CICIAMS. United Nations Non Governmental Organization (NGO)

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United Nations Non Governmental Organization (NGO) The Nurse s Role Related to Fertility Health, the Aging Population, & Replacement Population

United Nations Non Governmental Organization (NGO) Thank You, All Members of CICIAMS for the honor and privilege to serve 2015 to Present Patricia Sayers DNP RN CICIAMS UN Rep 2015 to Present Maria Arvonio MA RN 2015 to Present Marian Nowak DNP MPH RN 2015 to 2017 Patricia Staley RN Catholic Radio Host 2018 Courtney Donahue DNP RN (Youth Member) 2018 Sarah Donahue BSN RN (Youth Member)

United Nations Non Governmental Organization (NGO) Thank You, All Members of CICIAMS for the honor and privilege to serve Especially Geraldine Mc Sweeney, Donatus Akpan, St Anne John, Theresa Cheong, & Executive Board from 2015 to Present NGO = The Voice of Civil Society

United Nations Non Governmental Organization (NGO) Four Nursing NGOs at the United Nations 1. The International Catholic Committee of Nurses and Medico-Social Assistants (CICIAMS) 2. The Nightingale Initiative for Global Health (NIGH) 3. The International Council of Nurses (ICN) 4. Sigma Theta Tau International (STTI)

United Nations Non Governmental Organization (NGO) Focus: Population Division CICIAMS - consultation status - Office of Economic & Social Affairs (ECOSOC). Under ECOSOC, the Division of Population activities became our focus Adolescents & Youth /Aging Environment Family Planning / Fertility HIV/AIDS International Migration Marriage and Unions Mortality MDGs Population Policies / Trends SDGs / Urbanization

United Nations Non Governmental Organization (NGO) The Nurse s Role Related to Fertility Health, the Aging Population, & Replacement Population

United Nations 2030 Sustainable Developmental Goals The SDGs matter because they are intended to drive the allocation of global financial and human resources, and to help direct nations and donors policy priorities between now and 2030. (Galati, A.J., 2015,Guttmacher Institute)

United Nations Non Governmental Organization (NGO) Regarding: 1) Fertility Health 2) Aging Population 3) Replacement Population Attendee nurses will be able to: 1. Define these global health issues (Evidence-based) 2. Identify concerns affecting patients/catholic nurses 3. Acknowledge strategies addressing care concerns 4. Specify roles for Catholic Nurse engagement

The Free Dictionary Health [helth] a relative state in which one is able to function well physically, mentally, socially, and spiritually in order to express the full range of one's unique potentialities within the environment in which one is living https://medical-dictionary.thefreedictionary.com/wholistic+health

The Joint Commission The requirements that address spiritual needs and practices PC.02.02.13 Cultural & linguistic competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. P Culture' refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. https://npin.cdc.gov/pages/cultural-competence

Definition of Health CONSTITUTION OF THE WORLD HEALTH ORGANIZATION Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. What is missing in this statement?

Fertility Health The subject of fertility health refers to freedom from physical disease or injury and the functional condition of males and female s reproductive systems through all stages of life.

Fertility Health / Fertility Awareness United Nations = Reproductive Health Reproductive health is a state of complete physical, mental and social well-being, and not merely the absence of reproductive disease or infirmity. Reproductive health deals with the reproductive processes, functions and system at all stages of life UN POPULATION INFORMATION NETWORK What is missing in this statement?

Family planning has been promoted as the key to achieving all the SDGs Economic prosperity Women s empowerment, workforce participation Reduced health, education costs Environmental protection Improved maternal, child health

Reproductive Health greatest benefits from reducing unintended pregnancies would be seen in the poorest countries, with GDP increases ranging from one to eight percent by 2035. There are few interventions that would result in such wide-ranging impacts while offering such incredible return on investment. (World Bank)

2030 Sustainable Developmental Goals 1. No Poverty 3. Good Health & Well Being 5. Gender Equality Annually est. 74M unintended pregnancies in developing countries => failing or lack of contraceptive access. Of these unintended pregnancies, 36 million -> abortion n For each additional $1 spent on contraceptive services above current level, cost of pregnancy-related care is reduced by $2.22.

