Exploring experiences of infertility amongst women and men in low-income and middle-income countries: protocol for a qualitative systematic review

Abstract

IntroductionInfertility is increasingly recognised as a global public health issue for women and men that merits further investigation to support policy and programming. While research in high-income settings has examined the consequences of infertility and access to services, there has been limited synthesis of how individuals experience infertility in low-income and middle-income countries (LMICs). This protocol describes a systematic review that will synthesise qualitative evidence on experiences of infertility among women and men in LMICs.Methods and analysisThe review will follow the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) guidelines for reporting on qualitative evidence syntheses. The study team will search for published literature in PubMed, CINAHL and Scopus and PsycINFO databases and review available grey literature. Using Covidence software, two independent reviewers will conduct title and abstract screening based on inclusion and exclusion criteria, followed by full-text reviews and extraction by a larger team. Quality will be appraised using an adapted version of the Critical Appraisal Skills Programme guidelines. We will conduct thematic synthesis to characterise individual experiences and related factors at the individual, interpersonal, community and health system levels. We will develop a conceptual framework to describe evidence on experiences of infertility in LMICs and to help inform interventions across settings.Ethics and disseminationThis protocol has been internally approved as exempt by the Institutional Review Board of the Population Council, as it does not involve contact with human subjects or personally identifying data. Results of the review will be published in a peer-reviewed journal and will be used to inform future infertility research and programming in LMICs.PROSPERO registration numberCRD42021227742.

‘It’s about time’: policymakers’ and health practitioners’ perspectives on implementing fertility care in the Gambian health system

“…Despite (i) the importance of implementing fertility care within health systems, and (ii) the increased global attention given to in scaling-up sustainable health interventions, very few studies in the Global South have been conducted on infertility from a health systems perspective [ 26 , 27 ]. Here, we aim to understand the factors influencing the operationalisation of fertility care in The Gambia by drawing on the WHO’s health system building block framework [ 28 ], and documenting how current national health policies support the implementation of fertility care.…”