Dwindling family planning funds challenge Jamaica.

Network 13(3):22-3 (1993) PMID 12318097

Changes in international financial support for family planning (FP) in Jamaica will impact on the quality, availability, method mix, and distribution of contraceptives. National government will have to increase costs for reproductive health needs, develop cost recovery systems, and find creative ways to shift care to the private sector. There are difficulties in shifting care to private physicians. Physicians have little training in reproductive medicine or family planning (FP), and there is little financial incentive. Counseling on FP is too time consuming at 45 minutes per patient, when curative care takes 15 minutes per patient. Physicians have reservations about the safe use of specific FP methods. Physicians also do not have access to current information on contraceptive technology and related medical questions; e.g., they lack knowledge about handling bleeding problems from patients use of Depo-Provera. 8% of women currently use Depo-Provera, compared to 2% using IUDs, 9% using condoms, 15% seeking female sterilization, and 20% using oral contraceptives. The average family size is low at 2.9 children. More than half of women of reproductive age use a family planning method. The government's immediate strategy is to promote long-term and permanent methods instead of short-term methods. The government is also working with professional associations to promote increasing involvement of private physicians in FP. The government departments of health and family planning have begun a pilot program to test the ability of non-nursing staff to counsel on sterilization. Future plans are to increase responsibilities of trained non-nursing staff to include counseling on other FP methods and to expand minilaparotomy to major hospitals other than Victoria Jubilee Hospital.