By Laila Azzeh

AMMAN – If the total fertility rate (TFR) remains unchanged, Jordan’s population will double in about 30 years, placing more pressure on the environment, food, water, housing, health, education and employment services, experts say.

The current fertility rate is the same it has been since 2002, standing at an average of 3.8 children during the lifetime of a woman, according to Higher Population Council figures.

The demographic opportunity – the stage in the country’s development at which the ratio of dependents to workers is lowest – could be jeopardised if the trend continues, as social, economic and demographic advantages cannot be seized to reach prosperity, said Higher Population Council (HPC) Secretary General Raeda Qutob.

The council announced on Sunday that it was launching two policies: “The impact of changing the contraceptive method mix on Jordan’s TFR” and “Reducing discontinuation of contraceptive use and unmet need for family planning”.

“When a woman discontinues using family planning methods, even for a brief period, she may become pregnant unintentionally. Similarly, when a woman wants to limit or space births without using contraceptives, the risk of unplanned pregnancy becomes higher,” Qutob highlighted, noting that unintended pregnancies contribute to the high rates of fertility.

“Reducing the use of traditional methods by 50 per cent would contribute to a significant reduction in unplanned pregnancies, from 83,000 to 50,000,” said Qutob, stressing that policies recommend increasing access to family planning services and reducing the discontinuation rates, among other suggestions.

The secretary general indicated that, for example, 50 per cent of women stop taking contraceptive pills after one year of using them due to health concerns, lack of effective counselling and of health experts acceptable to women, who in their majority prefer to receive such services by female practitioners.

However, women health experts do not seem easy to come by or if they are, they are often found lacking the skills to tackle the issue.

“Jordan has a limited number of female physicians, and most are based in urban areas… Many female physicians are not trained to insert intrauterine devices (IUDs),” Qutob said, adding that researchers found that a 10 per cent increase in contraceptive prevalence is associated with a decline of 0.7 births per woman.

A council study shows that there were approximately 326 women physicians working in the private sector in 2009, 106 at the health ministry and 21 at the Jordan Association for Family Planning and Protection.

That is not enough to deal with the issue at hand.

Contraceptives are free of charge at the health ministry, which should make it convenient for families to control birth rates. However, it was found that more than one-third of the women who discontinued contraceptive use did so because they wanted to become pregnant.

The aim of the two policies above is to acquaint policy makers and concerned authorities with challenges facing family planning and reproductive health programmes in order to better direct programmes and initiatives to achieve the demographic opportunity.

HPC studies show that health providers are the primary source of information on reproductive health, followed by television, publications, family and friends; 24 per cent of gynaecologists believe that general practitioners should not provide family planning services.

Studies also indicate that 55 per cent of gynaecologists disapprove of trained midwives inserting IUDs.