

November 25th was the International Day for the Elimination of Violence Against Women. The UN High Commissioner for Human Rights Navi Pillay said "Ensuring women's and girls' rights, eliminating discrimination and achieving gender equality lie at the heart of the international human rights system."

In October, 14-year-old Malala Yousufzai was shot in the head and the neck by the Pakistani Taliban on her way back from school in Pakistan. The Taliban threatened to kill anyone else, including women and children, holding views they disagree with.

"Malala was targeted for her prominent role in promoting the fundamental right of education for girls and for criticizing the Taliban for actions such as destroying girls' schools and threatening to kill girls who attend them. The fact that they tried to do just that to her brought into sharp focus the extreme intolerance and physical danger facing many girls who try to exercise their basic human right to education in many other countries," Pillay said.

"The sad truth is that Malala's case is not an exceptional one and, had she been less prominent, her attempted murder might have passed more or less unnoticed."

In nearby Afghanistan since the Taliban were removed from power in 2001, they have reverted to guerrilla tactics which have included - as a matter of policy -- attacks on girls and women, especially in relation to their attempts to receive education.

"In the first six months of 2012 alone, the United Nations Assistance Mission in Afghanistan (UNAMA) verified 34 attacks against schools, including cases of burnings of school buildings, targeted killings and intimidation of teachers and school officials, armed attacks against and occupation of schools, and closures of girls' schools in particular. Incredibly, there have even been at least three separate attempts this year to poison girls attending schools in Afghanistan, with over 100 girls affected on each occasion."

The long distance travelled to school was as a major factor in parents deciding not to send their daughters to school, with security concerns one of the main reasons.

Girls' education has been subjected to deliberate attacks in more than 30 countries because of religious, sectarian, political or other ideological reasons. Girls get less education because their parents fear for their safety, worry about sexual violence or simply -- because of traditional values or lack of education themselves -- value their daughters' education less than that of their sons.

"Malala's bravery in confronting such practices touched a chord internationally. The attack led to an unprecedented outpouring of popular anger and major protests in favor of girls' education in Pakistan itself and in a number of other countries in the region." Important Pakistani and international educational initiatives have been launched in her name.

About 1.5 billion people live in countries affected by organized violence, either currently or recovering from political violence, fragility and high levels of homicide, according to the World Bank's World Development Report (WDR) 2011.

Economic, political and security challenges undermine development and trap fragile states in cycles of violence. National institutions must be bolstered and governance improved to value job creation, citizen security and justice, said the agency.

"Children living in fragile states are twice as likely to be under-nourished and three times as likely to be out of school. And the effects of violence in one area can spread to neighboring states and to other parts of the world, hurting development prospects of others and impeding economic prospects for entire regions."

Poverty rates are 20% higher in countries affected by violence over the last 30 years. Nations lose an estimated 0.7% of their annual gross domestic product (GDP) for each neighboring country involved in civil wars. In the four weeks following the unrest in Libya, global oil prices surged by 15%.

While much of the world has made huge progress in reducing poverty over the past 60 years, countries facing political instability and criminal violence are being left far behind and face stagnation, both in terms of economic growth and disappointing human development indicators.

Securing jobs and to paying attention to vulnerable groups of people are the "key to social stability and economic development in different nations", said a World Bank representative.

The World Bank said it could play a constructive role helping governments to "stabilize domestic prices and to secure the supply of food to citizens."

The report suggested improving global coordination through measures including providing more integrated assistance for citizen security, justice and jobs, forging new international consensus on the norms of responsible leadership and encouraging knowledge exchange.

Secretary of State Hillary Clinton called for an end to the "culture of violence" against women in impoverished Papua New Guinea during a lightning stop in November in the South Pacific nation.

Clinton, who was greeted by bare-chested men beating drums and face-painted women in grass skirts, announced a new initiative to help the island's women, who suffer staggering levels of violence, according to rights groups.

She also discussed ways of avoiding the "resource curse" with Prime Minister Michael Somare as PNG grapples with a huge influx of wealth from an upcoming gas project, as well as ways of fighting climate change.

"Giving women access to education, health services, economic opportunities, and the structures of power is critical for alleviating poverty and disease in every part of the world," she told an audience of mainly women during a visit to the country's parliament.

Clinton said the United States, PNG government and World Bank would bring together senior officials and business leaders from across the Pacific "to expand opportunities for women". The U.S. State Department is working with local groups to help women voters prepare for 2012 elections, hoping to ease their plight by encouraging more female MPs and is working with US energy giant Exxon Mobil and local groups on a mentoring programme "aimed at ending the culture of violence against women and girls in Papua New Guinea", she said.

Clinton, the first secretary of state to visit since 1998, meanwhile offered technical expertise to help PNG cope with the windfall of its 15-billion-US dollar liquefied natural gas project to supply Asian countries. "If not handled right a country can actually can end up becoming poorer," Clinton warned.

The plant, PNG's biggest resources project, is expected to double national income.

Several other developing countries that have experienced sudden energy investments only to become mired in corruption and political instability.

Around the world, as many as one in every three women has been beaten, coerced into sex, or abused is some other way. Games have the potential to have a very positive impact on gender issues by profoundly shifting beliefs, stereotypes, and attitudes. In Breakaway, a soccer electronic game, the player encounters real-life situations that resonate with a teen's experience such as peer pressure, competition, collaboration, teamwork, bullying, and negative gender stereotypes. Breakaway gives players choices that allow them to make decisions, face consequences, reflect, and practice behaviors in a game and story format. See http://news.cnet.com/8301-17938_105-20021734-1.html?tag=cnetRiver

Research showed that when women had access to the same rights and opportunities as men, they are more resilient to conflict and disaster, which could lead to better reconstruction efforts in their societies.

Generations of Change is a report highlighting how women in conflict and post-conflict situations fared 10 years after the Security Council adopted its landmark resolution which aimed to put a stop to sexual violence against women and girls in armed conflict and encourage greater participation by women in peacebuilding initiatives.

Women rarely waged war, but they often suffered the worst of it. In many of today's conflicts, women are disempowered by rape or the threat of it, HIV infection, or trauma and disabilities that often results from it.

Girls are disempowered when they can not go to school because of the threat of violence, when they are abducted or trafficked or when their families disintegrate or are forced to flee.

When it comes time to wage peace, women are too often denied a place at the negotiating table, but that through the stories of real people who lived through conflict in places like Liberia, or through natural disaster such as Haiti, the report showed that when women enjoyed the same rights as men, they were more resilient and could play a role in reconstruction, peace building and recovery.

To help women facing violence in war, urgent and concerted action is needed to stop impunity and bring justice, and it is important to replace crisis and underdevelopment with peace, justice and stability.

Investing in development softens crises. Rebuilding societies is as important as rebuilding houses, and it is key to renew societies and rectify entrenched inequalities.

This year s report contained narratives directly from people in those countries. Through the stories of individuals affected by conflict or catastrophe, the report showed how communities and civil society were healing old wounds and moving forward.

In Liberia women blockaded the doors where talks where being held, and would not let the men come out until they had a peace deal in hand.

Rebuilding took a long time. People continue to have trauma, women are in psychoanalysis and being medically treated for years and the violence has not stopped, and in at least two of the countries in the report, domestic violence has increased in peacetime. If a rape victim came back from a camp and their relatives said she dishonoured the family, it did not lend to women healing, psychologically or any other way.

Conflict and protracted humanitarian emergencies affected women and girls, men and boys. However, the panellists agreed that many women and young people had overcome seemingly insurmountable obstacles and had begun rebuilding their lives and societies. Conflict today is less about soldiers engaging in battle with soldiers on the other side of a national border, and more about combatants struggling for control within a single country and employing any means to break the will of civilians by disempowering them physically, psychologically, economically and socially.

Governments needed to seize opportunities that arose out of post-conflict recovery or that emerged from natural disasters to increase the chances that countries were not just rebuilt, but built back better and renewed, with women and men on an equal footing, with rights and opportunities for all and a foundation for development and security in the long run.

