An important component of any health care system is the delivery of high-quality sexual and reproductive health (SRH) care services. The World Health Organization (WHO) defines these services as the sexual and reproductive health care of both men and women throughout the life cycle, beginning in adolescence. In the United States, the provision of SRH care has tended to differ according to income and insurance coverage of the recipient. Roughly two-thirds of SRH services are delivered in private settings that typically serve patients with private health insurance.¹ Providers in those settings include a mix of obstetrician-gynecologists, primary care physicians, nurse...

This chapter answers the following question: What is the expected increase in demand for SRH services among women in the United States aged 15–44 in the next decade? An understanding of the answer will help us investigate the potential for a mismatch between supply and demand in the aggregate, as well as in particular care settings.

Here we describe a method for forecasting the total future utilization of SRH services by females of reproductive age (15–44) in the United States. Our principal interest is estimating utilization of the following four broad classes of SRH services through the year...

As noted in the introduction, the provision of SRH services is the domain of several groups of professionals with fairly specialized training. The number of obstetrician-gynecologists has grown roughly 14 percent from 1996 to 2006, about half the rate of all specialist physicians (Salsberg and Rivers, 2008). Because nearly 40 percent are over age 55, some experts have suggested the possibility of a future shortage (Smith, 2012). Nevertheless, the focus of this study is on provision of services in public settings to lower-income women and men, where NPs, and particularly NPs with a women’s health focus, have tended to be...

The results presented in Chapters 2 and 3 suggest a growing demand in the next decade for SRH services coupled with a potentially stagnant supply; this decline is not in the numbers of NPs in the United States but in the number of NPs providing SRH services. In this chapter, we explore possible reasons why the supply appears to be stagnant, leading to a possible coming shortage of NPs and NMs who can provide SRH services. Although we focus on NPs, we also discuss implications for NMs when relevant (and sometimes use the term, APRN, mainly referring in this case...

This chapter summarizes policy options available to address the projected gap between the growing demand for high-quality SRH services and the professionals with skills and competencies (particularly APRNs) to deliver those services. SRH services are delivered in a variety of settings and are intertwined with primary care and public health. The experts and clinic personnel we interviewed identified a broad range of policy options that could address the barriers discussed in Chapter 4. Based on their suggestions, the research team examined policy options in related fields that emphasize alignment of education and practice experience. The summary provided in this chapter...