Jamaica is currently working towards achieving the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Jamaica should reduce underfive deaths per 1,000 live births to ten, and increase measles immunisation to 100 per cent by 2015. The country has shown continued improvement both of these factors since 1990. In 2012 under-five mortality was approximately 17 deaths per 1,000 live births and measles immunisation is 93 per cent, which suggests that with good progress the country could achieve these targets by 2015.
While civil society recognises that there has been a marked improvement in immunisation levels and child mortality rates, reduced financing in the public health system will be one of the factors preventing Jamaica from meeting its MDG 4 target on time.
However, the work done towards the Millennium Development Goals to date has helped to establish a good platform from which a post-2015 agenda may be developed.
The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by three quarters between 1990 and 2015. When applying this target to Jamaica, maternal mortality should fall to 15 cases per 100,000 live births. In the period 2007-11 Jamaica reported a maternal mortality ratio of 95 deaths per 100,000 live births (this figure was estimated at 110 deaths per 100,000 by UN agencies/World Bank in 2010). Jamaica’s maternal mortality rate is more than six times the target figure set by MDG 5, so this part of the goal is unlikely to be achieved by 2015. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional.
In the period 2007-12 this figure stood at 98 per cent, suggesting that such a target is achievable.
There has been strong collaboration between the government and civil society organisations in the area of maternal health. Despite this, MDG 5 remains off target. Problem areas highlighted as preventing the target from being reached include the rise of NCDs, the migration of skilled health workers and the impact that poverty has on diet. As a step towards combatting these issues, user fees for public hospitals were abolished in 2010, improving access to health care.
MDG 6 aims for a reduction in the prevalence of HIV, malaria and other diseases. Jamaica’s HIV prevalence has fallen since 2000 but is still above 1990 levels. Since 1990, there has been a significant reduction in estimated tuberculosis (TB) mortality (when mortality data excludes cases co-morbid with HIV) but a rise in incidences (when data includes cases co-morbid with HIV). Improvement in these indicators is required if the country is to make significant progress towards MDG 6.
The post-2015 development agenda for Jamaica will focus on addressing NCDs, paying particular attention to obesity, diabetes and hypertension. While there have been significant gains in the area of HIV/AIDS, civil society organisations believe that declining investment in treatment measures and a lack of appropriate medication stand to threaten these gains. The stigma surrounding HIV/AIDS remains a serious issue that calls for a shift of cultural norms and the development of tolerance. There has been a rise in HIV infection rates among young women aged ten to 19 years, which civil society organisations believe has led to an increase in violence against women and girls. Cases of domestic violence are increasing in number, with childhood and intimate partner violence having increased by 28 per cent in the period 2010-12. Victims have been reluctant to report abuse due to the fear of being ostracised and intervention strategies are poor.