Clinical psychologist Alison Grundy, who works with sex abuse victims, said advertisers were reaching a dangerous new low by using sexual violence as a marketing tool, including Calvin Klein's jeans ad, which is said has connotations of gang rape.

"If we continue to subject future generations of young men to great barrages of aggressive, misogynist, over-sexualised and violent imagery in pornography, movies, computer games and advertising, we will continue to see the rates of sexual violence against women and children that continue unabated today. Or worse,' she said.

In a post on renowned women's advocate Melinda Tankard Reist's website, Ms Grundy said cases of gang rape of girls as young as 13 were increasingly being reported to professionals in NSW and that advertisers were blurring the line between rape and group sex and the Calvin Klein poster was "clearly intimating' the gang rape of a woman.

Menswear brand Roger David has also drawn fire for selling T-shirts with semi-naked, gagged women.

In the Democratic Republic of Congo, a UN visit has raised hopes of legal action over sexual violence.

The women of Kampala village, where 35 were raped, still sleep in the forest at night, for fear the rapists will return. They gathered to tell their stories to a special U.N. representative on sexual crime in conflict.

The mass rape of more than 300 women, several men and children in villages deep in the forest of the eastern Democratic Republic of Congo at the beginning of August has renewed momentum to tackle the sexual violence.

The prosecutor of the international criminal court in The Hague is sending a team to investigate the mass rapes.

Callixte Mbarushimana, executive secretary of the FDLR, one of the rebel groups implicated, was recently arrested under an ICC warrant in Paris. The core of the FDLR are Hutus who fled Rwanda after participating in the genocide of Tutsis in 1994, and are accused of war crimes in the DRC.

The arrest was a "crucial step in efforts to prosecute the massive sexual crimes committed in the DRC".

Although a peace treaty in 2003 formally brought to an end the decade-long war, atrocities - primarily against women - have not subsided. Rape is a way of humiliating and cowing local populations who may be used as slave labour.

The 80 Indian soldiers assigned as UN peacekeepers are often as brutal and ill-disciplined as the militia and rebels they are fighting.

After the rapes the government of President Joseph Kabila announced a temporary ban on mining, which may be lifted later this week. The idea is that government agents should tax the miners rather than leave them to run a gamut of illegal roadblocks manned by rebels, militia and rogue soldiers. But this seems unlikely to stop the brutality. UN sources say battalions of government troops that have fanned out across the jungle. They are now preying on the population, looting and raping.

The US Congress has approved a financial reform law that requires US-listed companies to disclose whether their products contain "conflict minerals" from the DRC.

In Nyasi village the women say they will only feel safe if UN peacekeepers patrol more often and stay close. "We had the courage to speak out because we've had enough. We're like dying people, who are no longer afraid because they know they're at the end of their journey."

China has loosened its one-child policy to allow more couples to have a second child in the rural areas of five provinces and two municipalities, it was announced on the sidelines of the ongoing session of the National People's Congress (NPC).

Couples from rural areas in the municipalities of Shanghai and Tianjin and the provinces of Liaoning, Jilin, Jiangsu, Anhui and Fujian could have a second child if either of them was the only child.

Currently rural couples can have a second child if the firstborn was a girl and both rural and urban couples can have a second child if the father and mother was the only child of their parents.

30 years ago China introduced the one-child policy bringing China's fertility rate to 1.5 today.

Issues related to aging, gender imbalances, urbanisation, an expanding shortage of migrant workers and an only-child generation may have led to the decision.

The number of people aged between 19 and 59 declined by 3.45 million year-on-year in 2012 on the Chinese mainland, making a significant dent in China's labor force.

Reports from few Indian states, including Rajasthan, Bihar, Chhattisgarh and Andhra Pradesh, suggest that thousands of women are having their uteruses removed for unscrupulous reasons, including many below the age of 40.

Sunita from a small village in Rajasthan, north-west India, said she "I went to the clinic because I had heavy bleeding during menstruation," she says. "The doctor did an ultrasound and said I might develop cancer. He rushed me into having a hysterectomy that same day."

Village leaders said about 90% of the village women have had the operation, including many in their 20s and 30s. The doctors charge about $200 for the operation and many families have to sell cattle and other assets to raise the money.

One doctor admitted that he sometimes didn't do biopsies before removing the uterus, only afterwards. In the U.K., to confirm a diagnosis of cancer, doctors would first perform a biopsy and other lab tests. In some cases, they would treat with radiotherapy and/or chemotherapy before recourse to a hysterectomy.

Dr Vineeta Gupta, a lady gynaecologist said she sees seven or eight women a week from villages in the region, who've been told they need hysterectomies but want a second opinion. She tells them that "an infection doesn't cause cancer. We'll cure the infection, I tell them, and you will be completely all right. Some are convinced but some are not convinced because they've been told: 'If you don't get your uterus removed you will get cancer and die.'"

This follows the rapid expansion of small private clinics and hospitals, especially in remote rural areas that are poorly served by the government health system.

In the U.K., most vast majority of hysterectomies are for women between the age of 40 and 50.

The operation can also lead to incontinence, irritable bowel syndrome, depression, back pain, loss of sexual pleasure, thrombosis and vaginal prolapse."

In 2008 the Indian government launched a national health insurance scheme, the RSBY, to help the poor. However the scheme appears to be encouraging unnecessary hysterectomies, as unethical private clinics exploit the vulnerable poor, using them as a means to tap into government funds.

In Samastipur, a district in the northern state of Bihar, the district magistrate did a survey that suggests that of 2,606 women who were examined, about 12% had had their uteruses removed unnecessarily.

"Life begins at conception" is the phrase frequently invoked by anti-choicers seeking to eliminate women's basic right to control over their own bodies, and it is the premise of policies pushed by the United States Conference of Catholic Bishops (USCCB) and fundamentalist evangelicals. It is the cornerstone of the so-called personhood laws attempted in both Colorado and Mississippi, and the basis for the "Sanctity of Life" bill co-sponsored by Congressmen Paul Ryan and Todd Akin. The result of all of these efforts, if they succeeded, would be a total ban on abortion without exception, and bans on many forms of contraception, in vitro fertilization, and health care for women who are or who may be pregnant - in other words, a radical shift in women's lives.

"Life begins at conception," suggests a question: are women people with the same fundamental rights as men, or are they essentially incubators whose ability to participate in society and the economy, and, quite literally, whose ability to live is dependent on whether they are, might be, or might become pregnant.

But the phrase is highly - and purposefully - misleading because it confuses simple biological cell division both with actual pregnancy and with actual, legal personhood, which are all very different things.

Vice President candidate Congressman Paul Ryan said he was pro-life - not simply because of his Catholic faith, but also because of reason and science, giving the example of when he and his wife saw the seven week ultrasound of their child, and when they saw heartbeat, even though the little 'baby' was in the shape of a bean, they were convinced that life begins at conception.

Of course life begins at conception. Having a child requires, as a first step, the successful integration of a sperm and an egg, or fertilization. By "life," we mean the essential starting place of a potential human being; a human being is the end result if the fertilized eggs go through the process of cell division, successfully implant in the uterus and develop into healthy embryos, and subsequently go successfully through the many other phases of development leading to their births.

The fact that life begins at conception is why women and men use birth control to prevent it from happening. Humans don't need modern "reason and science" to tell them they get pregnant from sex; as Homo Sapiens they have been conceiving, carrying, and bearing babies for at least some 160,000 years, and they've been trying to prevent pregnancy and induce abortions for just as long.

Evidence of condom use has been found in cave drawings in France dated between 12,000 and 15,000 years old and in 3,000 year-old illustrations in Egypt. Humans have used pessaries, herbs, and other objects to create barriers to fertilization when having sex, and have used many other more dangerous and less effective means in the hopes of preventing fertilization, a subsequent pregnancy, and later, the birth of a child.

Paul Ryan needed science to believe his wife was pregnant and that his daughter's "life" began with conception, while most of us don't need an ultrasound to know that "life" begins with conception and is a frequent consequence of having sex.