Fertility Health / Aging Population / Population Replacement Terms Definitions Statistics Trends Fertility Health UN Reproductive Health Global Measure Total Fertility Rate TFR Child/Woman Replacement Rate 2.1 UN 2017 World TFR 2.438 09/2018 World Pop est 7.6B (Worldometer, 9/18) 2100 World TFR 2.0 World Pop est 11.2B (UN,2017)

Population = Births, Longevity, & Migration 2100 80% Pop Africa & Asia Region 2020 2050 2100 World 7.8B 9.9B 11.2B Africa 1.4B 2.53B 4.47B Asia 4.6B 5.285 4.8B Europe 744M 716M 653M Latin America 664M 780M 712M North America 369M 435M 499M Oceana 42M 57M 72M

Projection 2020

Fertility Health / Aging Population / Replacement Population Terms Definitions Statistics Trends Aging Population Number of persons > 60 yo increases faster then youth 0-14 yo Median Age of World Population 2015 29.6yr Year 2100 Depends on Fertility Constant 23.6 Low 49.2 Medium 41.6 High 35.6

UN Key Factors of Population Growth: Births, Longevity, & Migration Fertility Health / Aging Population / Population Replacement Median Age 2015 29.6 yrs 2020 Age Median 2050 Age Median 2100 Age Median Constant Fertility 30.8 31.7 23.6 Low Fertility 31.2 40 49.2 Medium Fertility 30.9 36.8 41.6 High Fertility 30.6 32.2 35.6

UN Key Factors of Population Growth: Births, Longevity, & Migration Fertility Health / Aging Population / Population Replacement Demographic Dividend: the productivity boost enabled by declining fertility. Educational investment are made in a shrinking youth cohort. More resources for the few (lure families & societies) Essentials: Food, Water, Clothing, Housing, Vacations Education: Empowerment and Opportunities Less Poverty Less Hunger Less Sickness

UN Key Factors of Population Growth: Births, Longevity, & Migration Fertility Health / Aging Population / Population Replacement Demographic Deficit: reduction in wealth due to aging of the population: in financial context, the increase in budget deficit due to aging of the population When economies are comprised of more numbers of elderly, spend more on pensions, retirement benefits, healthcare costs, as well as eventually unable to find enough workers for the jobs being existing and created.

UN Key Factors of Population Growth: Births, Longevity, & Migration Fertility Health / Aging Population / Population Replacement MIGRATION HOSTS 2015-2050 Annually more than 100,000 migrants projected to USA, Germany, Canada, UK, Australia & Russian Federation. MIGRATION SENDERS 2015-2050 Annually, more then 100,000 from India, Bangladesh, China, Pakistan, and Indonesia CULTURAL & ENVIRONMENT TRANSITIONS

UN Key Factors of Population Growth: Births, Longevity, & Migration Fertility Health / Aging Population / Population Replacement World & Regions Urbanization 2018 World 55% Africa 49% Europe 74% Latin America Caribbean 78% North America 82% Oceana 67% Asia 49% URBANIZATION Currently, > half of the world s population in urban areas. By 2050, est 68% of world s population expected to live in urban areas. 90% from Asia & Africa Over 60% of land projected to become urban by 2030 is yet to be built.

Fertility Health / Aging Population / Population Replacement Objective #2 Identify concerns patients/catholic nurses 1. Reproductive Health Modalities being promoted in society violate Catholic/and other values, beliefs, and teachings 2. Aging population needs access to geriatric nursing skill sets, safe & healthy living environments, plus jobs suited for the elderly

Fertility Health / Aging Population / Population Replacement Objective #2 Identify concerns patients/catholic nurses 3. Migration: Childhood immunizations program, drugs shortages, health systems for refugees, lack of health records, concerns regarding HIV, Hep C, TB, internal parasites, & traumatic stress due to people leaving ancestral homes 4. Urbanization large urban centers are natural disaster prone (coastal hurricanes, monsoons, flooding) City slims house now est home of 1M. Migration to urban cities.

