The
Development Planning Unit
Government of the British Virgin Islands

NATIONAL REPORT FOR THE ICPD - Continued

5. THE POPULATION POLICY, PLANNING AND PROGRAMME FRAMEWORK

5.1 NATIONAL PERCEPTION OF POPULATION ISSUES

Population issues in the British Virgin Islands are perceived as a combination of issues particularly related to rapid immigration leading to or resulting in demographic problems, constraints imposed by demographic factors in the achievement of socio-economic development goals and unfavorable linkages between population, environment and development factors. Additionally, there are some secondary issues between population and the role, status and participation of women.

With the foreign born population increasing so rapidly over the last decade to approximate 50% of the total population today, immigration has certainly contributed to the high rates of population growth over a relatively short period. Inspite of the rapid immigration phenomenon, the BVI has relatively low and internationally acceptable fertility, infant, child and maternal mortality rates. On the other hand, the average age of marriage is twenty-three (23) years and the contraceptive prevalence rate is good. However, a decomposition of these demographic problems reveal that there is a significant difference between the indicators related to nationals and those related to non-nationals.

The fertility rate, a key indicator is virtually double for non-nationals and it is suspected, based on Family Planning records, that this is the case in respect of contraceptive prevalence. The question of low age at marriage is not really significant as cohabitation and child-bearing out of wedlock is significant between both nationals and non-nationals. Teenage pregnancy and the number of children of non-nationals remaining in their countries of origin have significant implications for our Education and Health systems in the event that they migrate to the BVI and our Balance of Payments system should they remain overseas. Contraceptive prevalence among non-nationals presents problems as religious and cultural factors in the countries of origin are not easily forgotten despite our efforts at information, education and communication on this subject.

With such a proportionately large foreign born population spread through all socio-economic groups of the country, nationals perceive that the country's resources are being drained through remittances of foreign workers, repatriation of profits by foreign owners and lost opportunity for up-and-coming nationals to enter the workforce and the ranks of entrepreneurship. The 1991 Population and Housing Census round did not adequately account for legal belongers. Instead, it identified only the foreign born population and failed to identify those non-citizens born in the BVI not qualifying as citizens under the provisions of the British Nationality Act of 1981. Infact, a number of the foreign born population have become naturalized citizens leaving the information gathered from the last Census round as only an overestimate of the true foreign born content in the population.

Census information leads us to conclude that the conventional dependency ratio cannot adequately reflect the true picture in the BVI as persons on their immigration application indicate that they have some 8,256 dependents living outside the BVI. The traditional dependency ratio provides a misleading picture of the economy in terms of savings ratio, household per capita income and spending etc. The traditional population and economic indicators, in the case of the BVI, overstates the economic well-being of the population being supported by the domestic workforce and in so doing substantially underestimates the magnitude of the social dimension as it relates to population issues.

The rapid growth in the population during the last decade, due to immigration in response to economic opportunities, has changed the demographics related to age, growth, distribution, structure and composition. In some instances, the economics of scale and the distribution of the population among islands and villages have presented some difficulty in the decision/making process regarding infrastructure, health and education projects. The age structure indicates that the population is young and likely to produce a substantial number of children within the next decade. These scenarios are likely to lead to issues related to land use or competition for the use of scarce resources for the construction of housing, the use of agricultural lands, land for the construction of additional road networks and land for the construction of productive infrastructure such as tourism plant. Clearly in this situation of extremely scarce resources, rapid population and economic growth and a very fragile environment, unfavorable linkages between population, environment and development will manifest themselves if left unchecked.

Happily as our population increases, the role and status of women has changed and improved, especially in the areas of employment, education, health and other social standings. However, the legal aspects of the existence of women are still not on par with to that of men in terms of the ability to convey residence and citizenship through marriage, the acquisition of property rights and certain property aspects relating to the dissolution of marriage. On the other hand, men do not enjoy equal rights in the conveyance of citizenship to children born out of wedlock as women citizens are able to do. Women have the legal right and for all practical purposes participate fully in all other aspects of the community in terms of employment, education, ownership of property, etc.

The national perceptions of population issues are based upon representations made by special interest groups to a recent committee appointed to advise government on how to improve the business climate. Groups such as the Hotel and Commerce Association, Chamber of Commerce and Immigrant Associations have had frank and full dialogue with Ministers and High Level Officials concerning demographic problems, demographic factors and unfavorable linkages between population, environment and development.

5.2 THE EVOLUTION OF POPULATION POLICY IN THE BVI

Like most developing countries, a series of measures which amount to a Population Policy has evolved from population accommodating/response to population influencing as the impacts of a changing and growing population became more pronounced reality. As the demographic situation became more acute in response to the rapid economic growth, the Government found there was no alternative to immigration. The major strategy was to implement a combination of explicit and implicit policies which had the combined effect of exerting an impact on and influencing of the population structure.

In order to ensure that development goals and economic growth targets were not severely hampered by conflicts between population, environment and development, Government's primary measures were the implementation of immigration laws and policies which gave the effect of reducing the number of persons being born in the BVI to foreign nationals. The Local Immigration Act of 1968 together with the British Nationality Act of 1981 have the effect of substantially controlling population growth by virtually eliminating the migration of dependents of imported labour. To further influence the demographic structure policy measures and implementation procedures institutionalizing family planning and promoting reduced fertility were at the centre of the strategy to avoid economic driven immigration creating severe and unmeetable demands for social services in health, education and welfare.