The question is not when life begins, but when does pregnancy begin? Does personhood begin at conception? Is a fertilized egg, blastocyst, embryo, or fetus a person with rights that take priority over those of the woman upon whose body it depends?

Women know that pregnancy leads to having a baby, they don't need 'evidence'.

Do women have the moral agency and fundamental rights to decide whether or not to commit themselves not only to the development of a life within their own bodies, but to a lifelong tie to another human being once a child is born?

Life begins with conception, but pregnancy begins when a fertilized egg successfully implants in the uterus and develops into a healthy embryo; implantation begins six to 12 days after fertilization. There is no pregnancy until implantation happens, which is why any method that prevents fertilization or implantation can not cause an abortion. 50%-80% of fertilized eggs never successfully impant and end in spontaneous miscarriage (and before a woman even knows she is pregnant) because of insufficient hormone levels or an non-viable egg or for some other reason.

Hormonal contraception, including emergency contraception, works to prevent fertilization in the first place. If you don't like abortion at any stage, you should be a supporter of contraception, and emergency contraception, which needs to be taken within 72 hours of unprotected intercourse to prevent fertilization from taking place.

Anti-choicers who support "personhood" legislation intentionally or unintentionally misrepresent the mechanisms of action of contraception and the medical definition of pregnancy to blur the lines between contraception and abortion. There is this lie perpetuated by the USCCB and fundamentalist evangelicals, which is a precursor to promoting their goals of eliminating both contraception and abortion, making abortion the equivalent of murder, and by extension, controlling women's bodies and their economic and social choices. This is exactly the goal of so-called personhood amendments that have been the subject of several ballot initiatives and of the "Sanctity of Human Life" act co-sponsored by Ryan and Akin.

In December 2011, former House Speaker Newt Gingrich (who in recent years converted to Catholicism) told a reporter that he believes that human life does not begin at conception but at "implantation and successful implantation" because if you say life begins at conception "you're going to open up an extraordinary range of very difficult questions." Shortly thereafter, however, Gingrich "clarified" his statement. to the global Catholic network, ETWN, and reiterated his belief that "human life begins at conception" and that "every unborn life is precious, no matter how conceived," vowing to support pro-life legislation aimed at the ultimate goal of legally protecting "all unborn human life."

The term "personhood" has no medical or scientific definition. The Vatican teaches that a fertilized egg is a "person" with full rights under the law. However, Jewish law and tradition does not recognize an egg, embryo, or fetus as a person or full human being, but rather "part and parcel of the pregnant women's body," the rights of which are subjugated to the health and well-being of the mother until birth. The United Methodist Church recognizes the primacy of the rights and health of women. Islamic scholars, like Jewish scholars, have debated the issues of "ensoulment" and personhood, and continue to do so with no over-riding consensus.

Roe v. Wade allows abortions up until fetal viability, except that the "viable fetus must yield to the woman's right to have an abortion to protect her health and life."

Women who face unintended and untenable pregnancies and choose abortion overwhelmingly prefer to terminate a pregnancy as early as possible. According to Guttmacher Institute: nearly 62% of women who terminate a pregnancy do so before nine weeks of pregnancy, before any fetus is involved. Nearly 80% of such abortions occur before 10 weeks, and nearly 90% by the end of the first trimester. It should be noted that anti-choice laws and policies such as banning early and safe medication abortion, mandated waiting periods and unnecessary ultrasounds - all serve to push early abortions later than they otherwise would be, and are, in fact, responsible for a large share of such abortions.

Women know what being pregnant means, more than any fetal heartbeat, sonogram, ultrasound, or lecture on pregnancy can show. When considering an abortion, women weigh the responsiblities they have... to themselves and their own futures, to any born children they have or any they may plan to have at a future date. It is about whether or not a woman wants to and is able to make a lifelong emotional, financial, and physical commitment - often at substantial cost to herself and/or to her family - to the person who will exist if a pregnancy is successfully brought to term; it's not just about getting through the "inconvenience" of a pregnancy.

Without recourse to safe abortion care, an unintended pregnancy is a forced pregnancy and a forced birth, and amounts to reproductive slavery. Only one person - the woman in question - has the right to decide whether, when, and under what circumstances to bring a new person into the world. The vast majority of women who have an abortion know they are ending biological life that they can not or do not want to sustain because the commitment to an actual child is a moral commitment they are not able, willing, or ready to make, or can not make for reasons of health or life.

If you have no choice and control over your body, you are less than an actual person in the eyes of the law. If conservatives are so worried about abortion the closer a pregnancy gets to viability, then anti-choicers would be making sure both contraception and early, safe abortion were widely available. And when you reduce a complex reality to a slogan like "personhood", you actually minimize the personhood of women.

While presidential hopeful Mitt Romney has said he opposes abortion, except in instances of rape, incest and when the mother's life is threatened, he recently said no abortion legislation is part of his agenda, but by executive order, not by legislation, he would reinstate the so-called Mexico City policy (aka Global Gag rule) that bans U.S. foreign aid dollars from being used to do abortions, he said.

In 1984 the Reagan administration officials - under pressure from its antiabortion and increasingly overt anti-family planning constituency - prepared a position paper for the U.N. international conference on population in Mexico City. The position went far beyond the 1973 Helms amendment, which had passed in 1973 - in the wake of the U.S. Supreme Court's decision in Roe v. Wade - to ban the use of U.S. funds under the Foreign Assistance Act from paying "for the performance of abortion as a method of family planning." This policy was one they could impose without the involvement of Congress.

The Mexico City policy disqualified foreign NGOs from eligibility for U.S. family planning assistance if they used non-U.S. funds to provide abortion services or information in the form of counseling or referrals, or to engage in advocacy within their own countries to liberalize abortion-related laws or policies.

An example of the effect this policy has had on women is Josephine, who at 29, was raped during the Congo's conflicts, became pregnant. She wanted an abortion, but didn't know where to get one, despite the many health services NGOs that operated in and around Congo, and had to carry her baby to term and raise him. "Today, the only thing that I can think about is that I want an abortion. I am hungry; I have no clothes and no soap. I don't have any money to pay for medical care. It would be better if I died with the baby in my womb," she told Amnesty International.

Thousands of girls and women raped and impregnated in armed conflict are routinely denied abortions with devastating consequences. An estimated 5% of rapes lead to pregnancy, which suggests that the 1.8 million women and girls raped during the Congo's crisis may have led to as many as 90,000 unwanted pregnancies.

President Barack Obama dropped the Mexico City policy on his tenth day in office.

You've probably heard about the blind Chinese dissident Chen Guangcheng who fled China earlier this year to escape persecution for exposing and protesting coerced abortions and involuntary sterilizations in China. His escape was followed by the story of a rural Chinese woman - Feng Jianmei - who was seven months pregnant and forced by local officials to have an abortion, causing outrage across China and across the globe.

Chen had never publicly advocated against abortion per se, only forced abortions as a violation of human rights. Yet, U.S. antiabortion activists and policymakers predictably latched onto Chen's and Feng Jianmei's struggles as vindications of their cause.

Reproductive rights advocates reiterate their long-standing principle: Coercion in reproductive decision making is wrong. Forcing a woman to terminate a pregnancy she wants or to continue a pregnancy that she does not want both violate the same human rights: the right to decide freely whether and when to bear a child and the right to have that decision respected by the government.

Throughout history, societies, religions and governments have often defined women's value by their childbearing capacity, subjecting them to coercion - either to have or to not have children for the greater good of those other than themselves. Motivation for such policies range from fears of a population explosion or implosion and the resulting impact on economic or environmental security; the desire for more workers, but no matter what the motivation - the reproductive self-determination and human rights of individual women are sacrificed.

From about 1950-1999, attention to reproductive rights violations has focused largely on actions by governments to curtail what they view as "overpopulation." The most notorious example was India during the 1970s, where the national government established population targets, mandatory sterilization, and punitive disincentives for large families, particularly among the poorest classes. In the 1990s, under former President Alberto Fujimori's regime, Peru sanctioned coercive and forced sterilizations of more than 346,000 poor and indigenous women and almost 25,000 men through intimidation and force. China's one-child policy - under which involuntary abortions are frequent if not technically condoned - fits this pattern.

