Poor shun birth control
Asignificant number of Jamaicans in abject poverty are refusing to use family planning programmes a local advocacy group has indicated.
“There is still the perception that a woman should have out her lot, and there is still a negative attitude towards contraception. Some people still argue that it’s a means to reduce the black population,” said chief executive officer of the St Ann-based National Family Planning Association, St Rachel Ustanny, who indicated that such views were primarily shared by people in some of the poorest rural and inner-city communities.
“We are noticing that there is still a large number of women in their child-bearing years who are having more children than they can afford to adequately care for. Women who are poor, with low educational levels are having more children, at least three more than the national average, which is about 2.8 children to every woman” she explained.
These poor and poorly educated Jamaican women fall into the very categories that the association targets with the help of churches and community organisations.
“Our primary target group are people who are marginalised, persons who are poor, persons who are generally unable to afford medical services and family planning services, and our message is simply, ‘for a better life’. We believe that when people are able to access family planning services, they can truly see a better quality of life, because they would be monitoring their state of sexual health and they would be able to make conscious decisions about family planning issues,” said Ustanny, as she outlined the role of her organisation.
But the problem remains, despite sustained family planning campaigns which were initiated decades ago by pioneering founders of the Jamaica Family Planning Association, Dr Lenworth Jacobs and his wife Beth. Their efforts gave birth to the staterun National Family Planning Board (NFPB) which promotes sustainable family planning services in Jamaica.
Dr Dalea Bean, lecturer at the Institute for Gender and Development Studies at the Mona campus of the University of the West Indies. She is advocating the need for more public education targeting both men and women.
“The myths associated with family planning and the view towards contraception use are not necessarily positive in some of these areas. There is also the view that you are trying to wipe out a race and these views result in people not hearing the message of those in family planning circles,”
“Apart from probably condoms, the woman is the one expected to go on the pill, but negotiating contraception use is a big part of the whole thing. If the women can’t negotiate contraception use with the men, then it will not happen, and for most men, a woman — especially if she is married or in a common law relationship — should not be insisting on condom use, as it raises questions regarding infidelity,” she said.
Despite concern that the family planning message isn’t reaching some members of the target population, Ustanny has maintained that the various entities involved in the family planning campaign have had some success, as the fertility rate has declined over time.
Her position is supported by data published in the 2011 World Population Report which points out that 73 per cent of married Jamaican women, up to age 49, were using contraception. Available data also supports Ustanny’s argument that fertility rate has fallen from approximately 4.5 births per woman in the 1970s to just over two children per woman in 2009.
The NFPB which conducts surveys every five years says it does not use the classification of urban or rural poor in its data collection. Instead, the state entity uses the categories of Kingston Metropolitan Area (KMA), Urban and Rural.
In its last survey done in 2008, the number of children per woman was 2.4. When broken down, the data showed that the rate in the KMA was 1.9, and 2.3 in other urban areas. However, for rural women, the rate was higher, with 2.7 children per woman.
Like Dr Bean, Ustanny is appealing for the introduction of more aggressive campaigning aimed at getting men and women, particularly from poor households to realise the negative impact of having too many children. She added that a renewed public education thrust must target women, many of whom she says use no form of contraception and continue to rely on their partners who may or may not choose to use a condom.
“We still have many issues, we still have situations where women enter relationships and bear children in order to secure money. There are also situations where some men continue to resist any attempt by their women to use contraceptives,” said Ustanny, as she highlighted the social and economic challenges associated with poor family planning practices.
While acknowledging that the family planning campaign could benefit from an intensified public education thrust, the NFPB says any revamping will be based on the availability of resources. However, the entity is pledging to continue outreach activities in communities across the country.