Way beyond just birth control

While in Gordon House, opposition senator and principal of Jamaica College, Ruel Reid, recently cited the inordinately high dependence (about 50 per cent of schoolchildren) on the government-sponsored Programme of Advancement Through Health and Education.

He deduced that many parents are unable to care for their progeny, and stated that he would not be opposed to legislation putting limits on the number of children that Jamaican couples can produce. Senator Reid cited communist China - in essence, saying that they used the one-child (per family) policy to help rein in socio-economic problems.

What Senator Reid did not say is that innumerable Chinese women undergo forced abortions, men and women undergo forced sterilisation, there is 'gendercide' and emerging socio-economic problems. The law has caused an ageing population and looming shortage in the labour force, and was reviewed last year.

In spite of my occupation, like the very vast majority of Jamaicans, I only saw the National Family Planning Board (NFPB) as just that: a government organisation created to limit the number of children produced in order to better manage the scarce economic and dwindling natural resources of our little island home.

But last October at a Caribbean College of Family Physicians clinical seminar aptly dubbed 'Family Matters', chairperson of the NFPB, Dr Sandra Knight, revealed an entirely new and different NFPB. This administration is well aware that our problems go way beyond just 'birth control'.

Consequently, about six months ago, under the direction of Minister of Health Fenton Ferguson, the NFPB was reincarnated as the 'Sexual Health Agency of Jamaica'. This entity assimilated the National HIV Programme and now deals with all things concerning sexual health.

New survey results

Dr Knight presented some very interesting statistics coming out of the most recent survey conducted to investigate our social norms, sexual and social attitudes and behaviour. Essentially, the 2008-2009 Reproductive Health Survey (RHS) was conducted to "... address the reproductive health of young adults and develop national strategies to reduce interpersonal violence ... ."

It surveyed 8,259 women (between 15 and 49 years old) and 2,775 men (between 15 and 24 years old) nationwide. It had a very high response rate, which bode well for its authenticity and accuracy.

Regarding legislating limits on children produced, the 'Two is Better Than Too Many' campaign apparently worked pretty well. In fact, although the age of first coitus for females has remained fairly steady since 1997 (at about 17 years of age), the survey showed that the country's fertility rate has been declining. It is currently 2.4 children per woman (the lowest recorded rate so far).

The survey looked at couples - 69 per cent of the women were either legally married, in consensual unions or in a visiting partner relationship. It looked at peak fertility in women and their educational level.

As expected, women with the highest educational levels had their children older (between 30 to 34 years old) and women with lower educational levels had their children between 20 to 24 years old. The same relationship held true for women with a higher socio-economic status versus those with a lower status.

The survey looked into myriad issues, including contraceptive knowledge, contraceptive uptake and use; gender differences in contraception knowledge and use, gender attitudes towards violence against women and different forms of rape.

The NFPB wants to use the data to engage the various stakeholders - the relevant government ministries, other entities and health-care providers. That way, they will get to the root of the family and population problem, and not just concentrate on contraception.

The NFPB plans to approach 'family planning' holistically, because the family (however you define it) is the nucleus of our society. Fractured, violent, nefarious and/or unstable families make for fractured, violent, nefarious and/or unstable societies.

Garth A. Rattray is a medical doctor. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.