But there there are also examples at the other end of the spectrum: to compel pregnancy and childbirth. Under President Nicolae Ceausescu's dictatorship in Romania, 1965-1989, the state implemented a radical pronatalist policy that outlawed all forms of contraception and banned abortion, with a few exceptions. Enforcement was by mandatory monthly gynecologic exams. As a result, maternal mortality - mostly the result of unsafe, illegal abortions - skyrocketed by 1989 to the highest level in Europe. Infant mortality also soared, while among those children who survived, thousands were abandoned in orphanages without basic food, health care and attention.

Even today, the governments of both Turkey and Iran announced their intentions to alter policies to restrict family planning and abortion services. The Turkish government proposed banning abortion after four weeks of pregnancy - a change from the current 10-week limit. Prime Minister Recep Tayyip Erdogan is calling for Turkish women to bear at least three children, equating abortion with murder and unpatriotic behavior, and asserting that family planning undermines economic development.

In Iran, Supreme Leader Ayatollah Ali Khamenei is urging Iranians to have more than two children to raise fertility rates, which have been falling substantially due to a highly successful government-backed family planning effort over the last two decades. Iran has a highly educated female population and a youth cohort that faces double-digit unemployment. Iran's health minister announced that "the budget for the population control program [i.e., family planning] has been fully eliminated."

In the 1960s, Paul Ehrlich's Population Bomb warned of mass global starvation and environmental destruction from a population explosion, even as the women's rights, civil rights and antipoverty movements were also shaping public consciousness. Among policymakers and advocates promoting access to family planning services, there was rising sensitivity to the United States' own troubled history with reproductive rights abuses, especially state- sanctioned involuntary sterilizations.

However, U.S. family planning policy - domestic and international - recognized the importance of voluntarism and informed consent from the very beginning. USAID guidelines from the 1960s insisted that assistance be conditioned on the voluntary participation of individuals free to choose among available methods that align with their own beliefs, culture and personal desires, and that USAID not promote any specific family planning policies or methods but, instead, support the ability of "people everywhere enjoy the fundamental freedom of controlling their reproduction, health, and welfare as they desire." This was later refined to: "The underlying principles of U.S. assistance for family planning are voluntarism and informed choice."

The U.S. Title X family planning program was created in 1970 to "assist in making comprehensive, voluntary family planning services readily available to all persons desiring such services." The Title X statute and accompanying regulations specify that the receipt of family planning services and information must be on a voluntary basis and that a woman's eligibility for other government assistance may not be conditioned on her acceptance of any contraceptive method. They require that a broad range of contraceptive methods and related counseling services be offered to clients, who may not be "subjected to any variation in quality of services because of the inability to pay."

On the conservative side, in 1973, shortly after Roe v. Wade, Congress passed the Helms amendment to restrict U.S. foreign assistance for abortions. Consequently all funding for abortions overseas, even in extreme cases such as rape, incest or when the mother's life is in jeopardy, has been withheld. In the U.S. conservatives passed the Hyde amendment, which prohibits federal Medicaid funding for abortion services for low-income U.S. women, unless the pregnancy would endanger the life of the woman or was the result of rape or incest. A Guttmacher review concludes that the Hyde amendment blocks approximately one in four Medicaid enrollees from having an abortion they otherwise would have if Medicaid funding were available.

Then there is the 1985 Kemp-Kasten amendment, in which U.S. funding is prohibited for any entity that "supports or participates in the management of a program of coercive abortion or involuntary sterilization," as determined by the president. Every Republican administration since Ronald Regan has used the provision to defund the United Nations Population Fund (UNFPA) for allegedly supporting coercion in China, despite the fact that multiple investigations - including one under the latter Bush administration - have found no evidence of UNFPA complicity. The UNFPA operates in China to promote voluntary family planning and to push the Chinese government to respect principles of reproductive integrity.

This year, Arizona and South Dakota joined seven other states in requiring counseling on the negative mental health consequences of abortion, even though experts have thoroughly debunked this claim. In July, a federal appellate court upheld a South Dakota law that mandates that a woman be informed, inaccurately, that an abortion may cause suicide or suicidal thoughts. The real purpose of these laws is to dissuade them from having an abortion at all. These restrictions violate the essence of anticoercion policies which seems ironic when conservatives are quick to condemn coercive efforts to stop pregnancy.

The Programme of Action of the landmark 1994 U.N. International Conference on Population and Development (ICPD) affirms the universal human right of "all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so." And, specifically, governments should aim to support individuals to enable "responsible voluntary decisions about child-bearing and methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law." Incentives or disincentives to alter fertility rates are to be viewed with suspicion.

At the recent London Family Planning Summit, sponsored by the Bill & Melinda Gates Foundation and the United Kingdom's international development agency (DFID), increased political and financial commitments for international family planning were garnered. Concern was expressed that the summit's stated goal of obtaining 120 million additional contraceptive users by 2020 could lead to overzealous implementation efforts, including "coercive family planning programs where quality of care and informed consent are ignored." In turn, more than 1,300 civil society organizations from 177 countries signed in support of the new global initiative launched at the summit, announcing their support for empowering women: "We commit to working with communities and reaching poor and vulnerable women and girls with evidence-based information so that they can make informed choices regarding their fertility and choice of contraceptive method."

The global reproductive health and rights community has made clear that its priorities lie in upholding choices for women everywhere, and that coercion - whether to prevent childbearing or compel childbearing - violates reproductive autonomy and should be unequivocally condemned.

Senegalese writer-director Ousmane Sembene makes an impassioned plea against the practice of salinde, or female circumcision, in this moving portrait of a society in transition. In a West African village run by uncompromising Muslim males, fiery Colle (Fatoumata Coulibaly) provides safe harbor for young girls fleeing their "cleansing" rituals. But what one man terms "a minor domestic issue" soon puts the whole town on the verge of bloodshed. This movie is available on Netflix DVD.

The increase of almost half a million in the UK population in just a year illustrates the continuing challenge posed by our growing numbers to society's goals of reducing emissions, protecting the natural habitat, ensuring food and energy security and providing adequate housing and services for all. England is already the most densely populated country in Europe.

The increase, announced by the Office of National Statistics, continues the pattern of recent years and is the highest since 1962, almost fifty years ago. It is made up almost equally of natural change and net in-migration.

Britons are living longer and having larger families than they have had in the recent past. One factor contributing to larger families may be child related changes to the tax system initiated by the last Labour government. At the same time, net in-migration is consistently standing at around 200,000 a year.

Population Matters chief executive Simon Ross commented "The constant increase in our population makes society's goals ever harder to achieve. Whether we talk about carbon emissions, protecting the natural habitat, food and energy security or the provision of housing and services, it is not in our interests for the population of the UK to keep increasing, year in year out. We ask individuals to consider the environment and sustainability when thinking about how many children they have. We also call on the government to look at the relationship between its policies and population numbers and take the action needed to stabilise the population. Specifically, they should look at enhancing family planning services and sex education, limiting automatic tax credits and benefit payments to the first two children per couple and taking more effective action to limit immigration."

The ACLU announced that a California school district is being sued by parents and students over its abstinence-only sex education program. Among other affronts to the concept of comprehensive sex education, the program's textbooks do not mention condoms, even in the chapters on protecting oneself from STIs and unintended pregnancy.

Manufacturers, health officials, and the public have found numerous ways to talk about contraception without really having to talk about it. Condoms were marketed as "sheaths, skins, shields, capotes, and 'rubber goods' for the 'gents.' Many companies emphasized testosterone-fueled virility with names like Spartans or Trojans.

In 1873 the Comstock Act criminalized any and all forms of contraception and euphemisms became a legal necessity. But by World War I, because of an emerging knowledge of communicable disease, particularly venereal disease, condoms began to build their reputation as prophylactics -- and that form of contraception became understood as a public health issue. That was the point where "protection," "safety," and other words with health implications became common.

