Consider provision before population

THE EDITOR, Madam:

As Jamaica grapples with declining birth rates, calls for women to have more children have grown increasingly urgent. On October 16, 2024, The Gleaner reported Health Minister Dr Christopher Tufton’s encouragement for women to have more children, a call revisited in May and July 2026.

Fertility rates have fallen below the replacement level of approximately 2.1 children per woman. When this persists, the population gradually becomes older, leaving proportionately fewer working-age individuals to support an increasingly elderly population. I understand the encouragement to have more children but, are our maternity services equipped for more births?

Wards are already overcrowded, and patients may be transferred between under-resourced facilities. Even basic necessities such as blood pressure machines and blood tubes are often lacking. In May 2026, the Ministry of Health and Wellness acknowledged shortages of specialist nurses, doctors, and allied health professionals.

How can we encourage women to have more children without ensuring that the systems entrusted with their care are equipped to do so?

Beyond the hospital, families face difficult calculations. Can I afford another child? Food, transportation, school, and housing? What if that child becomes ill? What if I become ill? These questions do not mean that Jamaicans value children or family less. They reflect economic reality. Family size cannot be separated from the cost of raising a family.

The biblical account of Creation offers a relevant principle. God did not create Adam and Eve first and then wonder where to put them. He first prepared an environment capable of sustaining life; then came humanity. Whatever one’s religious beliefs, there is wisdom in that sequence: provision preceded population.

Give mothers a healthcare system capable of safely receiving them. Give families confidence that they can feed, house, educate, and care for their children.

Provision before population is a fertility strategy worth considering.

LASONYA FLETCHER

THOMPSON

Black River, St Elizabeth