Discussion taking place at the Clinton Global Iniative.

PM Harris presents CARICOM’s concerns

An analysis of adolescent sexual and reproductive health and rights should play a key role in assessing the needs of Caribbean countries Dr. the Honourable Timothy Harris, Prime Minister of St. Kitts and Nevis and CARICOM Lead Head for Human Resources, Health and HIV told a group organized by the Clinton Global Initiative (CGI) on Sept. 21. The group was part of a three-day CGI 2016 Annual Meeting in New York City.

Dr. Harris told a CGI-group discussion titled “Combating Teen Pregnancy, Cervical Cancer, and HIV in Caribbean Girls and Women” that this type of analysis is necessary to reduce the gender gap and ensure that adolescents are not left behind.

The Clinton Foundation’s goals during the conference were to 1) Discuss how to support CGI commitment-makers working on girls’ and women’s health in the Caribbean through financial resources and supplies, commodities, and pharmaceuticals; Explore technical expertise that can benefit government, policy, pilot implementation, and scaling across the Caribbean; and to examine culturally relevant media and communications strategies, which are important vehicles for educating parents and young people about the benefits of both prevention and care seeking.

Dr. Harris commended the CGI for its concentration on Caribbean nations concerns and outlined the overreaching and compounding context of its commitment, including:

  • A legal gap analysis of adolescent sexual and reproductive health and rights illustrating that the minimum age for marriage varies greatly among countries and that while the legal age of consent ranges from 12 to 16 years, parental consent is required for accessing reproductive health services and commodities for those less than 18 years.
  • Sexual abuse is widespread throughout the Caribbean and affects many adolescent girls and boys. While not all sexual intercourse is forced, the Caribbean region has a high rate of forced sexual debut affecting 38% of adolescents (32% male and 48% female), with those younger than 12 years-old at higher risk of forced sexual debut (43 percent) than those between 13-15 (38 percent) and 16-18 years old (37 percent). Children and adolescents could be victims of different forms of sexual abuse. Most perpetrators are known to victims; they are frequently trusted caregivers (e.g. fathers, stepfathers, relatives, friend, and neighbours) who take advantage of their position. Regional evidence highlights the high levels of incest and intra-familiar sexual abuse in Caribbean countries.
  • In these circumstances the major point of concern in many Caribbean countries is that 20-25 percent of households are female-headed and where a father figure is absent.
  • CARICOM has established Health and Family Life Education (HFLE) as a vehicle through which comprehensive sexual education is delivered in the Caribbean. The aim of HFLE is to empower adolescents both in and out of school with knowledge and skills to make more informed choices about their health and wellness, inclusive of their sexual well-being. Yet there is resistance even to age appropriate sexual education and ambivalence and lack of aptitude by teachers and guidance counselors.
  • Many of the policies for the reduction of teenage pregnancy have focused on changing the behaviour of the girl and not addressing the underlying determinants – child marriage, gender inequality, poverty, sexual violence and coercion, lack of education and lack of access to reproductive health services.
  • Adolescent pregnancies in the poorest 20 percent of Caribbean populations are likely to be 4.8 times more births than the richest 20 percent.
  • The high level of cervical cancer is partly related to lack of information, lack of early detection and treatment.
  • It is also important to point out that WHO and UNICEF studies 2000-2011 show that that the involvement of older men with younger girls was considered to be widespread and even acceptable. They also show that 32 percent of adolescent boys 10-15 years were forced or coerced into their first sexual experience by older females and have been categorized as the “silent emergency.”
  • Both forms of abuse could be detrimental to the total development of the adolescent which includes social, academic, spiritual and by extension implications for the region’s economic growth.

“Some of the outcomes that this commitment will hopefully achieve may be guided by the recommendations of a 2014 CARICOM-UNFPA consultation on teenage pregnancy and related issues,” Dr. Harris said. “They provide a useful template for shaping the expected results of Every Caribbean Girl Every Caribbean Woman that by 2019 the region will:

  • Reduce the number of adolescent pregnancies in each country by at least 20 percent
  • Achieve universal access of adolescents to age appropriate accurate information as well as access to quality sexual and reproductive health services and commodities
  • Implement age appropriate gender and culturally sensitive comprehensive sexuality education at all levels of the education system including early childhood through the national Health and Family Life Education (HFLE) curriculum and the informal education modalities for those adolescents not in school.
  • Adapt Legal and Social protection mechanisms for the prevention of all forms of violence against adolescent girls.
  • Demonstrate that solutions to women’s health, especially with respect to cervical cancer, rest on an effective integrated health system with emphasis on early detection, “test and treat”
  • Apply legal standards that comply with international obligations including the Convention on the Rights of the Child (CRC) and the Convention on the Discrimination against Women (CEDAW).

Other speakers at the event were Her Excellency Sandra Granger, Guyana’s First Lady; Senator the Honourable Kamina Johnson Smith, Jamaica’s Minister of Foreign Affairs and Foreign Trade; Babatunde Osotimehin, Executive Director of the United Nations Population Fund; and the Right Honourable Patricia Scotland QC, the Commonwealth Secretary-General.  The chairperson was Dr. Edward Greene, the United Nations Secretary-General’s Special Envoy for HIV/AIDS in the Caribbean.