As time elapsed and the economic boom became sustained and temporary imports of labour assumed permanence through tenure and matrimony it became obvious that population policies would have to become accommodating/responsive to cope with rising demand of the larger population. The increasing population placed severe demands on the use of the environment; hence, the need for a measured response to ensure that the policy change was facilitated and that a sustainable economy within the context of our limited natural asset base was not hampered. Population policies of an accommodating nature were oriented around Town and Country Planning and land use regulations, housing in the provision services sites, education in the building of additional classroom and schools, health in the provision of more health, education services, hospital beds and better health care facilities and in economic infrastructure such as expanded electricity and water services.

Although the population responsive policies and measures have been more high profiled and required a substantial amount of resources, promotion and management, it was the population influencing or proactive strategies which had the larger impact on the immigration situation. With the sustained economic boom, the social integration of citizens and non-citizens and population accommodations measures it became evident that a further evolution of population policy was essential. The higher fertility rates among non-citizen women and the consequent numbers of non-citizen children to be repatriated as well as the number entering the workforce made it necessary for Government to respond with a more humanistic policy to immigration. The essence of this policy permitted on a selective and strictly controlled basis, at the highest political levels, the immigration of non-citizen children subject to the constraint of space available in present education facilities. The non-repatriation of HIV infected immigrants highlighted the humanistic approach as well.

Factors which restrained the evolution of population policies to the passive and the humanistic approach were the small size of the country, its relatively undeveloped inventory of infrastructure, the British Nationality Act of 1981, the population and economic situation in the nearby CARICOM and Caribbean countries, the desire to maintain the indigenous cultural identity of the BVI and the expressed goals of not allowing development or investment proposals to be the sole determinants of what level of economic growth was achieved.

In effect, population policies provide the strategy which has guided the economic development policies of the country over the last decade beginning with implicit policies during the economic boom, advancing to explicit and accommodating policies as the boom became sustained and temporary labour became permanent then moving to a humanistic approach to immigration policies today. In this regard, it is safe to conclude that the range and mix of population policies over the past three (3) decades have helped to resolve critical issues/situations arising from interrelations between population and socio-economic factors.

5.3 CURRENT STATUS OF POPULATION POLICY

 As indicated in an earlier section, current population policy reflects a mix of influencing and accommodation policies which have been recently tempered with a more humanistic approach to immigration. Population policy focus was passive until it was recognized that natural, social and economic systems were approaching capacity and that population development in respect of health, education, information, growth and composition had to be managed in a more integrated way to ensure a better balance between social and economic sectors and sustainable development respecting the limits of our natural systems.

Whilst there is no specific or comprehensive piece of legislation authorizing the establishment of population policies, strategies and measures, there is a collection of laws; the British Nationality Act (BNA) of 1981, the Immigration Act of 1968, the Labour Code of 1975 and other pieces of legislation related to Health, Trade, and Education. These implicit measures have been the nucleus of BVI population policy over the last three decades until it became apparent that it was necessary to focus on explicit measures to influence the country's demographic structure.

Institutional arrangements for the implementation of population policies are spread across key government agencies such as those responsible for Economic Planning, Social Development, Town & Country Planning, Health, Education, Information and Public Relations, Labour and Immigration. The missing ingredient in respect of institutional and organizational arrangements has been co-ordination. Operational procedures by some agencies were inconsistent with others. Because most population policy measures were explicit and laws and regulation, their objectives were not totally directed to impact on the demographic structure of the population. However, although not totally by design, implicit policies have essentially had the effect of systematically and radically altering the demographic structure of the population but not without some social consequences.

The substantive content of the population strategy being implemented can be summarized as being focused on the following:

(i) immigration strategy seeks to restrict population growth by restricting the migration of the dependents of workers and selectively requiring entry visas form countries with specifically tough economic circumstances;

(ii) labour policies give preference for employment opportunities to nationals and issue work permits on the basis demand by employers when suitable nationals are unavailable;

(iii) education and training strategies seek to prepare nationals for all areas of the workforce especially those high end occupations traditionally held by non-nationals and considered to be critical to certain industries in the national interest;

(iv) family planning policies seek to hold down the fertility rates through the distribution of contraceptives, information, education and communications and promotion sexual reproductive health;

(v) health strategy seeks to improve the longevity, health status and quality of life for all residents through reduction in the national mortality rate; and

(vi) strategy related to the role of women aims to upgrade and equalize their status through employment and educational opportunities, the concept of comparable worth and dealing with issues of sexism and sexual harassment.

National experiences with the formulation of policy goals and objectives, the setting of programme targets, the adoption of programme strategy and the components instruments being used are extremely limited as our population strategy to date has been ad hoc and responses to crisis situations as a result of the substantial economic activity of the last decade. In the absence of scientific research/observation instruments and programmes were either copied from other external situations which were perceived similar or, lastly designed without the benefit of extensive information on the local situation. The enactment of legislation usually resulted from an extreme situation in the workforce or pressure from some representative socioeconomic or political groups looking after their particular interest. Immigration and labour issues, being the more transparent and volatile ones received a great deal more attention while fertility, mortality, health and education issues, which were admittedly of a lower profile, received a lot less attention.

Until the approach to the presently being formulated National Integrated Development Plan (NIDP) 1995 - 1999, our efforts at integrating population policies with social, economic and environmental policies were infact very limited. In general, development was project oriented and there was very little macroeconomic planning; hence, there was limited scope for integrating policies of population with other policies. With the establishment of the Planning and Project Review Advisory Committee (PPRAC), an inter-ministerial and High-level Officials committee, the planning process changed dramatically to provide key decisions in the project development process, monitoring the implementation of critical projects and overseeing the planning process generally. Additionally, and more importantly, the NIDP, is our first attempt at integrated planning where population, social, economic and environment issues are being considered simultaneously and their objectives are, as well, targeted to be achieved simultaneously. Sectoral Plans, including a population plan, consisting of policy, strategy measures and some programmes are to be formulated in 1995.