The term "birth control" entered the lexicon in 1914, when it was coined by Margaret Sanger, a controversial hero in the field of reproductive rights. By "birth control," Sanger meant to put words to the idea of "voluntary, conscious control of the birth rate by means that prevent conception."

Although the health of women and children were also a priority, a lot of what Sanger and her followers were talking about when they referred to "birth control" is deeply disturbing by today's standards: they believed that certain populations -- specifically minorities and the poor -- should be kept from proliferating. Considering its strong eugenic undertones, it's surprising that the term is still so widely used.

On the upside, the introduction of the idea of birth control heralded a new era of talking openly about contraception. In a 1923 editorial for the New York Times, Sanger praised a bill that would allow doctors to discuss contraception with their patients:

In the 1940s, Planned Parenthood introduced the term "family planning" as a less radical way of talking about birth control. Turned intimate, the new discourse concerned a woman's right to sexual expression and to control over her body. In 1971 the Boston Women's Health Collective published When Our Bodies, Ourselves, with this in its preface:

"This knowledge has freed many of us from the constant energy-draining anxiety about becoming pregnant. It has made our pregnancies better because they no longer happen to us, but we actively choose them and enthusiastically participate in them. It has made our parenthood better because it is our choice rather than our destiny. This knowledge has freed us from playing the role of mother if it is not a role that fits us. It has given us a sense of a larger life space to work in, an invigorating and challenging sense of time and room to discover the energies and talents that are in us, to do the work we want to do. And one of the things we most want to do is to help make this freedom of choice, this life span, available to every woman."

In 1965, the Supreme Court made contraception legal for married couples; in 1972, it made access possible for single people as well. Women's health had taken on new meaning in 1960, when the pharmaceutical product was approved by the FDA as a form of oral birth control. By 20 years after it was first developed, 30 million women worldwide, including 10 million in the U.S., were on the Pill, allowing it to become a way of life.

As of last year, birth control is considered preventive care, required by Department of Health and Human Services to be covered by private insurers. And the U.S. government characterizes its family planning services, aided by Title X, as "educational, comprehensive medical or social activities which enable individuals, including minors, to determine freely the number and spacing of their children and to select the means by which this may be achieved."

Across Latin America fertility rates plummeted, even though abortion is illegal, the Catholic Church opposes birth control and government-run family planning is rare.

Migration to the cities, the expansion of the female workforce, better health care and the example of the small, affluent families portrayed on the region's popular soap operas have contributed to such a fast demographic shift that it caught social scientists by surprise. The number of children per woman when from 6 in 1960 to 2.3 by 2010.

Brazil has been particularly fascinating for demographers, it's fertility rate falling lower than in any other Latin American country except Cuba, which has state-sponsored family planning and legalized abortion. With a population of almost 200 million, there is a great gap between rich and poor, although millions have joined the middle class during Brazil's recent economic expansion.

The country's fertility rate has fallen from 6.15 children per woman in 1960 to less than 1.9 today. That is lower than the United States, which at 2 per woman is just enough for the population to replace itself.

Brazil's fertility rate took a big drop uniformly across the country. Suzana Cavenaghi, a Brazilian census bureau demographer. "We wouldn't expect that in a country that's so diverse, with a lot of poverty in so many places and so unequal, economically speaking."

Women were empowered by a pro-democracy movement that rose up against a 1970s-era military dictatorship. That dictatorship, which wanted to populate Brazil's remote areas, inadvertently contributed to fewer births by promoting industrialization. That led rural families to crowd into cities, where a brood of children could be a financial drain.

Women began to look for means of birth control, easily obtained without a prescription. Doctors in the public health service provided sterilizations, which became common, and women sought out pills that induced abortions long before those pills became the subject of controversy in the United States.

A report, "The Battle for Female Talent in Brazil," says that 59% of Brazilian women consider themselves “very ambitious" and that 80% of college-educated women aspire to upper-echelon positions. U.S. women are far less likely to give those responses.

The country's elaborate soaps, or telenovelas, have been an important factor in the drop in Brazilian fertility, researchers say. The protagonists inhabit an appealing, affluent, highflying world, whose distinguishing features include the small family.

While older Chinese may be shocked by the idea of sex education, in recent years China has seen a dramatic increase in premarital sex, and unwanted pregnancies and abortions among young girls.

For that reason sex education classes, complete with graphic drawings of sexual organs, will be introduced to a primary school in Beijing from this session on an experimental basis.

Medical clinics in China perform an estimated 13 million abortions a year. Add to that the abortions performed in unregistered medical clinics and then there are the 10 million abortion-inducing pills are sold every year.

Many people in China lack even the basic knowledge to prevent unwanted pregnancies. Li Ying, a professor at Peking University, says that young people need to acquire better knowledge about sex.

Nearly two-thirds of the abortions in the country's hospitals are performed on single women aged between 20 and 29 and nearly half of the women who underwent abortions said they did not use contraceptives, according to a study and a government official.

In countries like the United States, Britain, Germany, Japan and Singapore, all schools have sex education courses which begin from the early grades, even in primary schools.

Sex education in schools doesn't necessarily mean encouraging "sexual liberation". In China, where people are relatively conservative about sex, introducing sex education in schools in the early grades will help youngsters avoid unsafe sex rather than encourage them to have sex.

Because parents do not tell their offspring the facts about sexual activity and how to engage in it responsibly, every generation believes it "invented" sex. Sex is a normal activity that is on the minds of both men and women, therefore, humans do not have sex just for procreation. Sex serves multiple purposes, including personal pleasure, social bonding - as seen among live-in partners and spouses - and procreation.

Children and teenagers images and stories about romance and sex in the media almost every day. But the information they get may not be wholesome or accurate. Avoiding discussions on the subject won't prevent young people from taking interest in or having sex. It will only force them to get information from other sources which could be misleading and even dangerous, and could lead to unwanted pregnancies or sexually transmitted diseases.

Sex education should be appropriate to the age of the student. For older teens, the topics could include the physical mechanics of sex or "what sex is", the nature of sexual attraction, sexual feelings and sexual pleasure, various approaches to values related to sex, sexually transmissible diseases and how to prevent them, safe sex practices, sexual preferences, how to say "no" to sex and how to accept a "no", and actions to take if one becomes pregnant.

Sex - like other aspects of our lives - be dealt with frankly and appropriately in the educational process.

In a port town on Lake Tanganyika in Zambia, the official HIV infection rate is about 10.8%, lower than the national infection rate of 14%. Unofficial estimates put prevalence in Mpulungu much higher. A high volume of traffic and a low cost of living has made the place an attractive destination for sex workers. Its broken streets are lined with bars that never seem to close.

Free condoms are distributed at health clinics, guest houses and bars, but the subsidized condoms in attractive packaging, against the bland presentation of free condoms, are much more popular, even though they cost about 500 kwacha ($0.10) each.

Solomon Kaluba, an AIDS advisor, said the socially marketed condoms were preferred, as "sex is prestigious," and the packaging and presentation added to the currency of such condoms.

In sub-Saharan Africa women represent about 60% of all people living with HIV infection in the region. In young women aged 15-24 years, in some areas the prevalence of infection is nearly three times that of young men. This heightened vulnerability is driven by social, economic, and cultural factors that include transactional partnerships with older men, who are more likely to be infected. In gender-inequitable and transactional sexual relationships, decisions about behavioural change and condom use are mainly controlled by men and thus, prevention approaches have not greatly reduced the risk of HIV infection for young women in sub-Saharan Africa.

It was very disappointing that, in a large randomised trial of PRO2000 vaginal gel for the prevention of HIV-1 infection in women, 0·5% and 2% PRO2000 gels provided no protection against HIV infection. Results will certainly indicate the end of the road for PRO2000 as a potential HIV-prevention tool for women.

However, the results of the CAPRISA 004 trial, were released in July at the XVIII International AIDS Conference. These results showed that a microbicide containing 1% tenofovir reduced a woman's risk of HIV infection by 39% and the protective effect of the gel increased with consistency of use; women who used the gel in more than 80% of sex acts had a 54% reduction in HIV infections. The CAPRISA results are a substantial breakthrough for HIV prevention.

