Population and development CARICOM component

Evaluation covered the period 1982-1/88 and was based on document review and interviews with project and private sector personnel and staff from the National Population Task Forces (NPTF"s) created by CARICOM to formulate national population policies. Between 1980 and 1985, fertility rates declined drastically in the region as a whole (more modestly in Grenada and St. Lucia) and teenage fertility rates declined some 20%. These declines were largely due to the provision of contraceptives under another project component, although CARICOM"s consciousness-raising efforts with leaders proved helpful. All 9 participating countries formulated draft population policies; these have been adopted by Cabinets in 3 countries, although additional funding may be needed to set up the organizationl machinery needed to implement them. The policies have not been presented to Cabinets in the remaining 6 countries for various reasons, e.g., changes in and inaction by senior officials in the Ministries of Health (MOH"s) and governmental reluctance to establish an explicit population policy. The goal of formulating and disseminating medical policy and protocols for contraceptive services was largely unmet. Formal family planning (FP) policies and protocols are essentially nonexistent in the region, except in St. Vincent, and even there there is room for improvement. The draft medical policy on contraceptive services produced by CARICOM was more a reference than a policy document, was poorly organized, too narrow in focus, and failed to consider medical protocols. Monserrat is the only participating territory that developed a medical policy document out of its seminar discussions. In the absence of such a policy, medical staff are guided by personal and environmental factors - to the potential detriment of project efforts to expand FP services. Several lessons were learned. (1) Being placed under the MOH"s tended to isolate the NPTF"s from the mainstream of national planning; further, the lack of planners in the NPTF"s hampered the adoption of national policies and the development of sound population planning. (2) Critical population-related problems (e.g., continuing high un-/underemployment) remain to be resolved; these may best be addressed by a regional approach through CARICOM. (3) Project design made no provision for a full-time manager nor a full-time consultant for the medical policy component.