The Population Policy Statement (PPS) was drafted by the Population Unit of the DPU and is presently being reviewed by the recently established National Population Committee (NPC). The PPS will be forwarded to the Council of Ministers for formal approval by the PU.

 5.4 POPULATION IN DEVELOPMENT PLANNING

The results of the 1991 Population and Housing Census confirmed our assertion that population, particularly its demographic aspects, required careful attention at both the political and technical levels if the effort at development planning started by the UNDP in 1974 were to continue to be relevant and meaningful. Further, the 1991 round of the Population and Housing Census verifies our earlier findings, suggesting that the situation was more acute than that envisaged and indicated the urgency to change our strategy towards a more explicit one to infact influence the demographic structure of the population.

As we intensify our efforts to provide supportive infrastructure in strategic areas of the economy and attempt to close the gap between progress achieved in the industrial economic and social sectors, investment studies and pre-requisite conditions dictate that demographic data and population information should play a greater role in the determination of what must be done.

Fortunately, this period of rapid economic expansion and the resulting, but lagged, social progress, coincided with the UNDP programme to introduce the collection of macroeconomic and social statistics through the establishment of a Development Planning Unit with responsibility for national statistics. This modest start in national statistics has culminated in the production of vital (deaths, births, marriages) crime and justice, trade, tourism, health, immigration, labour and education statistics on an annual basis even though certain areas are less timely than others.

As expected, population is the most critical variable in our development planning process; hence, demographic data and population information is critical for informing the medium and long terms planning processes at the national level. Sectoral planning, particularly as it relates to infrastructure, education, health and social welfare by necessity, is demanding more and more population related data as input into the project cycle. As our orientation in development planning shifts from project planning to a more integrated orientation at the macro-level, our efforts at producing the full range of social and population statistics are being intensified.

Sectoral plans, for example in the environment, have used population information to determine the demand for agricultural land and marine products to estimate the potential burden to produce needed food. The carrying capacities of land and marine areas have played a prominent role in determining that our population should be addressed in an implicit way through our immigration policies. Development plans now reflect concerns for the status of women through the project planning process as well as the legal and cultural aspects of women's life in the society. The Womans Desk has proposed an aggressive programme of gender based statistics form the 1991 Population and Housing Census and the National Accounts Statistics database. Infact, a comprehensive workplan for women's issues has been developed and will be major inputs for the NIDP.

The Ministries of Health and Welfare, Education and Culture in collaboration with the Development Planning Unit have designed a comprehensive survey on Adolescents with a view towards identifying their main issues/problems and developing a detailed plan of action from the findings. Specifically, the project's goal is to promote and maintain the health status of adolescents to ensure that they can reach their full potential through a sound, mental, spiritual, social and physical well being. This survey collects demographic, nutritional, alcoholic drinking, drug abuse, sexual activity, entertainment and health information for the entire population between ages 12 and 24 with the primary target audience being 12-18 years and the secondary being 18-24 years. Additional information, education and communication programmes have been a significant part of the Ministries of Health and Social Welfare.

Current institutional arrangements to assist with the incorporation of demographic data in development planning include the previously mentioned PPRAC, the annual Budgetary Process exercise and the National Planning Process. Our approach to development planning has shifted to a STRATEGIC VISIONING APPROACH in which the concept of integrated planning is the main focus. The main development strategy seeks to provide longer healthier and more productive lives for the people of the British Virgin Islands. The essence of this strategy is that population factors are being given equal weight with environmental, social and economic issues in the formulation of the NIDP.

National Integrated Development Plan (NIDP), 1995 - 1999

This is the government's first attempt in 20 years at developing a National Development Plan. The previous plan was created in the early 1970s. One of the more salient features of this plan is the attempt at adopting an integrated approach. The Plan will comprise of eight basic components: fiscal policies and strategies; economic sectoral policies and strategies; macroeconomic policies and strategies; population strategies and policies; physical/spatial policies and strategies; environmental policies and strategies; social policies and strategies; human resources development strategies. The view being adopted is that all these components are interrelated and attempts will be made to create linkages among the different programmes and projects as well as to harmonize the related social, economic and population policies.

Among the strategies that will be adopted, include the conduct of intersectoral meetings to seek cooperation, exchange information, prioritize programmes, rationalize allocation of funds and ensure realistic target setting.

A number of preparatory activities have already been set in motion. These include: preparation of economic data which is currently in progress; collaboration with international agencies in the design of sector studies and the preparation of research reports. The main activity of the exercise concerned with the integration of all the sector plan elements is expected to begin in May. Target date for completion of the plan is November 1994.

The main constraints or problems encountered in the process of incorporating demographic data in development planning are centered around the absence of a strong population statistics database, the lack of strong political action in socially and politically sensitive situations, little or no capacity in social development planning and a pronounced weakness on the social side in central planning. However, strong and concrete measures are being made in Development Planning to improve data collection, statistical analysis and demographic analysis.

The Population Component

It is to be noted that the population factor has been given equal weight among the other social and economic programmes in the National Integrated Development plan. This is an indication of the government's acknowledgement of the close interrelations between population and development. Indeed, in recognition of the important role of population in the social and economic dynamics of the country, highest priority is now being placed on the integration of population issues in the planning process.

The population of the BVI has been growing at a rate of about 4 to 5 percent per annum, since 1980, with the pace accelerating in the more recent years. Migration has emerged as the most significant factor in the population equation and is responsible for most of the 50 percent growth experienced during the decade of the eighties. More than half of the population living in the country consist of immigrants who also account for approximately 80 percent of the population growth between 1980 and 1991. The social and economic consequences, especially in terms of the additional demands being placed on the social services, require careful planning not only to accommodate the growing population but also to develop appropriate intervention policies to ensure that the population changes are kept in line with the government's ability to provide for its basic needs as well as maintain an adequate standard of living.

