African Countries Must Grapple to Craft and Implement Policies on the Landscape of In-fertility.
September 07, 2024
By Nevison Mpofu*
Infertility is a disease of male or female reproductive system where there is failure to achieve pregnancy after 12 months or more of regular un-protected sexual inter-course. It is in two categories, primary or secondary in-fertility. Primary in-fertility is when pregnancy has never been achieved in a person’s lifetime. Secondary is when at least one [1] prior pregnancy has been achieved by a person.
Health policies on in-fertility in Sub-Saharan Africa are in labyrinth and lags development of Sexual Reproductive Health. There is clear explicitly evidence of in-fertility documentation which exists in many countries in the continent. Government programming that supports funding, attention and awareness is such a bitter challenge that needs to be looked at.
There is clear information down the lines that Sexual Reproductive Health, SRH services do not include bio-medical in-fertility treatment services within the domain of community and public health financing. Research work bares all that Assisted Reproductive Technologies like vitro-fertilization VF are expensive and beyond reach to many people who face in-fertility challenges. This kind of technology is more common in African urban centers than rural areas where the bigger population resides in developing countries.
Interventions, programs on awareness, sensitization and advocacy on in-fertility are not taken to communities in the continent. Interventions include psycho-social approaches using cognitive behavioral therapy, peer support groups, mass-media and social media approaches. These support those who experience in-fertility.
In a move to foster policy framework, vitiation of strategies and implementation, USAID has a funded project, the Agency for All Goal 2022 to 2027. This is meant to improve and sustain health and agency for individuals and communities which advance health and cross sector development out-comes. These include family planning and sexual reproductive health, maternal, new-born, child health, nutrition, infectious diseases and HIV and AIDS.
According to World Health Organization, world-wide, 1 in 6 people experience in-fertility, 186 million people, 45 million couples experience this in low to middle in-come countries [LMIC] WHO further goes on to say at least 8 to 12% couples in reproductive age experience in-fertility. Men and women account approximately 50% of cases of in-fertility each.
Quantified data by Pan-African-Visions gathered that WHO meta-analysis pooled estimate of lifetime in-fertility in Africa is 13,1%, pooled estimate of period in-fertility at specific point in time in Africa is 16,4%, the highest in the world.
Consequences of infertility which ignites policy development.
In Africa, failure to bear children is highly gendered and cultural in the whole of Africa. Africans have come a long way pinpointing at women as the ones who may or might be the problem in a marriage set-up. Women are at most victims because of many reasons biological and social. Women are the ones who carry pregnancy; therefore, they face victimized and scapegoated for no apparent and strong reasons.
Inferiority complex has much for long been placed on the lives of women while men are taken more superior. This social aspect is quite consequential to an extent that women face divorce, denial, loose marriages, verbal and physical abuse. Therefore, to a broader extent this ignites gender-based violence continuation for which Governments in Africa have crafted policies on over the past 2 to 4 decades.
Some consequences relate to biological. At last women in a bid to have children they end up taking some medical examinations which sometimes in the long run affects their compromised health especially if they take concoctions, herbs from unscrupulous traditional practitioners. It has also been said on several occasions that women who in their lifetime have gone or taken contraceptives get biologically affected health wise. This cascades down to suicide, despair and loss of all hope. This further causes stress, depression, anxiety and psychological stress and psychedelics.
There is little or no development in families affected by infertility because of lack of children, there is no education. At last couples end up in poverty and vulnerability. In other words, they face stigma and discrimination from some community members / couples who might have managed to have children in their lifetime. Economic hardships are a result of all these problems. Psychological stress leads to compromised health, a challenge which many people face in many developing and developed countries of the world.
Empowerment which is a process of enhancing individuals with the capacity to make choices and decisions is important in this area of health. Basic resources like finance, education, resources related to food and other basics all explain much about empowerment. Empowered individuals are capacitated with knowledge on how to make decisions about their reproductive lives. They participate in public discussions where they gain more information on sex and sexuality and related to sex and sexuality, reproductive health and AIDS. Continue…
Reproductive Empowerment is transformative process and an outcome. Individuals expand their capacity to make informed decisions about their reproductive lives, amplify their ability to participate in public and private discussions related to sexuality.
CAUSES … host of factors are anatomical, genetic, endocrinology and immunological. This is biological in nature which means therefore several people can be diagnosed to toxic substances and found to be along the same lines.
Preventable problems are related to reproductive tract infections, risk health care practices, exposure to toxic substances in the environment. In men sperm quality causes infertility. In female, abnormalities in reproductive hormonal expression, ovaries, fallopian tubes and uterus leads to infertility. In pregnancy, bilateral tubal occlusion is common. There is also lack of knowledge about menstrual cycle which results in poor management. Contraceptives use and delay to return to fertility after hormonal method use especially injectable use has no permanent causes.
With culture, there are super-natural causes, curses by ancestors, evil spirits, witchcraft, abortion, promiscuous behavior and being reckless during pregnancy or birth causes problems. However, this is subject of evidential general research………..
………. The next article will further explore how some countries in Sub-Sahara -Africa are managing in-fertility …
