RESPECTED former public servant Reginald Budhan says if the fall in Jamaica’s birth rate continues unabated, the island’s vision for developed country status “will remain a dream”.

Jamaica’s Population Health Status Report 2000–2022, which was tabled in Parliament in May, showed that the country continues to face a low birth rate problem with the total number of live births in the country declining sharply over the last 20 years. Overall, it said Jamaica’s crude birth rate, which is the number of annual live births per 1,000 population, declined by 10.2 percentage points from 21.7 per 1, 000 population in 2000 to 11.4 per 1000 population in 2022.

Jamaica has also fallen below the replacement-level fertility rate of 2.1 for the first time and is currently at 1.9. Replacement fertility is the total fertility rate at which women give birth to enough babies to sustain population levels.

Speaking during a forum hosted by the Hugh Wynter Institute for Reproductive Healthcare and Endoscopic Surgery at The University of the West Indies, titled ‘Sustainable Replacement Population: Protecting Your Fertility’, on Tuesday morning, Budhan said the issue called for immediate action.

“We have a problem now. The human resource of a country is its greatest asset. We had about 52,000 births last year and about 21,000 migrations and about 20,000 deaths; we have a serious problem…for us to be viable and sustainable and achieve a higher level of per capita income and standard of living, we must maintain a higher birth rate; that’s the only way we can compensate for the constant migration, failing which we will never be able to have the human resource or the quality because 80 per cent of those that migrate are our most educated,” Budhan said.

“If this continues Jamaica will never achieve its Vision 2030 goal. It will remain a dream and we will move it from 2030, to 2040, to 2050, we have a serious problem,” he declared.

Budhan, a former permanent secretary in the Ministry of Industry, Investment and Commerce, in stating that the ‘Two is Better Than Too Many’ campaign launched in the 1970s by the National Family Planning Board was “too effective”, and he called for a counter to that campaign “to undo it”.

He, in the meantime, said there needed to be emphasis repairing the social values which have declined and further called for “a culture of family” to be “promoted so women can feel the security of having children with a partner who will not leave partway”.

In the meantime, senior medical officer (SMO) at the Victoria Jubilee Hospital Dr Garth McDonald said while the socio-economic implications are clear, the overall effects and implications for the future also clear. McDonald was emphatic that while the focus on fertility is needed, infertility and the varying reasons should not be ignored.

“We have to look at the flip side. What about those women who want to have children, can’t have children and what are we doing to create incentives [as well as] investigate the problems which exist with infertility,” he said. He noted that another factor was that the state of the economy discourages women from wanting to have children.

Dr Loxley Christie, consultant obstetrician gynaecologist, who was among the panellists, said 15 per cent of all couples have fertility issues even though society tends to peg the female in the relationship as being at fault when no children are forthcoming.

“The woman will almost always be the one who presents to the doctors; however, the important number I need people to understand that if there are a hundred couples who come seeking help with infertility, there is a 50 per cent problem with the female and 50 per cent problem with the male. And quite often there may be a problem with the male only, or there may be a problem with the male and female but even if the female does have a diagnosis of infertility we have to investigate the male because quite often up to 50 per cent of the time there may also be a problem with the male,” he told the audience.

Christie suggested that a way be found to insert the conversation around fertility into the messaging of the Government’s ongoing healthy lifestyle programming.

“Add small bits to an already existing system; we are making it too difficult, it’s not that hard,” he said.

Meanwhile, in acknowledging the expenses associated with infertility treatment, he said the interventions are not covered by insurance companies because infertility, though acknowledged by the World Health Organization, has not been defined as a disease and as such is not insurable.

And Planning Institute of Jamaica (PIOJ) senior director, social policy, planning and research, Easton Williams, in pointing out that Jamaica’s first population policy in 1982 aimed at reaching replacement fertility by the late 1980s before being revised to 2000, said “we are really right now at the turning point in Jamaica and the Caribbean”.

Said Williams: “In fact, most of the countries in the Caribbean are now below replacement level, of the 26 countries, 22 are below replacement level. The challenge is up to us and I would suggest that we take a short-term, medium-term and long-term view to the problem we are facing.”

Professor Karen Carpenter, senior lecturer at the Institute for Gender & Development Studies, said while focus is being placed on fertility and childbearing, child rearing also needs to be addressed alongside the impact of socio-economic factors which are hampering men in their efforts to be good partners.

“Both partners should contribute to the care of the child. If we do not address how men have not moved forward while women have advanced themselves, we are not creating a balance,” she said to applause from the audience.

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