Another important population-related issue that is closely linked to the development process concerns the impending mismatch between the demand for and supply of skills, which is expected to materialize within the very near future. Some of the factors contributing to this situation include (a) the growing numbers in the youth population aged 15 - 29 (as a consequence of the past high fertility years and the population momentum impact) (b) the resultant increases in the numbers graduating from high school and community colleges and (c) the concomitant rise in the numbers returning from study programmes abroad which were financed by government (over 100 are estimated to return in 1993).

Of equal importance are the negative social consequences that could occur as a result of the disillusionment of the youth and the rise in the numbers unemployed as well as underemployed. The development of a manpower planning system could help to defuse the potentially explosive nature of this situation through the identification of areas of demand and supply, the development of employment generation and requisite training programmes to fill the gaps, and the provision of adequate career guidance and counselling services to tailor the aspirations of the youth to the real needs of the economy.

Functionally, a Population Affairs and Social Statistics (PASS) section was established within the Development Planning Unit to serve as the secretariat of the Population Unit and to be responsible for the production of population statistics and other population related data. Personnel in the PASS division have been trained at the Institute of Social Development (the Hague, Netherlands) and the U.S. Bureau of Census (Washington D.C., USA) in Population and Development and Population Statistics, respectively.

5.5 NATIONAL POPULATION PROGRAMME PROFILE

5.5.1 Maternal and Child Health and Family Planning Services

The implementation of MCH/FP services come under the National Health Programme and as such is administered by the Ministry of Health through hospitals and health care facilities with an adequate number of professional and support personnel.

The components of the programme includes antenatal, intranatal and postnatal health care services complemented by family planning and health education services. Child health care covers a well-developed and efficiently functioning programme of immunization, growth and nutrition monitoring and developmental monitoring. As well, programmes in school and adolescent health are part of the MCH/FP activities delivered without any cost recovery as the major thrust of national health policy. To deliver these MCH/FP services to the target population, clinic and Community Outreach service announcements are targeted at selected areas at strategic times are employed as secondary methods. Community Outreach methods include home and school visits, day care, postnatal dormisitary visits and periodic screening programmes.

The goals of MCH/FP during the period 1994 - 1996 which are consistent with present objectives and strategies are as follows:

(i) to ensure that all pregnant women are given adequate care, to ensure a healthy pregnancy and the birth of a full term healthy baby.

(ii) to ensure that all high risk pregnancies are delivered in hospital, attended by an Obstetrician and Pediatrician where necessary.

(iii) to ensure that during and after child birth mothers recover satisfactorily from physical and emotional stress with a healthy baby oriented towards breast feeding. A further goal is to motivate the mother in the areas of family planning and early cervical and breast cancer detection and treatment;

(iv) to promote high level child care and growing in a healthy atmosphere of love and security together with adequate nutrition;

(v) to enable couples to obtain contraceptives best suited for their needs by providing technical information on practices for wise decision making; and

(vi) to promote good health practices in individuals through the maintenance of disease surveillance, early detection of abnormalities and a good environment.

Attainment of these goals in a physical setting of many islands is a difficult and an expensive tasks requiring a substantial amount of resources, both human and financial, and health infrastructure facilities. In terms of human resources, approximately 105 professional and support staff including General Practitioners, Midwives, Staff Nurses, Obstetrician Gynecologists, Assistant Nurses, Support Staff and Management Personnel are employed to implement the programme. The financial resources to operate this programme annually amounts to US$1.3m excluding capital costs and rehabilitative maintenance on health infrastructure on nine (9) health centres and one (1) hospital.

Amoung the varied objectives which have met with some measure of success and are necessary to mention here include:

(i) the improvement of the coverage and utilization of clinic sessions for antenatal as well as the early detection and treatment of STD's;

(ii) development of a referral mechanism for obstetrical emergencies and where institutional care is not possible provide personnel for all home deliveries in intranatal care;

(iii) the provision of increased primary level, home visits, evaluation of mother and child and breast feeding support for postnatal care;

(iv) the attainment of 85% comprehensive immunization coverage of children under one (1) year and adequate treatment of common childhood diseases especially gastroenteritis, acute respiratory tract infections and measles;

(v) an increased number of couples using contraceptives and the number of women who have at least one (1) papsmear every two (2) years;

(vi) improved health services to the school aged children (5-19 years) within and without the education systems;

(vii) improved health assessment of mother and monitoring of foetal growth;

(viii) enhanced selection and use of appropriate contraception methods, cancer screening, detection and treatment of STD's and counselling.

The overall development strategy of BVIG is to enable the people to live longer, healthier and more productive lives. Key strategy measures in the NIDP provides for the development of skilled human resources and the building up of a health care delivery system capable of extending life expectancy and the quality of life. In this way the health sector objectives, particularly those of the MCH/FP services programmes, are consistent with the overall development strategy for the medium and long terms.

As indicated earlier, the MCH/FP services programme is essentially a part of the national priorities on a recurrent basis; therefore, it is financed and implemented through the National Budget and the Annual Operating Plan, respectively. NGO's including women groups, family planning associations and HIV/AIDS interest groups run smaller and similar activities parallel to and integrated with the activities of the MCH/FP services programme on a regular basis as supplements. Services are well distributed with Health Centres in every district and the hospital in the largest population centre.

In terms of financing, the National Budget has paid for staff costs and the provision of supplies while international donor financing agencies such as the British Development Division (BDD) and PAHO have provided consultancies and travel to attend regional meetings.