Promising, preliminary results from another potential prevention method controlled by women: conditional cash transfers. After 18 months' follow-up of a study in Malawi, girls in the cash group who were in school at the start of the study had a 60% lower HIV prevalence compared with schoolgirls who received no payments (1·2% vs 3·0%, p<0·05). This result was probably due to a reduction in transactional sex with older men.

Importantly, the results held even for a group of girls who received cash with no school attendance requirements (unconditional cash). The effect increased with payment size, which suggested that extreme poverty had a central influence on girls' sexual choices.

Although neither tenofovir microbicide gel nor conditional cash transfers will be an immediate prevention panacea, these promising approaches have the potential to greatly expand prevention options for women in sub-Saharan Africa.

Leading scientists fighting the world's worst HIV and AIDS epidemic have called on African leaders to head a month-long sexual abstinence campaign, saying it would substantially cut new infections by up to 45%, a huge step in countries such as South Africa, Zimbabwe and Swaziland.

There is some evidence that a newly infected person is most likely to transmit HIV in the month after being exposed to it.

Researchers focused on religious groups, such as Muslims who abstain from sex during Ramadan, and Zimbabwe's Marange Apostolic sect, which bans sex during Passover.

Muslim countries have an HIV prevalence rate of 0.2%. The low rate has previously been attributed to the universal practice of male circumcision. But Muslim men are also protected from HIV by the ban on sex during the daylight hours of Ramadan, as well as strict teachings on alcohol use, homosexuality and extra-marital sex.

Predominantly Christian South Africa has 18.1% (5.7 million people) living with Aids. Zimbabwe has a similar proportion but members of the Marange sect have lower rates than the surrounding population. Swaziland, a small kingdom wedged between South Africa and Mozambique, has the highest proportion of infections in the world, at 26.1%.

This kind of initiative could provide countries with a one-off, short-term adaptation that is cost-effective, easy to monitor and does not create additional stigma.

A month-long pledge to use a condom could also be effective. The main thing is to agree on a period in which the entire population would live by the same rule.

In Swaziland, the idea was welcomed by the agency in charge of AIDS prevention. "We see this kind of initiative as a way of breaking the cycle. We think a good month to do it would be during the southern African spring, in October or November."

Some boyfriends of teen girls have been known to hide their birth control pills, along with beating them or locking them in a closet if they find the pills in their possession.

Other boyfriends insist on an abortion of their girl friend becomes pregnant, continuously harrassing the girl if she continues the pregnancy.

Expert researchers on dating violence and unintended pregnancy say such stories are all too common. Two new studies have shown the striking frequency with which young men who try to force their partners to get pregnant, not to settle down as family men but rather to exert control. This control may include attempts to force both pregnancy and abortion, even in the same relationship. This phenomenon is called "reproductive coercion," in which abusive partners subject young women already at risk of violence to the additional health risks of pregnancy and sexually transmitted infections.

We must now understand not only who's forcing whom to get pregnant but also the meaning and causes of "unwanted" pregnancy. "If we are serious about stopping unplanned pregnancy in this country, we simply must address the sexual violence and reproductive control that often cause it," says Esta Soler, president of the Family Violence Prevention Fund, which has been a leading advocate on the issue.

In a study of women aged 18-49 with a history of intimate partner violence, 74% reported having experienced some form of reproductive control, including forced unprotected intercourse, failure to withdraw as promised or sabotaging of condoms, and threats of violence if they had an abortion.

The study authors recommend that service providers in women's health clinics offer birth control (such as IUDs) that can be hidden from partners if reproductive coercion is suspected.

In a study of 1,300 16-29 year old women, "Pregnancy Coercion, Intimate Partner Violence and Unintended Pregnancy," published in the January issue of the journal Contraception. Women seeking services at five different Northern California reproductive health clinics were surveyed. Among those who had experienced intercourse, 53% ssid they'd experienced physical or sexual violence from a partner, and 20% said they had experienced pregnancy coercion; 15% said they experienced birth control sabotage, including hiding or flushing birth control pills down the toilet, intentional breaking of condoms and removing contraceptive rings or patches.

In January, the Guttmacher Institute reported that between 2005 and 2006 the pregnancy rate among girls ages 15 to 19 had jumped for the first time since 1990, by a factor of 3%. "There are a multitude of reasons for the recent increase in teen pregnancy," ... "Reproductive coercion may be one piece of the puzzle." Recent research demonstrates that there's a clear need for relationship violence prevention to be integrated into pregnancy prevention and sexual health curricula. Preventing unwanted pregnancy appears to be about more than making contraception available.

"It's imperative that we teach kids comprehensive sex ed that includes awareness of violence and coercion. The more we can help them understand what constitutes a good relationship and where you go for help when something's not good, the more they have a fighting chance," says Debra Hauser, executive vice president of Advocates For Youth.

In 2009 President Obama signed into law a $114.5 million teen pregnancy prevention initiative based on medically accurate, research-based information. $75 million is reserved for programming already proven effective, and at least $25 million is earmarked for research and testing of innovative new approaches.

The Family Violence Prevention Fund has just launched a $3 million violence-prevention initiative called Project Connect, designed to find new ways to identify and respond to domestic and sexual violence, including reproductive coercion. Working with ten state health departments and violence-prevention advocacy groups nationwide, the fund will train staff at family planning, adolescent health, home visitation and other maternal child health programs to understand domestic violence and reproductive coercion so that they recognize it when they see it and know how to help.

An IUD is a T-shaped device - smaller than a penny - that is inserted by a doctor or nurse in a less-than 15 minute procedure, and remains in the uterus, preventing pregnancy for up to ten years with minimal side effects.

In 2002, IUDs made up 2% of Americans' contraceptive use. Now combined use of the ParaGard copper IUD and Mirena hormonal IUD accounts for more than 10%, and the rate is expected to continue rising, thanks to inclusion in the Affordable Care Act's contraception coverage mandate.

There are about 4,700 IUD-related threads on Mothering.com.

Costs for the device and insertion can be as much as $1,000. An aggressively marketed and fatally defective seventies model, the Dalkon Shield, waylaid the IUD's popularity when it was recalled amid a highly publicized, class-action lawsuit. One of Dalkon Shield's disastrous side effects was pelvic inflammatory disease, a complication of gonorrhea and chlamydia that can cause infertility. Consequently, some doctors can be reluctant to prescribe IUDs to women who haven't finished having children or sleeping around. Nonetheless, its reputation held in Europe, where about 20% of contraceptive-using women currently have one.

Are you tired of refilling birth control prescriptions? Can't remember where you left your pills? With the IUD, you're baby-proof for up to ten years. Do the hormones in birth control pills make you cry? The IUD is as effective as sterilization until you take it out.

USAID workers say that the IUD is among the most popular methods of birth control worldwide, favored in countries where men resist condom use.

The device is inserted into the uterus is through the cervix, which can hurt.

The American College of Obstetricians and Gynecologists has recommended IUDs "as a first-line contraceptive option" for sexually active teenagers this year, but NARAL Pro-Choice New York recently found that about a third of 16- to 17-year-old women don't know anything about the IUD, and one in five 18- to 25-year-olds had never heard of it either.

Finding a doctor who will insert and IUD may be a problem. "Many providers are not up to date on the research," said Dr. Sophia Yen, an adolescent medicine specialist who thinks the IUD is an underrated strategy for preventing teen pregnancies.

About 20% of the U.S. female population have chosen to be childfree, with this percentage having doubled in the last three decades. Women who choose to be childfree have to contend with being cast as social pariahs: "selfish," "self-centered," "baby-haters." "Given the rapid growth of this trend, we sought out a variety of perspectives on how this specifically impacts Jewish women".

Click on the link in the headline for the articles.

The world is running out of time to make sure there is enough food, water and energy to meet the needs of a rapidly growing population a recent U.N. report warned.

