‘We are always desperate and will try anything to conceive’: The convoluted and dynamic process of health seeking among women with infertility in the West Coast Region of The Gambia

Dierickx, Susan; Balen, Julie; Longman, Chia; Rahbari, Ladan; Clarke, Ed; Jarju, Bintou; Coene, Gily

doi:10.1371/journal.pone.0211634

Cited by 20 publications

(29 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stakeholders’ understandings of the causes and treatments of infertility did not differ greatly from the stories of women with infertility (see [20] for details on people’s treatment seeking in case of infertility). They mentioned that many individuals rely on indigenous healers and attend sacred places for treatment.…”

Section: Resultsmentioning

confidence: 99%

“…In this study sample key stakeholders were formal health care providers, international agencies working on women’s rights and health, governmental institutions and NGOs working on the broader topic of women’s rights, infertility and/or who have been working with kanyaleng kafoolu (i.e. local groups of women who experience infertility and child loss and who organise themselves in order to cope with their circumstances and also to overcome their health problems) [3,20,27]. Some politicians and high-level policy-makers were contacted but were unfortunately unable to participate due to other obligations.…”

Section: Methodsmentioning

confidence: 99%

“…The Gambia has recently faced major political change. The former authoritarian President Yahya Jammeh (in power between 1994–2017) was internationally criticised for his provision of herbal treatments to ‘cure’ infertility, HIV/AIDS and asthma [20–22]. His leadership was characterised by brutal treatment of his opponents, including targeted assassinations and forced exiles [21].…”

Section: Introductionmentioning

confidence: 99%

“…His leadership was characterised by brutal treatment of his opponents, including targeted assassinations and forced exiles [21]. However, since early 2017, when a democratically elected government came into place following the 2016 elections and a brief transition period, there has been a re-opening of the broader health system to these issues, including an increased focus on infertility [20]. Furthermore, previous research on infertility in The Gambia has demonstrated the collaboration between organisations with a development agenda and kanyaleng kafoolu (i.e.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, previous research on infertility in The Gambia has demonstrated the collaboration between organisations with a development agenda and kanyaleng kafoolu (i.e. organisations for women who have been unable to achieve the local reproductive norm of a large family) [3,20,23]. Kanyaleng kafoo membership serves both as a coping mechanism and as a proactive effort to overcome infertility or child mortality by begging God and confusing the spiritual forces (i.e.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

The fertile grounds of reproductive activism in The Gambia: A qualitative study of local key stakeholders’ understandings and heterogeneous actions related to infertility

et al. 2019

Self Cite

View full text Add to dashboard Cite

IntroductionWhile several studies have focussed on the experiences of women living with infertility, there is a paucity of information related to understandings, representations and actions of key stakeholders (i.e. organisations and individual actors involved in activities or professional care surrounding infertility) when it comes to infertility in Sub-Saharan Africa. This ethnographic study conducted in The Gambia, West Africa, focuses on how key stakeholders in the country understand infertility, and on their activities to improve the lives of people with infertility.MethodologyThis ethnographic study draws on primary and secondary data for thematic analysis. Primary qualitative data were collected using in-depth interviews, observations, informal conversations and group discussion with various stakeholders (i.e. health care providers and representatives of non-governmental, governmental and international organisations). Sources of secondary data included government and non-governmental reports and media outputs.ResultsResults illustrated that most key stakeholders had a good understanding of the cultural frameworks and social realities of women living with infertility, with less focus on, or awareness of, men’s experiences of infertility. We distinguished three different positions of these actors and organisations, first, the infertility supporters, i.e. those who despite political challenges and a lack of funding, initiated activities to raise awareness about the problems people with infertility are facing and aim to increase access to infertility services. The second are moderate supporters, i.e. those who recognise the problems infertility poses and whose organisations target some of the perceived causes of infertility (i.e. lack of health education and harmful cultural practices). A third group of neutral or moderate opponents consist mainly of formal health care providers who do not consider infertility a current priority, given many competing demands in the resource-constrained healthcare system.ConclusionWhile international donors still largely neglect the emotional and social implications of infertility in Sub-Saharan African countries, some local stakeholders are working to bring services closer to people with infertility. The efforts of these local stakeholders require support and integration, and should include engaging with different groups for widespread sensitisation to reduce stigma and promote attendance to health centres for reproductive health challenges.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%