5.5.2 Population Information, Education and Communication

Population Information, Education and Communication (IEC) components of population activities are unfortunately concentrated in the more highly profile areas such as HIV/AIDS, Family Planning and the Prevention of Teenage Pregnancy. Further, the IEC components are normally not designed in the programmes as an integral activity but treated as a somewhat independent aspect of implementation. Further, yet in some instances, the IEC are targeted at very narrow segments of the population at times in a uncoordinated fashion.

Although it is accepted that population IEC are broad and complex involving many activities to reach many people of differing characteristics and needs, our national effort in respect of awareness in health, women, youth and socialization issues could be more effective. The general lack of population issues awareness is caused by an ineffective level of resources, inadequately trained personnel, uncoordinated activities, lack of planning and decentralization of population activities management. These problems have resulted in less than optimum use of the communication and information technologies and media available. If it was desirable to identify the areas in population affairs that are most critical and warrant more attention, IEC would be among the top contenders. Because of inadequate IEC activities, the BVI Community is yet to develop the attitude that population views and behavior must be formed early and maintained throughout life.

While our population IEC activities seek to promote understanding and awareness of population issues and how they are addressed by individuals, the national focus from agencies looking after their own special interest or responsibility compromises progress nationally. No doubt the absence of an effective National Population Committee (NPC), our definition of population affairs and the consequent disaggregated approach to management of population related programme contributed substantially to the absence of a well designed, evaluated and implemented IEC programme. Instead, IEC activities are concentrated on areas in which international donor financing is received, such as health, family planning and women's issues where these activities are mandatory. An effective NPC would alleviate these problems as it would be a multi-sectoral body responsible for providing overall population policy direction, programme design and monitoring and coordination of population - development projects and programmes.

In the BVI, most population IEC activities are implemented through the Department of Information and Public Relations which has responsibility for the entire Public Service. Clearly under these circumstances and the lack of adequate resources the population IEC component will be disadvantaged. However, inspite of this situation, certain areas such as HIV/AIDS, women issues, sexual and reproductive health have been prominent on AM radio and newspapers. Additionally, a new quarterly health magazine has been recently established with good circulation and readership. These limited successes are an indication that with more effective programme design, evaluation and implementation, we could accomplish much more. These information spots, articles and programmes have not highlighted the effect of changes in population structure and distribution on national life or the demographic and health benefits of family planning to all segments of the population.

Population IEC in the BVI could be much more effective if it was strategically planned and implemented taking advantage of the information and media systems available countrywide both private and public. The need to research the IEC needs of all segments of the population and to design client-orientation responsive programmatic activities is recognized but the political support given needs to provide the requisite resources. Population IEC must be implemented and with the understanding that it is a continuous process through life and not just limited to support services and counselling for segments affected by teenage pregnancy, HIV/AIDS, drug abuse and discrimination. Population IEC must be cast in a more positive role as an absolutely essential process in the socialization of the community and not just a response to community crises.

5.5.3 Population Data Collection and Analysis

Institutional arrangement for data collection and analysis is co-ordinated by the Population Statistics and Affairs Division of the Development Planning and Statistics Department. Collection and analysis of data related to population fall under the general work plan for the social sectors; however, given the urgent and late developing concern for population issues, priority has been given to this area. In general, there is a substantial amount of raw data on family planning and migration. Most of the raw data is not yet in compliance with international standards, norms or convention thereby producing a comparability problem.

Data collection and analysis related generally to the health of the population such as births, deaths, marriages, illness and family planning are available but extended efforts to conform to internationally accepted formats and conventions are necessary. In the case of family planning data from government agencies is available but this probably represents half of all activities as these types of services are generally procured from the many private providers who are not legally obligated to surrender this information. Similarly, as some maternal and child health care services tend to be delivered by private providers, the data is becoming less available. Data on immigration and labour is available and conforms with international accepted standards. Data analysis is covered by three statisticians who are trained in demography and statistical analysis required for the highest levels.

In the past, the absence of institutional measures, and mechanisms and a legal framework have served as a serious constraint in development of a comprehensive population database. Population has not been perceived as a series of subject portfolios in the ministries ; hence, there was no official conception of it as an integration of activities across ministries. Similarly, the absence of an expressed policy, a co-ordinating unit and a programme of activities have impacted severely on our capacity to develop a significant population database. The absence of a General Statistics Act has left only the Census Act as the legal framework for the collection of data on any area related to population.

With the establishment of the Population Affairs and Social Statistics Division (PASS), population data collection is likely to be enhanced given that computerized immigration, labour, births, deaths and family planning databases are well advanced in development at the single-user as opposed to the network level. In our National Accounts a conscious effort is being made to develop a gender based system to satisfy the requirements of the newly established Women's Desk. Data from the 1991 Population and Housing Census is being fully utilized and analyzed for demographic purposes. The major area of concern remains data on social development and welfare and on health.

On a trial basis, the Development Planning Unit has obtained a copy of an Integrated Database Software to examine the possibility of adopting this to develop an integrated database of population, economic, social and environmental issues. Our objective here is to truly integrate demographic and population related data into project analysis. In this regard, training in this type of analysis is required and this has been addressed with training of a demographer and a population data specialist.

The major issues facing population data collection and analysis is the absence of a strong legal framework, inadequate numbers of trained resources in key population sectoral areas and lack of software and hardware to take the population statistics programme forward.

5.5.4 Women, Population and Development

Although the BVI, through the United Kingdom, recognizes gender equality as a human right under the provisions of the Universal Declaration on Human Rights, full effect has not been realized for women in the effort of improving the status of all income and class groups. Some institutionalized, legal and social forms of discrimination continues against women and girls. GBVI recognizes the need to empower women to improve their status relative to health, education and employment. The mixed results of the success of women empowerment is proof that the integration of women into the population and development as both participants and beneficiaries is most critical for socioeconomic development. There remains considerable concern in the areas of abuse and violence against women; accordingly, alleviation of this situation is given priority in the legal and social programmes agenda.

