Adolescent fertility doing well, but …

THE EDITOR, Madam:

Between 2000 and 2020, Jamaica achieved the largest reduction in adolescent fertility rate (AFR) among Caribbean countries, 57.2 per cent. That is highly commendable.

We started on the journey in 1979, when the government reduced the Age of Civil Responsibility (ACR) from 18 to 16. This first step allowed 16 and 17-year-olds access to health services without the hurdle of parental consent. Jamaica was the first Commonwealth Caribbean country to do that.

But teenagers need their own space, and it took us 38 years to give meaning to that legal provision. The first teen hub was established in 2017 in Half-Way Tree. And, in 2023, a second one established in Morant Bay.

We have taken two important steps – legalisation and service provision – and we have outperformed the rest of the region. Yet, our AFR is still slightly above the regional average.

Far more revealing is a comparison of the average Caribbean AFR with those of all our former colonisers. Ours is 35.4 and theirs is 5.2, a world of difference.

Generally, the Caribbean clings to criminalisation and punishment, while the countries that gave us those laws have moved to legalisation and education. The evidence is overwhelming.

This ‘European‘ approach is not alien to the Caribbean. Bermuda and The Bahamas have adopted this style. So, too, have Martinique, Aruba, and Guadeloupe.

A recent assessment of health and family life education in the Caribbean showed that no country in the region had met the minimum international standard for comprehensive sexuality education. Gee, we can’t even use the word sex to describe the curriculum!

Let’s go back to our pioneering step in 1979 when we reduced the ACR to 16. That merely corrected an absurd legal gap of allowing legal sex at 16 but withholding autonomous access to contraceptives until 18.

It did nothing to address the social reality where 29 per cent of adolescents report being sexually active by age 15.

One country in the Caribbean, Guyana, has recognised the nonsense of arbitrary age barriers and allowed a child of any age access to HIV testing without parental consent. That is in the best interest of the child and the community.

Why not take the same prudent approach to sexual and reproductive health – remove any artificial age limit for healthcare and take drastic steps to improve sex education in schools, churches, and for out-of-school teens?

FRED NUNES