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Reproductive Health Survey Reproductive Health Survey Jamaica 1997 Final Report National Family Planning Board February 1999 REPRODUCTIVE HEALTH SURVEY 1997 JAMAICA FINAL REPORT Carmen P. McFarlane, M.Sc. (Econ.) Jay S. Friedman, M.A. Howard I. Goldberg, Ph. D. Leo Morris, Ph.D., M.P.H. NATIONAL FAMILY PLANNING BOARD February, 1999 PRINTED BY: U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Disease Control & Prevention Atlanta, Georgia 30333 PREFACE The 1997 Reproductive Health Survey (RPS) is the sixth in a series of periodic enquiries conducted for the National Family Planning Board (NFPB) into measures of fertility, contraception and other reproductive health issues among women in the reproductive age group and young adults males. The findings are used to monitor and evaluate the effectiveness of the various interventions, which are aimed at achieving the overall goal and objectives of the national programme. It was previously called the Contraceptive Prevalence Survey (CPS) and covered a wide range of issues mainly related to family planning. With the recognition at the 1994 International Conference on Population and Development (ICPD) in Cairo that family planning is the single most important intervention in achieving reproductive health goals, it has been renamed the Reproductive Health Survey. In order to provide reproductive health services to young adults 15-24 years old, a young adult module was also included. Additional questions have been explored in the survey as they related to pap smears and breast self-examination. The findings will presented in two publications as final reports, a General Report and a Young Adult Report. We acknowledge the financial support of the United States Agency For International Development (USAID) as well as the technical support of the Division of Reproductive Health, Centers for Disease Control and Prevention (CDC) and McFarlane Consultants Ltd. in all aspects of the survey, the Statistical Institute of Jamaica (STATIN) for field work and data entry and the Population Reference Bureau for the development of a Summary Chartbook on the findings of the survey. We especially thank the Six Thousand Three Hundred and Eighty Four (6384) women and the Two Thousand Two Hundred and Seventy Nine (2279) young men who agreed to be interviewed and invited our interviewers into their homes. Beryl Chevannes (Mrs) National Family Planning Board i ACKNOWLEDGMENTS The NFPB also wishes to acknowledge the support of the following organizations and individuals who made important contributions to the development, implementation and finalization of this report. United States Agency For International Development, Kingston Dr. John Swallow, Director, Office of General Development Mrs. Grace-Ann Grey, Programme Specialist, Office of General Development Centers For Disease Control And Prevention, Atlanta Mr. Jay Friedman, Programme Analyst, Division of Reproductive Health Dr. Howard Goldberg, Deputy Chief, Division of Reproductive Health Dr. Leo Morris, Chief, Division of Reproductive Health Ms. Rebecca Amerson, Systems Analyst, Division of Reproductive Health McFarlane Consultants Mrs. Carmen McFarlane, Project Director National Family Planning Board Dr. Olivia McDonald, Medical Director Mrs. Ellen Radlein, Director Projects, Research And Statistics Mrs. Eugenia McFarquhar, Family Planning Coordinator Mrs. Janet Davis, Director, Information, Education and Communication Mrs. Jasmin Gissiawan, Regional Liaison Officer Mr. Martin Campbell, Parish Liaison Officer Mr. Neville Parkins, Regional Liaison Officer Statistical Institute Of Jamaica Mr. Vernon James, Executive Director Ms. Isbeth Bernard, Director. Division Of Surveys Mrs. Merville Anderson, Deputy Director, Division Of Census And Related Studies Mrs. Valerie Nam, Director, Division Of Census And Related Studies Ms. Day Dawn Simon, Deputy Director. Division Of Surveys Mrs. Donneth Edmondson, Systems Analyst Mr. Martin Brown, Senior Statistician, Division Of Surveys Mr. Hubert Sherrard, Senior Statistician Mrs. Sophia Bucknor, Statistician Ms. Juliet McCalla, Statistician Mrs. Phyllis Wilks, Statistician ii Ministry Of Health Dr. Eva Fuller, Principal Medical Officer, Primary Health Care Dr. Deanna Ashley, Principal Medical Officer, Secondary Health Care University Of The West Indies Dr. Affette McCaw-Binns, Department Of Community Health Population Reference Bureau, Washington Mr. Carl Haub, Demographer Ms. Julia Beamish, Health Communications Specialist iii iv CONTENTS Page No. PREFACE i ACKNOWLEDGMENTS ii TABLE OF CONTENTS iv LIST OF TABLES AND FIGURES viii EXECUTIVE SUMMARY 1 CHAPTER 1 - BACKGROUND 9 l.A Historical, Geographical, Demographic and Social Background 9 1.B Population Policies and Programmes 11 l.C Objectives of the 1997 JRHS 14 l.D Users of the Data 15 1.E Coverage of the 1997 JRHS 15 l.F Administration of the Survey 16 