Not so easy!

Barbados’ ageing population and declining birth rate cannot be tackled simply by asking people to have more children. 

This is according to executive director of the Barbados Family Planning Association (BFPA), Anderson Langdon, who said the issue runs much deeper than choice.

He said the rising incidents of sexually-transmitted infections (STIs) and non-communicable diseases (NCDs), as well as increased cost of living, are all major factors that have contributed to the declining birth rates over the years. 

Langdon stressed that Government and wider society needs to address these challenges first if there is to be change in the current demographic trends.  

He told the nation team this was a reality which the BFPA had foreseen for some time and, as a result, had shifted its services to include components such as fertility treatment.  

“We have an unhealthy population when it comes to the things that create better fertility.
There are many countries that have low birth rates which have low fertility rates, but a lot of them
do not have the health challenges that we know impact fertility. If we had less diabetes, if we had less STIs, if we had better decision-making when it came to sexual health, the challenges that impact fertility we would not have. We do not talk about the genetic predispositions to lack of fertility that are also impacting Barbados,” Langdon said.

According to the World Health Organisation, NCDs are the leading causes of ill health among women of reproductive age and an increasingly important cause of maternal morbidity and mortality worldwide. The US Centers for Disease Control and Prevention lists chlamydia and gonorrhea as “important preventable causes of pelvic inflammatory disease (PID) and infertility. Untreated, about 10-15 per cent of women with chlamydia will develop PID. Chlamydia can also cause fallopian tube infection without any symptoms”.

According to the most recent statistics from the Ministry of Health, in 2021 the Best dos-Santos Public Health Laboratory performed chlamydia trachomatis (CT) and neisseria gonorrhea (NG) testing on 1 152 urine samples. There were 21 positive NG cases resulting in a 1.8 per cent positivity rate, while the 131 positive cases for CT resulted in an 11.4 per cent positivity rate. 

The median age of NG cases was 23 years, with most cases occurring between the ages of 15 and 29 years (71.4 per cent). The median age of CT cases was 23 years, with most cases between 20 and 34 years (72.5 per cent). The rates of CT were highest among the 20-24 age group (39.7 per cent). Similarly, the rates of NG were highest among the 20-24 age group (42.9 per cent). 

A greater proportion of females tested positive for both CT and NG (79.4 per cent and 61.9 per cent, respectively).

Barbados’ NCD statistics paint a much grimmer picture, with eight out of ten deaths recorded in this country due to NCDs.

The BFPA director continued: “Fertility is also not just the rate, but also the ability and the environment to have children. We must create an environment that would encourage people to want to have children. People are not saying that they do not want to have children because of illness or disability. Instead, they do not want to have children because of the high cost of living. They do not want to bring a child into this world if they cannot afford and give it all that it needs.” 

Referencing the just completed census, Prime Minister Mia Amor Mottley informed the country in her Budget speech last week that one in four Barbadians was over the age of 60, and one in five over 65. Driving home the gravity of the situation, she disclosed that with death rates significantly outstripping the birth rates, in 25 years’ time, 50 per cent of the population will be over 60.  

Langdon said that contrary to some beliefs in the public, research continues to show that access to family planning, including contraception, plays a critical role in reducing the challenges that impact fertility. He made it clear that the BFPA remains focused on quality of family. 

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