The 1991 Population and Housing Census indicates that women make up 48.7% of the population and that 15.0% of those are immigrants who work predominantly in the middle to low wage earners brackets. The data further shows that women are mostly in the low paying service areas such as clerks, domestic workers, bar maids etc. The number of single women and women headed households are suggesting that the father less family is becoming a reality. On the other hand, there seems to be a considerable number of women who have made it into top positions in the public sector as well as in private enterprises. Women, as indicated by an inventory of students at tertiary institutions abroad, out number men almost two to one studying in all areas including professions that were traditionally reserved for men. Recent trends indicate that women with high school and college education are being paid on an equal basis with men. However, the great disparity seems to be between men and women who are not well-educated and the largest number of women falls in this category.

Although women make up one third of all doctors and lawyers, there are a number of women living in what may be classified as less fortunate circumstances. Crime Statistics indicate an increase in repeated cases of domestic violence and rape. Studies on food and nutrition indicate that women are two likely to be obese due to diet and lack of exercise. Women's health issues leave cause for concern in the areas of miscarriages, the transmission of HIV and teenage pregnancy. The legal framework discriminates against women in inheritance with respect to children born out of wedlock, the conveyance of belonger status and the court's handling of domestic violence.

Recognizing the grave socio-economic consequences for women continuing in the situations described moved Government to the create a Women's Desk to function in an advisory capacity to government departments & ministries and in a functional capacity organizing programmes and co-ordinating projects with private and public sector agencies. The Women's Desk has developed an Action Plan for the period 1993 - 2000 which seeks to achieve law reform, establish a Women's Studies Section in the Public Library, conduct a Good Parenting Campaign, to develop a programme to provide Institutional Support for Women and Children in Crisis, to implement a community based Education Programme, to prepare a series of Gender Based Statistics in National Accounts Statistics, and to formulate a community based health education programme. Additionally, whilst not specifically aimed, a major part of the programmes are designed to reduce the impact of teenage pregnancy through a strategy of information, education and communication to change the current policy of expelling pregnant teenagers from high school and providing simultaneously an alternative education programme which takes into account the needs of young mothers for day care and good parenting programmes. The idea is to provide the necessary supportive framework early to avoid burdening social institutions later.

The Development Planning Unit has undertaken to provide gender based statistics on income, expenditure and all other economic activities over three to five years to provide an academic/empirical basis for policy and strategy formulation in respect of women.

5.5.5 Mortality

All indicators of mortality including crude death rates, life expectancy and infant mortality have either improved notable or remained statistically consistent over the period 1983-1992. However, for several reasons one has to approach mortality trend statistics in the BVI with caution. In the first instance, the population is very small and changes of any significance in the number of deaths can result in wide changes in the indicators. Secondly, the procurement of health services overseas in nearby countries tend to have the effect of understating vital events should the patient die abroad in the case of older adults and babies. Notwithstanding the foregoing caution, it can be concluded that the BVI, from 1983 to 1992, has had access to adequate health care services as evidenced in the mortality levels achieved and maintained.

Figure 5.5.5.1
Crude Death Rates (CDR) 1983 - 1992

The Crude Death Rate (CDR) - the number of deaths per 1,000 population - is the simplest and most common measure of mortality. For the British Virgin Islands, the CDR fluctuated from year to year and ranged from 4.0 in 1988 to 5.9 in 1986. Expectedly, a sex-specific breakdown of the CDR shows that males continually have higher mortality levels than females; the former ranging from 5.0 (1983) to 7.4 (1987)and the latter ranging from 3.0 (1988) to 4.9 (1983) (See Table 5.5.5.1 and Figure 5.5.5.1 for illustrations).

In the analysis of mortality, it was not evident that any population segment had experienced rates outside of what is normally expected in upper developing countries. Although as indicated by Table 5.5.5.1, the broad Age-Specific Death Rates (ASDR's) most deaths occurred in the critical stages of life, i.e. at birth and at older ages these population groups are naturally most vulnerable. However, it must be observed that mortality rates for persons 0 - 1 year have improved substantially over the past four years and no doubt the Maternal and Child Health Care services programme adopted in the late 1980's has contributed significantly to this performance. Infant mortality rates spread across all regions and socioeconomic groups virtually in equal proportion testify that the free health care delivery system is effective for both nationals and immigrants. Adequate access to the free health care system for the old and young through the national network of facilities has impacted positively on the mortality trends over the past decade.

Figure 5.5.5.2
Life Expectancies at Birth
1983 - 1992

These ages continued to register considerably much higher mortality levels for the period under review. As a consequence, the "endogenous" causes of death excessively out paced the "exogenous" causes of death as deaths at the "critical" stages tend to be health related (See Table 5.5.5.1 and Figures 5.5.5.4 and 5.5.5.5 for illustrations).

As can be seen from the other indicators (See Table 5.5.5.1 and Figure 5.5.5.3), the British Virgin Islands has had and continues to maintain very favorable mortality levels. The fluctuations in all indicators are a direct result of the small magnitude of numbers that are involved in the computation of these mortality statistics. It is such that any changes in the numbers, no matter how small, causes drastic movements in the measures. Drastic changes which therefore will not necessarily be attributable to changes in the health status of the British Virgin Islands.

Table 5.5.5.1
Mortality Trends
1983 - 1992

Although the incidence of HIV infection and AIDS among children is insignificant in respect of mortality, there have been cases and concern exists. Causes of death due to external and environmental circumstances related to the consumption of tobacco, alcohol, or drugs, have not seriously impacted on mortality as indicated by Table 5.5.5.1. Maternal mortality, while being the leading cause of death in many developing countries, is insignificant due to the effectiveness of MCH/FP programmes. The effectiveness of maternity services in the context of primary health and improved services in safe-motherhood education, nutrition programmes, family planning, prenatal and postnatal care and delivery assistance by competent personnel have contributed substantially to the low mortality rate experienced.