l.G The Sample Design 16 l.H Questionnaire Design and Development 17 1.I Recruitment and Training 18 l.J Field Work 19 l.K Response Rates 19 CHAPTER 2 - CHARACTERISTICS OF THE SURVEY POPULATION 21 2.A General 21 2.B Age Distribution of the Survey Population 21 2.C Marital and Union Status 21 2.D Educational Level 24 2.E Employment Status 24 2.F Religion 25 2.G Children Ever Born 26 2.H Socio Economic Index 26 CHAPTER 3 - FERTILITY AND FERTILITY-RELATED FACTORS 27 3.A Age At Menarche And Sexual Experience 27 3.B Breast-Feeding and Postpartum Insusceptibility 28 3.C Current Sexual Activity 29 3.D Fertility Rates 30 3.E Planning Status of Last Pregnancy 31 v Page No. CHAPTER 4 - REPRODUCTIVE HEALTH 33 4.A Maternal Health and Child Care 33 4.B Cancer Screening 37 4.C Forced Sexual Intercourse 38 CHAPTER 5 - CONTRACEPTIVE KNOWLEDGE 39 5.A Knowledge of Contraceptive Methods 39 5.B Opinions on Sexuality, Pregnancy and Attitudes to Life 40 CHAPTER 6 - CONTRACEPTIVE USAGE 43 6.A Ever Use of Contraceptives 43 6.B Initial Use Of Contraceptives 44 6.B Current Use of Contraceptives 44 6.C Source of Contraception 49 CHAPTER 7 - HORMONAL CONTRACEPTIVE USE 51 7.A Pill Use 51 7.B Injection Use 53 CHAPTER 8 - CONDOM USE 55 8.A Condom Use 55 8.B Reasons for Condom Use 56 8.C Effectiveness of Condoms: Respondent's Perception 57 CHAPTER 9 - STERILIZATION - USE AND DEMAND 59 9.A Use of Sterilization 59 9.B Satisfaction with Sterilization 59 9.C Demand for Sterilization 60 9.D Reasons for Non Sterilization 60 CHAPTER 10 - NON USE OF CONTRACEPTIVES 63 10.A Discontinuation Rates 63 10.B Reason for Not Using a Contraceptive Method 63 10.C Need for Family Planning Services 64 vi Page No. CHAPTER 11 - YOUNG ADULTS 67 11.A General 67 11.B Socio Demographic Characteristics 67 11.C Exposure to Family Life / Sex Education 67 11.D Exposure to Sexual Activity 68 11.E Contraceptive Use at First Intercourse 69 11.F Source of Condoms 69 11.G Reasons for Not Using Contraception at First Intercourse 70 REFERENCES 71 TABLES AND FIGURES APPENDIX I: SAMPLING ERROR ESTIMATES APPENDIX II: COMMENTS MADE AT NATIONAL DISSEMINATION SEMINAR APPENDIX III: QUESTIONNAIRES A. Household Questionnaire - Female (Form RHS 1 A) B. Individual Questionnaire - Female (Form RHS 2) C. Household Questionnaire - Male (Form RHS 1B) D. Individual Questionnaire - Male (Form RHS 3) vii LIST OF TABLES AND FIGURES 1.1 Household And Individual Interview Status Women Aged 15-49 And Men Aged 15-24 2.1 Age Distribution Of Women 15-49 By Five-Year Age Group, Compared With 1989, 1993 CPSs And 1987, 1992, 1996 STATIN Estimates 2.2 Union Status Of Women 15-49 Years of Age By 5-Year Age Group 2.3 Selected Socio-Demographic Characteristics Of Women 15-49 Years of Age, By 5-Year Age Group 3.1 Mean Age At First Menstrual Period Women Aged 15 to 49, By Selected Characteristics Compared With The 1993 and 1989 Contraceptive Prevalence Surveys 3.2 Percent Of Women Aged 15-49 Who Have Ever Had Sexual Relations, By Age And Church Attendance, Compared To 1993 CPS 3.3 Percent Of Young Adult Men Aged 15-24 Who Have Ever Had Sexual Relations, By Age And Church Attendance, Compared To 1993 CPS 3.4 Percent Of Women 15-49 Who Had Their First Sexual Relation And Their First Birth Before Selected Ages And Median Age At First Sexual Relation And First Birth, By Current Age Group 3.5 Percent Of Women 15-49 Who Breast-Fed Their Last Child And The Mean Duration Of That Breast-Feeding, By Selected Characteristics. Women 15-49 Who Had A Birth Within 5 Years Of Their Interview 3.6 Percent Of Women 15-49 Who Had A Birth In The 24 Months Prior To The Survey Who: 1. Are Still Breast-Feeding; 2. Are Post-Partum Amenorrheic; 3. Have Not Resumed Sexual Intercourse; 4. Are Post- Partum Insusceptible. By Number Of Months Since Last Birth. 3.7 Percent Of Women 15-49 Who Had A Birth In The 24 Months Prior To The Survey Who: 1. Are Still Breast-Feeding; 2. Are Post-Partum Amenorrheic; 3. Have Not Resumed Sexual Intercourse; 4. Are Post- Partum Insusceptible. By Selected Characteristics. 3.8 Respondents' Opinion Of Ideal Breast-Feeding Duration, By Selected Characteristics. Women Aged 15-49 3.9 Percent Of Women 15-49 Who Are Currently Sexually Active, By Current Relationship Status 3.10 Relationship With Last Sexual Partner, By Current Relationship Status Women Aged 15-24 Who Are Sexually Active. viii 3.11 Of Women 15-49 Who Are Not Currently Sexually Active, The Percentage Who Have Had Sexual Intercourse In The Past Three Months By Relationship Status. 3.12 Percent Of Young Adult Men Who Are Sexually Active, By Current Relationship Status. 3.13 Relationship With Last Sexual Partner, By Current Relationship Status Young Adult Men Aged 15-24 Who Are Sexually Active. 3.14 Age-Specific Fertility Rates And Total Fertility Rate (TFR) Jamaica, By Maternal Age, Compared With 1975 Fertility Survey, 1983 JCPS, 1989 JCPS, 1993 JCPS Fig.
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