Gareth Manning, Gleaner Reporter
A representative at the Durex booth shows the proper way to put on a condom during an AIDS Awareness event put on by the National Family Planning Board at the St. Williams Grant Park, downtown, Kingston, earlier this year. Recent research shows that significant numbers of sexually active minors do not use any form of contraceptives. - Rudolph Brown/Chief Photographer
Even as the country continues to battle with what is still a growing HIV/AIDS crisis, health-service providers in most of the public health centres are refusing to give contraceptives to adolescent girls.
The situation has some advocates and health practitioners concerned as it could lead to an increase in the incidence of unwanted pregnancies, and hamper efforts to control the rate of HIV infection among teens.
Data show there is a high rate of HIV infection, particularly among girls 10 to 19 years old, who are three times more likely to be infected than boys their age.
The challenge to access contraceptives is being compounded by what appears to be a conflict between the law and public policy practice. Some health-service providers believe they could be prosecuted for failing to report a suspected case of abuse and for facilitating the abuse of a minor under the Child Care and Protection Act.
Ethical obligation
This is despite a recent policy which dictates to public health-service providers that they have an ethical obligation to provide minors with contraceptives in cases where it is likely they would begin or continue to have sexual intercourse with or without the use of contraception.
These issues are among some of the findings highlighted in a recent study of contraceptive use among a sample of 238 sexually active children ages nine to 17 years old. It was presented at the Caribbean Child Research conference on October 23.
The research, which was conducted by health-policy analyst and doctoral candidate at the University of the West Indies, Mona (UWI), Tazhmoye Crawford, also shows that a number of providers that have been refusing to supply contraceptives to girls on the basis that they are too young, are providing boys with the same service without reservation.
She notes, though, that while some health services did not give contraceptives, some counselled the girls.
President of the Pharmaceutical Society of Jamaica, Norman Dunn, says private pharmacies can do only that.
"For girls 12 and upwards, we counsel them and try to find out: Why do they seek this service? Have you been placed on it before? If you have been placed on it, by whom? If you have never been placed on it before, we normally refer them to their physician," says Dunn.
Need for law
But children advocates are of the view that there needs to be law allowing health-service providers to give contraceptives to minors, as it is a fact that they are having sex.
Attorney-at-law and chairman of the Jamaica Coalition on the Rights of the Child, Margarette Macaulay, says there is a government policy in place which allows health professionals to give contraceptives to minors without the knowledge or consent of parents.
"We all have to accept that underage girls and boys are engaging in sexual contact and, if they are, despite what everyone can do to try to convince them to abstain, we still have to protect them because they are vulnerable," Macaulay argues.
But, she says, despite common law and policy, there are health-care providers that are are refusing girls contraceptive services because of their personal convictions.
"I think it's not necessarily that they are worried about the law; I think it's their own personal reaction, because when I talk to groups about the issue, when it is brought up, the reaction is against the Cabinet policy by and large," she states. "[But] If they are engaging in sex, we have to protect them, otherwise they will get AIDS or get pregnant and other sorts of things," Macaulay adds.
While her offices have never received complaints of girls being denied access to contraceptives, Children's Advocate, Mary Clarke, states that, except in certain circumstances, professionals are expected to act in the best interest of the child and not withhold services.
"The policy has parameters and it states clearly where confidentiality must be breached as in the cases of sexually transmitted disease, pregnancy, sexual violence. The health professional should inform the individual that he intends to disclose the information and the consequences of such disclosure," Clarke says. The Gleaner has been informed that the Ministry of Health is currently working on legislation to address the issue.
gareth.manning@gleaner jm.com.