Figure 5.5.5.3
Infant Mortality Rates (IMRs)
1983 - 1992

The mortality indicators of life expectancy, crude death rates and infant mortality rates are all testimony to the effectiveness of the health care delivery system performance over the short term but its continued effectiveness is questionable given the consequences of immigration from different cultures. It is quite clear that to minimize sexually transmitted diseases and HIV infections more resources at all levels are required to promote safe and responsible sex, to provide sexual and health education and to provide preventive, diagnostic and curative treatment if the above-mentioned mortality indicators are to remain in the present ranges.

Figure 5.5.5.4
Broad Age-Specific Death Rates (ASDRs)
1983 - 1992

The gradual improvement in the life expectancy indicators is welcomed and could be enhanced if our primary health care could deliver a better level of curative services. The life expectancy data shows that the movement is very small meaning that substantial or significant increases would result only if areas such as dieting, exercise, environmental conditions and substance abuse, particularly alcohol, are as well improved.

Figure 5.5.5.5
Causes of Death
1983 - 1992

The National Population Programme in respect of health as it impacts mortality has been positive and this was achieved by obtaining and strategically applying adequate levels of human and financial resources. Further, it was the IEC components of the programme which has been so effective in Maternal and Child Health, Family Planning and Mortality.

5.5.6 Population Distribution

The information derived from the 1991 Population Census lends itself to various ways of population distribution, but only the distribution of the population by islands, age and sex will be dealt with below.

The total population of the British Virgin Islands when distributed regionally shows that Tortola, the largest island with an area of 59.2 square kilometers accounts for 13,232 or 82.1% of the population, followed by Virgin Gorda with 2,437 or 15.1%, Anegada 1.0%, Jost Van Dyke 0.9% and the smaller islands combined 0.9%.

Table 5.5.6.1 below gives a comparison of the distribution of the population by islands and their densities for the 1980 and 1991 censuses.

Table 5.5.6.1
British Virgin Islands Population Density by Island
1980, 1991

Of special interest is the considerable increase of 72.6% in the population of Virgin Gorda and 45.0% in Tortola during the intercensal years 1980 to 1991. On the other hand, in Anegada and the smaller islands there were declines of 1.2% and 7.7% respectively. The very impressive population growth in Virgin Gorda and Tortola during the intercensal period 1980 to 1991 attests to the development in terms of the tourism, construction, financial services, transportation and communication sectors of the economy. 

Table 5.5.6.2
Population by Sex and Five Year Age Group
1960,1970,1980 and 1991

The age and sex distributions of the population for the census years 1960, 1970, 1980 and 1991 as outlined in Table 5.5.6.2, shows that these distributions do not follow the pattern of other Caribbean Countries.

The 1980 and 1991 age distributions differ from those of other Caribbean Countries that it does not show a rapid depletion by emigration of residents after age 20. In the 1991 age distribution, the 25 to 29 and 30 to 34 age groups are actually larger than the 20 to 24 age group and it is only after age 34 that the cohorts shrink rapidly in size. This unusual age structure can be explained largely by the recent rapid structural transformation of the economy of the British Virgin Islands after 1960 when emigration had been balanced and surpassed by substantial immigration of young adults mainly from the Eastern Caribbean Countries.

In Table 5.5.6.3, the sex ratios by age groups for census years 1960, 1970, 1980 and 1991, do not exhibit the steady decline with which can be observed in most populations of other countries, as a consequence of the generally lower mortality of females than males at all ages.

Instead the pattern is irregular, probably as a result of sex selecting immigration and because of the small numbers involved. It is very unusual to find at almost all ages above 50 years, the sex ratios are above 100 as observed in census years 1980 and 1991, thus indicating that there are more males than females even in the oldest age groups. This indicates that either retirement immigration or return migration is probably mostly confined to males.

Table 5.5.6.3
Sex Ratio 1960, 1970, 1980 and 1991
Sex Ratio (males per 100 females)

5.5.7 Internal and International Migration

There is absolute freedom of movement to live and work anywhere in the BVI except in the case of immigrant workers whose place of work are conditions stipulated in their permits to enter and work within the country. Immigration into the BVI for work or residence is governed by the Immigration Act and policies surrounding its administrative procedures. Immigration is on an individual basis once the demand for labour is verified or the individual has the means to retire in the BVI and his character is desirable. There are no restrictions on emigration for any reasons. In view of the present good economic situation, emigration to the United Stated Virgin Islands (USVI) and the United States of America (USA) has virtually disappeared from the extraordinary numbers in the last four to six decades.

Census information suggests that internal migration from the smaller or sister islands exists only among the highly skilled and the new entrants to the job market. This is a result of the type of employment available on the sister islands being predominantly tourism, construction and agriculture related; hence, those desiring otherwise must migrate to the largest island. This internal migration is essentially one way similar to that of moving from a rural to urban areas. Migration to the USVI and USA has been substantially reduced to persons going abroad for an education. These emigrants are typical recently out of high school or would have been in the job market for a short while.

