An evaluation of comprehensiveness, feasibility and acceptability of a fertility awareness educational tool

Abstract

The World Health Organization (WHO) and World Bank have identified infertility as a global public health issue. Since the 1980s, WHO has advocated for a focus on prevention, especially where the burden of prevalence is highest, specifically in women from low- and middle-income countries (LMIC). The aim of the two studies presented here is to demonstrate a process to enhance implementation efforts in fertility awareness programmes that could assist in preventing some forms of infertility, and increase understanding of factors that could result in fertility problems. The fertility status awareness tool (FertiSTAT) for the Middle East was adapted to provide an illustrative example of requirements for region- or country-specific adaptation. The mixed methods approach used included a survey of international medical experts concerning the comprehensiveness of risks included in the original FertiSTAT (Study I), and stakeholder meetings to assess the feasibility and acceptability of using an adapted FertiSTAT in the Middle East (Study II). The results indicate that the content of the original FertiSTAT was acceptable but not comprehensive in its coverage of potential risk factors; for example, it did not include genital tuberculosis, human immunodeficiency virus, consanguineous relationships and female genital mutilation/cutting. Furthermore, stakeholder meetings revealed that implementation in the Middle East would be enhanced by the use of more culturally sensitive wording. The data highlight the importance of implementation research with participants from LMIC, and the need for standardized protocols for adaptation of any fertility awareness programme or tool before practical application.

A rapid scoping review of fear of infertility in Africa

“…People making choices would fear future infertility less if infertility caused less dire consequences for those affected. Current initiatives to increase understanding and awareness of causes of fertility problems [ 49 ], integration of fertility care in sexual and reproductive health policy [ 52 ] and inclusion of fertility topics in national education curriculums should help. We agree with recent calls for integration at such levels [ 50 ] because it would stimulate the necessary partnerships across areas where FOI was observed and strengthen potential for timely research and health education.…”

“…Fear of infertility was also associated with religious practices (e.g., prayer, fasting) or divine interventions [30,33,39,41,45]. Men and women sought biomedical treatment [18,47,49,50] but some kept treatment secret [30,37].…”

Female subfertility

“…Given the steady increase in the median maternal age at first birth, future research should address the potential link between fertility knowledge, treatment beliefs and planning of parenthood. Public health programmes need to raise awareness of the effects on fertility of lifestyle choices, and of practices such as female genital mutilation and consanguineous marriage 106 . Increased research is required on effective ways to address lifestyle factors that affect fertility.…”

Innovative Strategies for Developing Tuberculosis Implementation Research in Sudan

“…The prevalence of risk factors of tuberculosis can be used to ascertain the vulnerable groups and develop public health strategies namely adequate surveillance system and early warning and response body to guard particularly against multi-drug resistant tuberculosis. Principally, the risk of anti-drugs resistant disease is very high; this increases the need to nd new low-cost drugs (18)(19)(20). One of the more interesting aspects of the present study into new implementation systems may in fact be the sequencing of their outcomes.…”