Ministry Seeking to Consolidate Reproductive Health Services

Director of the Health Promotion and Protection Division in the Ministry of Health and the Environment, Dr. Eva Lewis-Fuller, has said that the Ministry is looking at consolidating its reproductive health services, in order to accommodate adolescents.
“Adolescent reproductive health in the Ministry of Health has been a focus of attention for some time…Some people might call it re-enforcement, where we have pieces of it in many different areas. We have the Family Planning Board, Health Promotion and Protection, Family Health; we have some Non-Governmental Organisations (NGO’s) with whom we work; the Ministry of Education has programmes in schools, and we’ve been saying we need to consolidate this to look at how the pieces of the puzzle lie, and make sure we are not missing any pieces; that we are all working together for the same goals and targets and we are not wasting resources,” she said.
Dr. Lewis-Fuller was speaking at the opening of the Regional Consultation on ‘Universal Access to Reproductive Health by 2015: Linking Reproductive Health and HIV/AIDS’, being held at the Knutsford Court Hotel in Kingston from September 29 to October 1.
The consultation forms part of efforts by the United Nations Population Fund (UNFPA), to develop a Caribbean-wide partnership for the advancement of the International Conference on Population and Development (ICPD) goal of Universal Access to Reproductive Health by 2015, recently enshrined as part of the Millennium Development Goals (MDGs).
Dr. Lewis-Fuller said that in merging the reproductive health services, there would be some difficulty in determining the foundation for these services. “We know we can’t have everything in one place, but where is the base? People think that that base should be in family health, since that looks at the whole family, and we are moving towards putting the base in family health, with linkages in all the other areas,” she noted.
The Director pointed out further, that in re-orienting the health services, the Ministry would also be looking at the kind of reproductive health services that should be offered, especially to the adolescent.
“It is well known that the Sexually Transmitted Disease (STD) rate among the adolescent is much higher, especially females. It’s about three times as high as the males of the same age, and that is because it is believed that they are having sexual contact with older men who are not using any protection, and (many of them) are doing it for economic reasons,” Dr. Lewis-Fuller argued.
“All these issues we have to take into consideration. A teenager doesn’t want to meet her grandmother in the same health centre when she is going for an STD (test) and the grandmother is going to check her blood pressure and that is why, for example, we get teenagers coming in late, when they do get pregnant – in the second and third trimester – or not at all until they are at delivery,” she explained.
“So, we are saying, should we have special services for this age group in reproductive health, should we integrate the whole thing? Persons are saying, well if we have special services for that, then we are going to have to have special services for all the other things. So, I think what comes out of this meeting will be of particular importance and interest to the Ministry of Health in Jamaica, and I am sure to other countries in the region,” the Director added.
Dr. Lewis-Fuller said it is very timely that focus is again placed on reproductive health, especially in relation to adolescents. “Perhaps the issue of reproductive health always comes back to the adolescent, and whenever we speak of reproductive health, we automatically focus on the adolescent, because that is the age group when persons are having their sexual debut; they are experimenting. All studies have shown that 60 per cent of the 15 to 19 year olds are actively having sex. Many of them, of course, doing very risky things – not wearing a condom. It is at an age where confusion reigns – the search for identity, changes in physiology, hormones – and so it is fitting to focus on the adolescent,” she said.
She also called for more research into the male reproductive health issues. “I think we have begun to look into it. But I think the Jamaican male is still a challenge, and I don’t think we fully understand what goes on in the head of the Jamaican male. We know that they are very sensitive to reproductive health issues, it is really a challenge understanding the thinking of our men on sexuality issues, HIV/AIDS, with which a whole host of myths and behaviours abound. We need to get to the bottom of that,” the Director argued.
Former Minister of Foreign Affairs and Foreign Trade in Barbados, Dame Billie Miller, in her address, said she felt pleased and vindicated that “we are seeking more and better ways of forging linkages between HIV/AIDS and sexual reproductive health, with a view to further integration. In a region which is second only to sub-Saharan Africa, in terms of prevalence, we need to be engineering every strategy, every mechanism which can help us to halt the relentless march of this disease in the Caribbean.”
She said that the MDG Report of 2008, notes that Latin America and the Caribbean are still not meeting targets, and that although total fertility has declined substantially, adolescent fertility is declining slowly. “In fact, it has fallen by very little,” she said, noting that the Caribbean statistics have to be disaggregated from Latin American statistics for closer study.
The Report, she said, further cites the rising number of adolescent HIV/AIDS cases. “We know that, universally, every day nearly 7,500 people become infected with HIV and 5,500 die from AIDS, mostly due to lack of HIV prevention and treatment services. The number of people living with HIV rose from an estimated 29.5 million in 2001 to 33 million in 2007. We know that the majority are in sub-Saharan Africa, but we know that we are next on the list. The number of people who die from AIDS has started to show decline, from 2.2 million in 2005 to 2 million in 2007. But, in almost every region, women represent a growing share of people living with HIV – in sub-Saharan Africa almost 60 per cent – and we know that this is true in our region as well. Antiretroviral drugs are adding years to peoples’ lives, but the need for treatment still outpaces the available supply,” Dame Miller informed.
The UNFPA is an international development agency that promotes the right of every woman, man, and child, to enjoy a life of health and equal opportunity. It supports countries in using population data for policies and programmes to reduce poverty and to ensure that every pregnancy is wanted, every birth is safe, every young person is free of HIV/AIDS, and every girl and woman is treated with dignity and respect.