Status of Women Health In Belize

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Status of Women Health In Belize
 

– Reported, February 11, 2012

 

According to a BFLA Family Health Survey, the mean age of Belizean females for first sexual intercourse is 18 years. However, for women aged 15 to 19 the mean is 16 years, while for women 40 to 44 years it is 18. The age at first sexual intercourse varies by ethnic group; Mestizo women having the highest mean age, 18 years. Overall, 18% of women had their first sexual intercourse while still in school, the rate being higher among rural women. However, for most (96%) their first sexual intercourse was on a consensual basis, as well as to use a contraceptive, 61%. Only 17% of women had used a contraceptive during their first intercourse, and of these, 63% of their partners used a condom” (BFLA, 2000, p. 4). What is noteworthy about this fact is that, “while 77% used a contraceptive to avoid pregnancy, only 2% used it as a measure against HIV infection and 21% used it for both reasons” (BFLA, 2000, p. 3-4).
Married, fecund women had high contraceptive use. Their methods of contraceptive choice in descending order are orals, injectables, condoms and Rhythm/Billings method. During the survey, 15% of women needed family planning services. Many of these women had little education and had four or more children (BFLA, 2000). Almost all women between the ages of 13 and 34 found it acceptable to educate on the topics of human reproduction, contraception and sexually transmitted infections including HIV/AIDS. The preference of 75% of the women was that these topics be taught to children from 10-14 years of age. Most of the women indicated that they had learned about pregnancy from their parents/guardian, but did not receive birth control information from the same source. Most received information from BFLA and knew that it was the place to go for such instruction (BFLA, 2000).
The Total Fertility Rate (TFR) calculated from the survey is 3.7, which is much lower than that of 4.5 reported in 1991. The TFR is the average number of births a woman is likely to have during her lifetime. The TFR for urban women is much lower (3.1) than that of rural women (4.2). The TFR is highest in Toledo (5.6) and Stann Creek Districts (5.2) and lowest in Belize District (3.0). As expected, TFR decreases with education, being 2.73 for women with 9+ years of education. A low rate of fertility was experienced by Catholics (3.85) (BFLA, 2000, p. 4).

Forty-two percent of the women had at least one pregnancy in the five years prior to their interview; 72% of those had planned their last pregnancy. To the majority of women (56%), family planning means “planning the number of children.” Seventy two percent feel that a woman’s “financial situation” is the main reason for limiting the number of children she should have. While 69% of all women feel the woman has the right to decide about her pregnancy, only 45% of Maya women agree. A high proportion of women (44%) agree with abortion for “health reasons of the mother” or “because of rape” (37%). The decision-making process can be of significant importance in a relationship, and it is worth noting that 80% of the women feel that both partners should decide on the number of children they should have – 22% more than in 1991. The increase was even higher among urban women. The desire for greater cooperation is also seen when 80% of the women feel that both partners should decide on contraceptive use (BFLA, 2000, p. 4-5).

Knowledge about contraceptives is high, ranging from 92% (oral contraceptives) to 11% (Billings method). There is a direct correlation between knowledge level and education received. Urban women aged 35-39 years use contraceptives at a 70% rate. The lowest rate is among adolescents at 37%. Abortion is illegal in Belize unless two physicians concur that it may be done if the mother’s life is in great jeopardy. According to a website for historical abortion statistics for Belize, in the year 1996 there were 2,603 legal abortions performed (Johnston, 2004). That same year there were 6,678 births in the country. That seems to indicate a very high number of women whose lives were in “serious jeopardy.” According to Klima (2002), out of 441 admissions to Belize City Hospital in 1995, one third were spontaneous abortions and two thirds were from complications of self-induced or illegal abortions (Esquivel, 1997, p. 46). Abortion has been linked to infertility as well as future ectopic pregnancies. These illegal abortions usually involve the insertion of a catheter into the uterus resulting in infection and abortion. Many of these women come to the hospital hemorrhaging, and the abortion is completed there. The authors did not find any deaths reported from septic abortions, but those numbers may be hidden due to inaccurate reporting of the cause of death.

Commercial sex is a reality in Belize. The sex worker population seems to be comprised of women trafficked into Belize from Honduras or Guatemala as well as native Belizean women. Prostitutes ply their trade in brothels or by free-lancing. There is a great deal of variability in the use of protection by these women. Those in brothels tended to receive more frequent routine medical care and were more likely to use contraceptives (Cameron, 1997; International Women’s Rights Watch, 2003).
The International Women’s Rights Watch (2003) reported that many women are enticed into the country by men who promise work as dancers in “dance halls,” as housekeepers or waitresses. These women usually enter the country illegally and upon their arrival, the men take their passports, put them to work prostituting, and hold their wages. Belize has no specific legislation prohibiting prostitution or the exploitation of prostitutes. Prostitution is defined as a petty crime, and the sex worker is routinely penalized while her client goes free.