As indicated earlier, immigrants make up almost 50% of the population and are spread across all economic, social and occupational groups. Net migration, made up mostly of immigration, has been the single most contributing factor to population increase and has been responsible for 61.6% of 46.6% growth experienced between the 1980 and 1991 Population and Housing Censuses. The phenomena of immigration is directly responsible for the creation of the Immigration and Labour departments which together accounted for $1.018m or 1.7% of total recurrent expenditure and 48 or 3.6% of all permanent and pensionable employees in the public service (Central Government). Recently, with the acute shortage of labour, the public service has imported a number of skilled persons in engineering, health, education, police and administration by offering generous remuneration packages containing 25% gratuities, housing and relocation allowances on a basic two (2) year contract. On immigration, dependents particularly school-age children of immigrant workers are not normally permitted entry because of the lack of excess capacity in the school system,. Immigrants must be free of contagious diseases and be of good character. Immigration qualifying due to the tenure of stay are giving residence and citizenship if they have qualified under the Immigration Act or entered into matrimony with a belonger. Immigrants married to belongers are exempted from work permits.

5.5.8 Multi-Sectoral Activities

Multi-sectoral activities under the National Population Programme profile include limited population research pertaining to Immigration, the effects and relationship between population and environment, Aging in the population, Adolescents and Youth and HIV/AIDS. Management of these activities is decentralized to the Ministries of planning, Environment and Health and Welfare with no agency responsible for co-ordination to ensure that resources are being effectively and efficiently utilized. Activities under HIV/AIDS and Adolescents and Youth are now the main focus of multi-sectoral activities; consequently, a greater level of resources, both financial and human, are allocated to them.

Population Research

The recently changed population dynamics brought on by rapid economic growth and the consequential immigration to meet the demand for labour signalled to Government that the integration of population and related issues in the development process is a prerequisite to stable socioeconomic development. Although little population research has occurred outside of census activities, BVIG is assembling the trained human resources and institutional infrastructure necessary to conduct extended research in association with expert consultants. The establishment of a National Population Committee (NPC), the drafting of Provisional Population Policy statement and training of a demographer/statistician at the Institute of Population and Development in the Netherlands are indications of a developing research capability. Additionally, and currently underway, the training of an Assistant Statistician at the Bureau of Census, the computerization of the records of immigrants and the political commitments to review immigration policies are further indications of the establishment of a firm basis for population research.

Population and the Environment

The linkages between population and the environment in an extremely small country of limited resources where tourism is the major income earner are of critical importance. Development strategy pertaining to the marine environment, the use of land for agricultural and housing purposes and infrastructural development must be delicately managed to ensure sustainable development. Policies in this area revolve around the concept of sustainable development and are detailed in our National Report for the United Nations Conference on Environment and Development (UNCED).

Strategies related to strategic management of the marine environment are based on preservation to permit the replenishment of fish socks, the protection of mangrove areas, management of sand mining, halt the destruction of trees and manage natural attractions. The physical development plans formulated jointly by the Departments of Conservation and Fisheries and Town & Country Planning aim to provide the best possible environment for residences and productive activities while ensuring sustainability. Sanitation, public health and recreational guidelines observed in these strategies seek to better the quality of life in the most effective way given our limited and very fragile resources together with our main economic activity, tourism. Comprehensive legislation under development or ready for implementation in the areas of physical planning and coastal zone management are the centre piece of our strategy to avoid the further development of unfavorable linkages between population, development and the environment.

Aging

Annual Vital Statistics and information obtained from the 1991 Round of Housing and Population Census indicate that the BVI is a country of intermediate age. However, there are pockets aging and the development of a need for institutional care because "adult-children" are required to work and are therefore no longer available to provide care for needing relatives on a full-time basis.

Strategy measures to provide services for the aging, including homes for institutional care in the three major population centers, free health care for persons 65 years and older and welfare grants to those persons so qualifying in addition to the benefits from the national insurance system. As well, the Department of Social Development administers a programme of physical activities for the elderly including information on health issues and issues in the community in general. Finally, private sector health care and pharmaceutical items providers offer substantial discounts to persons 65 years and over.

Adolescents and Youth

A relatively recent phenomena of adolescents and youth being the segments of the population most participating in criminal activities against persons and property, drug use and abuse and Law and Order activities is of great concern to BVIG. This concern has prompted the Ministries of health and Welfare in collaboration with the Development Planning Unit to undertake a comprehensive survey on person 12 - 24 years on drug use, religion, sexual activities for adolescents and youth including programmes and projects. The results of this survey will guide the development of policies and strategies for correction of the anti-social phenomena of youth involved in criminal activity in a major way.

The current strategy to deal with the problems associated with adolescent males is to provide alternative activities in the prime crime time hours such as night basketball and software games together with sponsorship of music and related activities. Activities related to Information, Education and Communications are targeted in the areas of drug use/abuse, sex and sexual health issue and HIV/AIDS.

HIV/AIDS

Historically, the British Virgin Islands HIV/AIDS and Sexual Health Programme began in 1987 formulated using strategies identifies by the World Health Organizations's Global Programme on AIDS. These include Programme Management, Epidemiological Surveillance, Prevention of Sexual Transmission, Prevention of Perinatal Transmission, Prevention of Transmission through Blood and Blood Products and Reduction of the Impact of HIV/AIDS on Individuals Groups and Society. Activities of the programme are integrated into and implemented through the Department of Public Health.

With the global epidemic of HIV/AIDS hitting with an increasing number of cases being diagnosed, the Department of Public health focused on four main strategies namely Programme Management, Health Promotion, Quality of Care and Surveillance of Communicable Diseases. The objective of the present programme is to empower people to assist in the process at the individual and community levels in the fight against HIV/AIDS. health authorities have set up a mechanism to allow persons requiring the HIV antibody test to be received prior counselling. IEC activities in this area is highlighted by the recently implemented Quarter Publication - "Fit for Life" -of the Health Education office in which HIV/AIDS matters and issues are prominently featured. The publication suggests and supports the setting of strong prevention and education programmes in the workplace and the participation of the wider business community.

National Population Report: Part 6>

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