Fertility Health / Aging Population / Population Replacement Objective 3. Acknowledge strategies addressing care concerns 1. Reproductive Health Modalities in Violation of Cultural Sensitivity: a) Advocate & deliver fertility health modalities in keeping with Catholic teachings (NaproTechnology, Billings, Marquette) a) Advocate for cultural competency (human rights) b) Advocate for informed consent (to include risks and alternatives) 2. Aging population needs expansion of geriatric nursing skill sets, geriatric nursing programs & living environments plus jobs suited for the elderly

Fertility Health / Aging Population / Population Replacement Objective 3. Acknowledge strategies addressing care concerns 3. Migration: Involvement of nurses in planning health care systems for migrants, provide incentives for nurses to engage in migrant services, advocate for migrants/join others 4. Urbanization Fortify the presence of nurses in urban areas, jobs, schools of nursing, involve nurses in planning, incentive for nurses, focus: health promotion/prevention

Fertility Health / Aging Population / Population Replacement Objective #4 Specify roles for Catholic nurse engagement 1. Practice Roles: Fertility Health/Fertility Awareness a) Certifications in Evidence-based Methods consistent with Catholic teaching (NaproTechnology, Billings, ie) b) Services Accessibility & Affordability - clinics c) Expertise in cultural sensitivity certification, advanced degrees 2. Practice Role: Aging population a) Expand geriatric nursing skill sets & services b) Promote health & safety in the home environments/communities c) Elder jobs d) How can elder nurses contribute

Fertility Health / Aging Population / Population Replacement Objective #4 Specify roles for Catholic nurse engagement 3. Practice roles in Migration: Involvement of nurses in planning health care systems for migrants, provide incentives for nurses to engage in migrant services, advocate for migrants 4. Practice roles re Urbanization Fortify the presence of nurses in urban areas, jobs, involve nurses in planning, incentive for nurses, focus: health promotion/prevention

Object #4 Specify Nursing Roles Concern Education Research Policy Fertility Health Fertility Awareness. Prepare Faculty. Accessible Programs.Affordable Programs Quantitive & Qualitative Studies RCT Outcome data Publish. Disseminate Advocate: Respect life policies Birth to deaths Revise definitions, Cultural competency, informed consent, Funds Publish Disseminate

Object #4 Specify Nursing Roles Concern Education Research Policy Aging Population. Prepare Faculty. Accessible Programs.Affordable Programs Quantitive & Qualitative Studies RCT Outcome data Publish. Disseminate Advocate: Respect life policies Birth to deaths Safe & healthy environments Jobs for aging Education for aging Funds Publish Disseminate

Object #4 Specify Nursing Roles Concern Education Research Policy Replacement Population/ Migration Prepare Faculty. Accessible Programs.Affordable Programs.Educational Pathways Quantitive & Qualitative Studies RCT Outcome data Publish. Disseminate Advocate: Respect life policies Safe & healthy environments Language education Health Records Funds Publish Disseminate

Thank You Please Share Your Experiences & Comments

The Nurse s Role Related to Fertility Health / the Aging Population / Replacement Population MIGRATION PROJECTIONS HOSTS 2015-2050 Annually more than 100,000 migrants projected to USA, Germany, Canada, UK, Australia & Russian Federation. SENDERS 2015-2050 Annually, more then 100,000 from India, Bangladesh, China, Pakistan, and Indonesia CULTURAL & ENVIRONMENT TRANSITIONS

Concerns affecting patients and Catholic nurses A. UN Reproductive Health Population reduction methods being promoted 1) Hormonal contraception 2) IUD 3) Sterilization 4) Abortion UN Mandate: Universal access a global human right

Concerns affecting patients and Catholic nurses Education for Sustaining Health: Engaging Development, Respecting Life Respect for life

Objective 2: Identify the issues for Catholic Nursing engagement A. Fertility Health (UN Reproductive Health) Population reduction methods being promoted 1) hormonal contraception, 2) IUD, 3) sterilization 2. Universal access a human right

United Nations Non Governmental Organization (NGO)

Objective 2: Identify the issues for Catholic Nursing engagement B. The Aging Population 1. Demographic dividend (short term gains!) More women in the work force greater productivity 2. Few children more money and resources fewer people 3. Greater family prosperity greater national prosperity B1. Issues 1. Need for 2. Gains are short term 2. Demographic winter prospect looms

United Nations Non Governmental Organization (NGO)

United Nations Non Governmental Organization (NGO)

United Nations Non Governmental Organization (NGO)

United Nations Non Governmental Organization (NGO)

United Nations Non Governmental Organization (NGO)

Fertility Health / Aging Population / Replacement Population 1. Identify the global health issues Define term UN Global Statistics (Evidence-based) UN Pattern and Trend Documents (Evidence-based) 2. Discuss concerns Cultural sensitivity Health benefits and risks 3. Acknowledge strategies 4. Catholic Nurse Roles: Practice, Education, Research, & Policy