Contraceptive awareness high, report shows

AWARENESS of the methods of contraception among males and females of reproductive age in Jamaica remains relatively high, with the emergency contraceptive pill having had the most significant increase in awareness among females and males of reproductive age, the newest Reproductive Health Survey, Jamaica is showing.

The recently released 2021 survey, which looks at the fertility, contraception, and reproductive health of women and men aged 15 to 49 years, also showed that there were reductions in the awareness of older-type methods like the intrauterine device (IUD/Copper T), diaphragm, and spermicides, compared to awareness in previous surveys. However, the proportion of females and males who used a method of contraception remains high, with most respondents indicating that they had used a modern method.

The household survey was conducted by Statistical Institute of Jamaica on behalf of the National Family Planning Board. It covers fertility; contraceptive use, knowledge, attitude and practice; reproductive health; maternal and newborn care; infant and child mortality; sexually transmitted infections including HIV/AIDS; gender-based violence; and the reproductive health of respondents 15-49 years. The data also generated indicators on Jamaica’s progress towards achieving Sustainable Development Goal (SDG) 3 on good health and well-being, including SDG 3.7.1 on contraceptive use, and estimates for SDG 5 on gender equality. The information gleaned is used in determining programme implementation and other vital issues specific to how the country deals with matters relating to reproductive health.

There were 5,008 participants – 3,224 females and 1,784 males. Close to one-half (46.1 per cent) of respondents resided in rural areas, less than one-third (31.6 per cent) resided in other urban centres (OUCs), while 22.3 per cent lived in the Kingston metropolitan area.

The series of questions surrounding contraceptive knowledge and use asked respondents about their knowledge and use of different contraceptive methods. These included permanent, long-acting, reversible options, and hormonal and barrier methods. Respondents were asked several questions related to contraceptive use, including use in their most recent sexual encounter with multiple partners, who obtained the method, from where, and whether there was a desire to utilise a different method.

Results showed that the male condom was the most widely used method of contraception among both sexes. It has consistently been the method with the highest level of awareness and use over several surveys, the researchers noted.

Females were asked if they or their partners had ever used contraception. In 2021, 86.8 per cent of females reported ever using a method of contraception. The statistics show that the lifetime exposure to contraceptives among reproductive age females has steadily increased over time, from 70.5 per cent in 1989 to 86.8 per cent in 2021.

The lifetime use of a method of contraception was highest among females who lived in the Kingston metropolitan area (90.0 per cent) when compared to females who resided in OUCs (85.8 per cent), and rural areas (85.9 per cent). The proportion of females who had ever used a method of contraception was lowest among adolescent females 15-19 years (39.7 per cent); those in no steady relationship (64.8 per cent); and females with no children (65.6 per cent).

The most popular methods of contraception among females of childbearing age across six surveys has shifted from the oral contraceptive pill (OCP) in 1993 to the male condom in 2021. Use of the OCP declined to 45.4 per cent in 2021 from a high of 53.8 per cent in 2008, while the emergency contraceptive pill had the largest overall increase in 2021 to 36.5 per cent compared to ever-use rates in 2008 (10.9 per cent) and 2002 (3.9 per cent).

Most males 15-49 years (88.6 per cent) stated that they or their partner had used a method of contraception during their lifetime, especially those with post-secondary education (90.1 per cent) and in the highest wealth quintile (91.0 per cent). Seven of 10 males using contraception were employing a modern method while 59.2 per cent had used a traditional method. Consistent with the female data, the most widely used modern contraceptive methods reported by males or their partners were the male condom (75.7 per cent), emergency contraceptive pill (30.2per cent), and the OCP (30.1 per cent).

For current use of contraceptives — a measure of the proportion of females in unions who had used a method of contraception within the last 30 days — 60.6 per cent (married, common-law, or visiting union) reported that they or their partners were currently using a method of contraception. Compared to other surveys, this was the lowest reported contraceptive rate (1997, 65.9 per cent; 2002, 69.1 per cent; 2008, 72.5 per cent). By socio-demographic characteristics the contraceptive prevalence rate was highest among females who lived in rural areas (62.2 per cent); females with ‘four or more live births’ (74.2 per cent); and females from households who were considered at the ‘medium level’ on the socio-economic scale .

In each survey year as the number of live births increased, the contraceptive prevalence rate also increased. Also, current use of specified contraceptive methods varied with females’ relationship status. In 2021 the prevalence of condom use (9.6 per cent) was lowest among married females and highest among females in a sexual boyfriend relationship (41.5 per cent). The prevalence of female sterilisation (11.1 per cent) and IUD/Copper T (6.5 per cent) was highest among married females. Females in a non-sexual boyfriend union (95.3 per cent) and those not in a steady relationship (90 per cent) made up the largest segment of non-users of a contraceptive method in the last 30 days

Like females, males were also asked if they or their partners had used a method of contraception during the last 30 days. A little over one-half of males (51.7 per cent) were currently using a method of contraception. Current use of contraceptives among males increased as education level increased (less than secondary, 42.4 per cent; secondary, 53.0 per cent; post-secondary, 55.9 per cent). Current contraceptive use was lowest among males with no live births (42.8 per cent), and highest among males with three live births (78.1 per cent).

“Improving contraceptive awareness and acceptability is integral to any reproductive health campaign. It allows persons the reproductive freedom to choose the timing and spacing of births and protection from HIV and other STIs,” the report explained. “Although awareness of different methods continues to be high across surveys, a small proportion of females who were in a union and currently using a method of contraception desire to use another method… [and] for females, concerns about costs and side effects are among some barriers to using their preferred method.”