The world's population, now at 7 billion, is expected to reach 9 billion by 2040, with 3 billion of them middle-class consumers, increasing the demand for resources exponentially, and at a risk of condemning up to 3 billion people into poverty.

Even by 2030, the world will need at least 50% more food, 45% more energy and 30% more water at a time when a changing environment is creating new limits to supply, says the UN .

Efforts towards sustainable development are neither fast enough nor deep enough, as well as suffering from a lack of political will, the UN high-level panel on global sustainability said. "To achieve sustainability, a transformation of the global economy is required" it said. "Tinkering on the margins will not do the job. The current global economic crisis ... offers an opportunity for significant reforms."

Although the number of people living in absolute poverty has been reduced to 27% of world population from 46% in 1990 and the global economy has grown 75% since 1992, improved lifestyles and changing consumer habits have put natural resources under increasing strain.

There are 20 million more undernourished people now than in 2000; 5.2 million hectares of forest are lost per year - an area the size of Costa Rica; 85%t of all fish stocks are over-exploited or depleted; and carbon dioxide emissions have risen 38% between 1990 and 2009, which heightens the risk of sea level rise and more extreme weather.

The panel made 56 recommendations for sustainable development to be included in economic policy as quickly as possible.

EU Climate Commissioner Connie Hedegaard suggested: "Let's use the upcoming Rio+20 summit to kick off this global transition towards a sustainable growth model for the 21st century that the world so badly needs."

The report urged governments to agree on a set of sustainable development goals which would complement the eight Millennium Development Goals to 2015 and create a framework for action after 2015.

It suggested an "evergreen revolution," which would at least double productivity while reducing resource use and avoiding further biodiversity losses; more efficient management of water and marine ecosystems; universal access to affordable sustainable energy by 2030; pricing of carbon and natural resources should be established through taxation, regulation or emissions trading schemes by 2020 and phasing out of fossil fuel subsidies; reform of national fiscal and credit systems to provide long-term incentives for sustainable practices as well as disincentives for unsustainable ones; application of sustainable development criteria to their investment decisions for sovereign wealth and public pension fund, development banks and export credit agencies; strengthening the relationship between policy and science by regularly examining the science behind environmental thresholds or "tipping points"; and naming a chief scientific adviser or board to advise the organization.

The report is available at www.un.org/gsp/

Even if areas dedicated to conserving plants, animals, and other species that provide Earth's life support system increased tenfold, it would not be enough without dealing with the big issues of the 21st century: population, overconsumption and inefficient resource use, according to a study published in the journal Marine Ecology Progress Series. The lead author is Camilo Mora of University of Hawaii at Manoa and the co-author is Peter Sale, a marine biologist and assistant director of the United Nations University's Institute for Water, Environment and Health.

Talking about the agreement to put 17% of land and 10% of oceans on the planet under protection by 2020 in the global biodiversity protection agreement in Nagoya, Japan, Sale said it was "very unlikely those targets will be reached" due to conflicts between growing needs for food and other resources. "Even if those targets were achieved, it is not going to stop the decline in biodiversity," he said.

Fence off one forest and the logging pressure increases in another. Make one coral reef off limits to fishing and the fishing boats go the next reef. In any case, fences or patrol boats can't keep out the impacts of pollution or climate change.

The pressures on the planet's resources are escalating so quickly that "the problem is running away from the solution.

Even though the size and number of protected areas on land and sea has increased dramatically since the 1980s, now totaling over 100,000 in number and covering 17 million square kilometres of land and two million square kilometres of oceans, species are going extinct faster than ever before. The reality is that most protected areas are not truly protected. Up to 70% of marine protected areas are "paper parks", protected in name only, said Mora.

"We were surprised the evidence from the past 30 years was so clear," said Mora.

Todays global expenditures on protected areas today are estimated at six billion dollars per year, but effectively managing existing protected areas requires an estimated 24 billion dollars per year.

"Protected areas are a false hope in terms of preventing the loss of biodiversity," Sale reported.

Biodiversity is humanity's only life-support system, delivering everything from food, to clean water and air, to recreation and tourism, to novel chemicals that drive our advanced civilization, said Mora.

The strategy to halt the loss of biodiversity is with protected areas is like putting all our eggs in one basket." Mora said.

In 1985, when the world's population was five billion people, the amount of nature's resources being used or impacted became more than the planet could sustain indefinitely according to many estimates, said Mora.

By 2050, earth's population is projected to reach 10 billion people and without a change in consumption patterns, the cumulative use of natural resources will amount to the productivity of up to 27 planet Earths, the study found.

The average U.S. citizen's ecological footprint is about 10 hectares, while a Haitian's is less than one. The planet could sustain us if everyone's footprint averaged two ha, Mora said.

If there are more people, then there are simply fewer resources available for everyone, so population control will be needed along the lines of "one child per woman", he said.

Idea Cellular is offering 3G services, and, along with, entertainment to distract people from having sex.

Power cuts can mean a stoppage of ones favorite TV shows and lack of entertainment in the lives of ordinary citizens could have often resulted in couples falling prey to unplanned family extensions which has added to the population of the country.

Mobile TV, Gaming, Video Calling, Social Networking on Super Fast Internet - all can offer non-stop entertainment to help people stay connected and entertained.

Idea's ad leaves a message that there will be 'No Aabaadi, No Barbaadi' (which translates to "No population so No Wastage of Resources!) because people will be '3G pe Busy'.

Births in the U.S. had been on the rise for years, and the number hit an all-time high of more than 4.3 million in 2007.

Last year, the number of births fell 3%, according to preliminary figures released Wednesday by the Centers for Disease Control and Prevention.

The falling birth rate seemed to bottom out in October, November and December, so the decline could be slowing, but it's too early to say.

The lower birth rates may be because women who are unemployed or have other money problems feel they can't afford to start a family or add to it.

In 2008 and 2009, the only increase in births was in women older than 40 — considered more sensitive to the ticking of their biological clocks.

Another factor behind the decline may be a drop in immigration to the United States, blamed on the weak job market. "Hispanics have higher birth rates," said Dr. Roger Rochat, a researcher who has studied fertility and abortion trends.

Progress in development, security and human rights must go hand in hand. There will be no development without security and no security without development.

These words underscore the threats to the well-being and security of our world-from HIV/AIDS, terrorism, climate change and poverty - these require a mix of interventions and partnerships. One area of growing attention is failing states. There is an increasing desire to understand what makes a state more peaceful, democratic, and better able to provide for the needs of its citizens. Steps must be taken toward achieving poverty alleviation. Population age structure can have an impact on stability, governance, economic development and the well-being of its people. Age structures are dynamic and can be shaped-through policies that affect births, deaths and migration, such as programs that promote family planning, girls' education, maternal and child health, HIV/AIDS prevention, care and treatment. Poverty, disease, inadequate health care, lack of education and economic opportunity pose risks, in terms of human well-being and state security.

We must do more to support developing nations with access to family planning and the protection of individual rights. In East Asia, with one-half of the world's population under the age of 30, and one-half of the population of sub-Saharan Africa under age 20, the needs are great.

5 billion people live in developing nations and half of them are under age 25. Annan suggested: -- developing nations reorient their development strategies toward job creation, with particular emphasis on agriculture, which now employs 70% of workers; -- more spending on education and health care and less on defence and security;
-- make developing nations more attractive to investment by strengthening regulatory and financial systems and good governance; -- the international financial mechanism (World Bank and International Monetary Fund) should be strengthened to facilitate a flow of long-term capital from developed nations; -- an increased flow of long-term capital to the very poorest nations.

