Dr. Stewart McKoy has dedicated his life to ensuring the needs of both men and women are equally represented in the provision of healthcare at the Jamaica Family Planning Association (JFPA). When Dr. McKoy returned to Jamaica from overseas medical studies in the 1980s, the frustration at the failure of many Jamaican males to use contraception was a continuing concern. This led to him making a strong case for vasectomies to be offered as part of JFPA’s contraceptive options. Whilst the initial response from local males was disheartening, Dr. McKoy took the grassroots approach to get the buy-in of males to consider contraception use. Getting men on board “Someone once said it’s only by varied reiteration that unfamiliar truths can be introduced to reluctant minds. We used to go out into the countryside and give talks. In those times, I came down heavily on men. I remember after one talk, when I was finished, the driver of the JFPA van said they [men] didn’t like what I was saying. I saw a bar outside and went, carried them in, and said drinks on me. By the second round they opened up and were receptive,” he said. The reception would form the catalyst he needed to ensure that men, too, benefitted from sexual and reproductive healthcare. Men were choosing vasectomies if they already had children and didn’t plan to have any more. In addition, Dr. McKoy was an instrumental voice in the Men’s Clinic that was formerly operated by JFPA and also encouraged the inclusion of women at the meetings, in order to increase male participation and uptake of healthcare. “When we as men get sick with our prostate it is women who are going to look after us. But we have to put interest in our own self to offset it before it puts us in that situation where we can’t help yourself. It came down to that and the males eventually started coming. The health education got out and men started confiding more in health services,” he said.   It could be a matter of life or death McKoy said it is important that women use contraception and take their sexual and reproductive health seriously. If neglected, Dr McKoy said it could be a matter of life or death. He refers to a case of a young mother who was complacent towards having pap smears and ended up dying a preventable death as a result of cervical cancer. “Over the years I saw the opportunity to do pap smears out of the clinic. The mobile unit gave us access to so many patients. We had persons who neglected to do it. One patient in particular - she was not yet 30 years old. She had three children and after every delivery, she was told by the hospital to do a pap smear. She didn’t do it and eventually got cervical cancer. When she was to do the pap smear, she didn’t come. One morning they brought her and had to lift her up out of the car. At that time doctors said they couldn’t do anything for her,” Dr. McKoy said while fighting back tears. “It wasn’t necessary. We had to go out more to meet people, educate them teach them the importance of sexual and reproductive health.” That experience was his driving force to continue the work in sexual and reproductive healthcare. Dr. McKoy said the message about family planning, sexual and reproductive health must be continued through education in community outreach projects.

From their inception, cultural barriers and stigma have threatened the work of the Jamaica Family Planning Association (JFPA). Although some myths around family planning are still prevalent, according to one senior healthcare provider at the Beth Jacobs Clinic in St Ann,  there have been some positive shifts. Registered midwife Dorothy Boyd-Brown who first began working with the Association in 1973, said the organization has made its mark and reduced barriers and stigmatizing behavior towards family planning and sexual and reproductive health and rights. Boyd-Brown, head of maternal and child-care/sexual and reproductive healthcare at the Beth Jacobs Clinic said cultural barriers were often seen in families lacking basic knowledge about sexual health. “I remember some time ago a lady beat her daughter the first time she had her period as she believed the only way, she could see her period, is if a man had gone there [if the child was sexually active]. I had to send for her [mother] and have a session with both her and the child as to how a period works. “She apologized to her daughter and said she was sorry. She never had the knowledge and she was happy for places like these where she could come and learn – both parent and child,” Boyd-Brown said. Information sharing is important She also highlights that religious groups once perpetuated stigma, so much so that women feared even walking near the FAMPLAN clinic. “Churchwomen would hide and come, tell their husbands, partners or friend they are going to the doctor as they have a pain in their foot, which nuh guh suh [was not true]. Every minute you would see them looking to see if any church brother or sister came on the premises to see them as they would go back and tell the Minister because they don’t support family planning. But that was in the 90s,” Boyd Brown said. Boyd-Brown says things have changed and the church participates in training sessions about family planning encouraging members to be informed about contraceptive care and their sexual and reproductive health and rights. But despite the wealth of information and forward-thinking of the communities the Beth Jacobs Clinic serves, Boyd-Brown said there are some prevailing myths, which if left unaddressed threaten to repeal the work of the Association. “Information sharing is important, and we try to have brochures on various STIs, and issues around sexual reproductive health and rights. But there are people who still believe ‘sex with a virgin cures’ HIV, plus there are myths around contraceptive use too. We encourage reading. Back in the 70s, 80s, 90s we had a good library where we encouraged people to read, get books, get brochures. That is not so much now,” Boyd-Brown said. Boyd-Brown also faces the challenge of ensuring women continue to access healthcare. “I saw a lady in the market who told me from the last day I did her pap smear she hasn’t done another one. That was five years ago. I had one recently - no pap smear for 14 years. I delivered her last child,” Boyd-Brown said. Despite the challenge, she remains dedicated to the task and shares that her commitment also helps to improve women’s choices. It is Boyd-Brown’s hopes that the once active Mobile Unit with community-based distributors will be reintegrated into JFPA’s healthcare delivery to be able to reach under-served communities.  Boyd-Brown added, “JFPA has made its mark. It will never leave Jamaica or die.”