As concerns mount over Jamaica's declining birth and fertility rates, Health and Wellness Minister Dr Christopher Tufton is encouraging women who can afford to have children to do so.
“If you can afford it, … why not have?” he asked at the reopening of a refurbished breastfeeding room at the Victoria Jubilee Hospital (VJH) in Kingston on Tuesday.
The facility, which supports mothers and their premature infants in the nursery, was renovated by the Kiwanis Club of New Kingston at a cost of $500 thousand.
While acknowledging the socio-economic implications of declining birth and fertility rates, Tufton noted that this is an issue that needs to be “assertively looked at” over time.
With some 52,000 births recorded in 2023, Jamaica showed a recorded fertility rate – number of live births per 1,000 women within the childbearing age range, often 15-44 years old – of 1.9. This is below the internationally accepted rate of 2.1 for population replacement.
Estimates since the start of 2024 indicate that Jamaica's birth rate – number of live births per 1,000 people in the population – stands at 14.895 births per 1,000, which shows a 1.64 per cent decline from 2023. The decline in births is common to about 22 countries in the region.
Global fertility rates have been declining in all countries for decades, moving from 4.84 in 1950 to 2.23 in 2021, and will continue to drop to 1.59 by 2100, according to an analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021.
Along with increasing support for parents and caregivers, the research conducted by the University of Washington stated that, unless countries facilitate ethical immigration, populations are expected to contract in areas where fertility is below 2.1 children per person who could give birth.
A similar suggestion was made by Tufton.
“Maintaining your population doesn't necessarily mean people having more children. It could also mean a more open society, where labour and people can move from other jurisdictions. We are a melting pot in terms of different populations,” he told The Gleaner.
According to the minister, this is currently being manifested as the country moves to import labour.
“The reality is that it is not even a discussion because it is happening, and it's happening because we have a [labour] shortage,” he said.
“In healthcare right now, we are having conversations with Nigeria, the Philippines and other places to bring in more health workers, because, if we don't have the locals to deal with the demands, we are going to have to bring people in or attract people. That's one form of controlling or influencing the population to match the demands of the system,” he added.
While stressing the need for a more “aggressive policy” to address the country's declining birth and fertility rates, Tufton pointed to the 20-day paternity leave introduced in the public sector in January 2023, which he said could serve as a form of incentive.
He noted, too, the ministry's push to reform primary healthcare.
“It's not really to encourage people to have children, but it is to provide appropriate levels of support for those who choose to, and that could be an incentive also, indirectly,” he said.
In the meantime, the minister lauded the altruism of the Kiwanis Club of New Kingston for upgrading the breastfeeding room at the largest maternity facility in the Caribbean, which recorded 6,018 births in 2023.
The refurbishing included the beautification of the room and the addition of lounge chairs.
“This contribution here, as I understand, will see a significant improvement not just in the look and feel and the comfort level of the facility, but also in terms of the equipment and some of the critical things that are needed – warmers, monitors, … [and] pumps,” Tufton said.
Dr Garth McDonald, senior medical officer at the VJH, told The Gleaner that the hospital has a premature birth rate – babies born before 37 weeks – of 13 per cent. He said this is within the global average of 4-16 per cent.