Violence Against Women
One of the “official” persons interviewed in Belize was the social worker at the Women’s Center in Belize City. The Women’s Department operates under the auspices of the Belize Ministry of Human Development, Women, and Civil Society, and focuses on four major areas: education on issues of interest to women; training so that women may enter the workforce (remedial math and English, home economics, garment construction, computer literacy, and personal development); community development; and policy development. They have offices in six of the largest cities in Belize. The social worker indicated that violence against women is definitely a problem in Belize. The government has attempted to educate people that family violence may involve more than just women. So far, the Women’s Department and the Ministry of Health have created a form for data collection, and have been trying to instruct police, health workers, and other service workers on using the form appropriately so that accurate statistics can be gathered. At this writing, the form has been in use for about four years and has only produced statistics from 2000 through 2001. In 2001, there were 688 total incidents of intimate partner violence (IPV) reported: 616 were women, 72 were men. The age group most affected was 15-44 years, the same as the childbearing years. Seventy percent of incidents were urban, 30%, rural. IPV per ethnic group is as follows: Mestizo, 37%; Creole, 41%; Garifuna, 7%; Maya, 3%; East Indian, 6%; Ketchi, 1%; Chinese, 0%; Other, 4%, Unknown, 1% (Women’s Department, 2003).
The highest incidence of IPV was in the age group between 25 and 29. Five hundred fifty-eight of these women were within the reproductive age group. For women, 455 cases were of physical violence, 348 were psychological abuse, 56 were sexual abuse, and 143 were classified as “other.” The frequency of IPV between common-law couples was 41% (283), between married couples, 36% (248), and 11.6% (80) between ex-spouses. Other abusers were identified as caregivers, fathers, mothers, siblings, others, and unknown. Six hundred three were male aggressors, 76 were female aggressors, and nine were unknown. Two hundred twenty-nine of the 688 batterings were repeated (Women’s Department, 2003).

The social worker at the Women’s Center can only refer women to available services. People are referred for medical care, social services, police protection, public health nurses and psychiatric nurse practitioners, and to family court. The social worker said there is a deep stigma in Belize attached to going to a “counselor” as that indicates you are mentally ill. Therefore, she never uses the word “counselor,” but attempts to make decisions that include adequate treatment. She can also refer women to Haven House (the country’s only domestic violence shelter) in Belize City. If necessary the woman and her children can stay at Haven House up to six months with government subsidization of their stay. The sheltered women at Haven House receive whatever services they need to empower them to live independently if that is their desire. Many women do not want to leave their abusive partners, only to end the abuse.

The social worker commented that the reported annual rate of abuse in 2001 is much lower than the rate of actual abuse. Part of the problem lies in the proper use of reportage forms. The social worker also feels that health workers treat women and send them home without adequate investigation of the situation. It is clear that intensive, ongoing education is necessary to enable health workers to understand and be able to assess victims of abuse. The country as a whole has an “Integrated Model of Care for Family Violence.” Belize was one of several countries in which a fair amount of research was performed in an effort to determine how communities wanted to handle domestic violence.

There are 102 males for every 100 females . After age 65, the male to female ratio shifts to a slightly higher population of women. Age distribution of the population shows that it is quite young. The median age is 18.9 years, approximately 42% of the population is under age 15, and 60% is under age 25, with similar proportions of women and men.
Appendices D and E are a compilation of other demographic indicators. With an infant mortality rate of 27.07/1,000 live births , Belize ranks 99th in the world. The reported total fertility rate is 3.86 children born/woman . Also noteworthy is the maternal mortality rate of 110.6/100,000 live births. Maternal mortality is difficult to assess in Belize due to its size. Internationally, maternal mortality is computed using 100,000 live births as the denominator, however, as Belize does not have that many births per year, maternal mortality statistics are commonly estimated. In 2001, the maternal mortality rate was reported as 139/1,000 live births.

Credits: Carrol A. M. Smith and Carrie Klima

More Information at:
http://www.uic.edu/nursing/ghlo/forms/ACountryReportonWomen’sHealthinBelizeFINAL2.doc.

 

 

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