Cities in the Phillipines face water and sanitation crises as the population grows. 50% of the world's population lives in cities and towns and one billion live in slums and squatter settlements without clean water or decent sanitation. Metro Cebu in the Phillipines has a population of two million and is expected to grow. The Rotary Club of Cebu provided 15 toilets with water that were turned over to the community. But they will have to charge a small fee to maintain them and pay for the water. All cities grow on a supply of good water, the removal of wastewater, and attention to pollution control. But better governance means all citizens' needs must be considered. Government institutions must allow community-based organizations a greater role in determining projects.

by Dr. Ceasar Chelala. To educate all the world's children, governments have to spend an additional $7 billion per year for the next 10 years. This amount is less than what is spent yearly on cosmetics in the United States or on ice cream in Europe. 855 million people are functionally illiterate, according to UNICEF. Each additional year spent by mothers in primary schools reduces the children's risk of premature death by almost 10%. Education of mothers is also associated with smaller family size.

In Brazil, illiterate women have an average of 6.5 children, but those with secondary education have 2.5 children. In urban India, the mortality rate among the children of uneducated women is more than double than those of children of educated women.

Primary education among Philippine mothers reduces the risks of child mortality by half. Girls represent 2/3 of children who don't go to school. There are 250 million working children and also children caught in armed conflicts or other emergencies, who don't go to school.

In Africa, children who lost one or both parents to AIDS will not be able to enroll or will have to drop out of school. It is suggested that both governments and international lending institutions implement debt-reduction policies for those countries willing to provide increased resources for basic education.

If one thinks the crucial issue defining carrying capacity is topsoil,
then one seems faced with achieving roughly an 80 percent reduction in
human population over about 7 decades. This would support the McCluney
conclusion [that we are all doomed] if that were the only strategy. But there are other strategies. If somehow the technology for no-till agriculture (also called low-till or conservation tillage) could become widespread throughout the Third World, and if drainage tiles could be installed under the world's irrigation systems (except those in monsoon cli mates), then one might get away with a 20 or so percent reduction in population over a similar time-frame (or some equivalent trade-off between
population-reduction and time-frame). This suggests that we ought to
ponder some carefully compiled set of options and strategies for
achieving this goal before giving up.

Conservation-tillage agriculture reduces the energy inputs needed by
agriculture, and has been widely adopted in the US, not to conserve soil
but to save money. (American farmers have always refused to do any soil
conservation that the taxpayer does not pay for.) Thus selling the
Third World on conservation tillage does not seem like a really hard
sell. Drainage tiles could be a harder sell. But with population growth
slowing so dramatically in recent decades, this may free up the capital
needed for the investment in tile (capital that would otherwise have been
used to build more houses, feed more faces etc.). So the remaining parts
of the strategy might come from a list of options for achieving a modest
20 or so percent reduction in world population over the first half or so
of the 21st century. The very least we could do is develop that list of
options. Below, off the top of my head, are some contributions to this
list.

(1) Increase First-World funding for international family
planning--sufficient to insure that everyone in the Third World has
access to family planning services. The money involved here is on the
order of $10 billion/year--peanuts relative to the First World's military
bud get--a budget which probably could never begin to achieve the global
stability that $10 billion in family planning services could achieve.
The stability created could provide massive benefits in terms of
increased security for the First World's capital investment in the Third
World (now several hundred billion dollars/year). Thus $10 billion/year
is not a cost at all, but a profit-making venture for the First
World--with huge financial pay-offs, even neglecting the more
philosophical/humanitarian issues. All we need to do is get around a
bunch of Christian-, Moslem-, Jewish- and Hindu fundamentalists. I have
compiled a large file of facts, figures, arguments and analyses that
support increased US support for international family planning. The
environmental community could get off its back-side and collectively
develop and improve such a compilation, and every year jump into the
arena of public opinion with facts blazing.

Universally available contraception could reduce fertility by some thing
on the order of 0.5 children per woman--a major advance.

(2) Invest more in providing family planning services to poor First
World folk in order to reduce the number of unwanted children in the
First World. The investment being talking about here is on the order of
hundreds of millions of dollars per year for the US. Studies have shown
that every dollar invested in this service returns many dollars in
economic benefits for the economy as a whole. All we need to do is get
around a bunch of religious fundamentalists. I have compiled a file of
facts, figures, arguments and analyses that support increased US support
for domestic family planning. The environmental community could get off
its back-side and collectively develop and improve such a compilation,
and every year (around budget time) jump into the arena of public opinion
with arguments blazing.

(3) Increase women's economic options world-wide. This always results
in women wanting fewer children, and with universally available family
planning they can have whatever number they want. I am only guessing,
but I suspect that this holds the possibility of another 0.5 children per
woman reduction in fertility (based on the difference between First-World
fertilities and Third-World fertilities where contraceptives are readily
available). Again, the opposition is the religious fundamentalists
mentioned above.

(4) Separate out children from social security systems. A primary
motive for having children is for old-age security--especially in the
Third World. Finding more alternatives could provide large payoffs in
terms of reduced fertility. Reductions in population growth rate in
recent decades may free up the capital needed for increased old-age
security. What First World citizens could do to bring this change about
in the Third World is difficult to imagine, but it is something to think
about.

(5) Limit immigration into the First World in order to reduce Third
World population growth. Third World leaders tend to see emigration as a
far easier option for dealing with surplus populations than pushing
family planning past local clergy. Third World citizens see each child
as a lottery ticket--a child that can emigrate to the First World and
send home lots of cash. Once everyone in the Third World recognizes that
they must deal internally with their population growth, attitudes would
probably change markedly. Virtually every country in the First World is
now clamping down hard on immigration except one--the US, and even there
people are growing more aware of immigration issues and effects on the US
economy. Clearly the ball is already rolling for this option. All we
need to do is give it a push.

(6) Reduce the use of animal (particularly cow-) intermediaries in human
consumption of grain. This would significantly increase agricultural
efficiency and reduce the need for (and the stress on) crop land.
Per-capita production of grain is leveling off or dropping already, so
just the impending increasing cost of grain could bring this option about
without anyone taking any conscious actions toward this goal. Admittedly
this may not be a large benefit because it puts more pressure on the
world's 32 million square kilometers of grazing land--a tad over a third
of the world's biologically productive land--that are already overgrazed
by a factor of about 2.

(7) Increase support for contraceptive research. Research and
devel opment on contraceptives is probably the main reason why fertility
has dropped so markedly in recent decades. Cheaper, more reliable and
more easily delivered contraceptives can still produce massive bene fits
in terms of reducing fertility. Supporting political drives for making
RU486 available in the US, and donating money to the Population Council
(which does much of the R&D on new contraceptives) are things all of us
can do.

Looking at all of the above, I cannot dispute the legitimacy of
McCluney's pessimism [that we are doomed], but to conclude that all is without hope seems premature.

If we really want to get pessimistic, we should probably look inward.
With all due respects to my fellow environmentalists, I grow
increasingly annoyed at how they and their organizations can indicate
such strong feelings about their environmental values, and then totally
betray those feelings with something near contempt for:

(a) doing the homework they need to do to push their cause effectively in
the arena of public opinion;

(b) creating the organizational structure needed for the collection,
organizing, analysis, storage, retrieval, sharing and disseminating the
information needed for effective environmental advocacy

  As long as children have a 1-in-10 chance of dying before their fifth birthday, it will be difficult to persuade India's women to plan smaller families. A comprehensive package that includes immunizations and prenatal checkups in small villages is replacing the old target based policies. But India cannot do it alone. Wealthier nations, including the United States, must keep up their commitment to achieving a sustainable population. Later this summer the House-Senate committee will be hammering out the differences between two compromise resolutions: the usual strictures that would gag family planning organizations from even discussing abortion, and the one requiring that family planning organizations certify that they are using US funds to reduce the incidence of abortion. The people of India and the developing world cannot wait much longer for the politicians to catch up

Here is yet another way to slow population growth. Add this to: providing contraceptives, educating women, reproductive health and family planning services, educating men, and micro-credit.
Population Communications International has been studying linkages between family planning and natural resource conservation at the local level. Over the past 7 years, PAI has identified and described 48 projects linking these activities in Latin America, Africa, and Asia.

This involves a holistic approach to community needs, engages ongoing community effort, may work synergistically to improve access to and use of environmental and reproductive health services, may improve the overall condition of women, may encourage men to become more active partners in reproductive health, and may be more cost-effective than other single-sector approaches.