Academic journal article Perspectives in Public Health

Consequences of Infertility in Developing Countries

Academic journal article Perspectives in Public Health

Consequences of Infertility in Developing Countries

Article excerpt

Keywords

infertility; developing countries; economic consequences; social consequences; psychological consequences; infecundity and men

Abstract

Infertility affects more than 10% of the world's population. In developing countries, there are severe social, psychological and economic consequences for infertile men and women. All of the cited references are compiled from primary peer-reviewed research articles that were conducted through one-to-one interviews or focus groups in countries of developing regions, such as Africa, Asia and the Middle East. The following paper seeks to raise awareness of the consequences of infertility in developing nations and identify infertility as an under-observed, but significant public health issue. It is proposed that education programmes tailored to each society's specific religious beliefs and grounded traditions must be implemented in order to reverse the social stigma, detrimental psychological effects, and loss of economic security that results from infertility.

INTRODUCTION

Infertility is a public health issue, with more than 10% of the world's population having difficulty conceiving through natural methods. Infertility is defined as not having conceived after one year of unprotected sexual intercourse.1 Primary infertility is the inability to bear any children. Secondary infertility is the inability to become pregnant after previously conceiving, whether or not the first pregnancy came to full term.2 The face of infertility has long been stereotyped as a career-driven, wealthy, Caucasian, over-40-year-old woman who delayed becoming pregnant until after she had established herself independently;3 however, this is not the case.

The majority of people with infertility issues are residents of Third World countries.4 There are very limited data on the prevalence of infertility in the developing world, but few dated studies show that infertility affects more than 20% of people in Gambia, Ethiopia and Nigeria. The prevalence of infertility in Asia, South America and the Caribbean has not been reported.5-9 The present manuscript will show that infertility not only affects women, but also men; it will also show that infertility affects couples of all ages, races and class divisions. The chief concern of this article is to focus on the consequences of infertility in poorresource nations.

Every culture holds different reasons and beliefs as to why infertility is stigmatised; however, universal trends persist. Generally, consequences fall under one of three categories: social, psychological or economic. In many developing countries, social stigmas are attached to infertility.10,11 For example, women cannot join communal social groups, since access to this privilege follows pregnancy. 12,13 However, it is not only women who are affected by infecundity; infertile men are also plagued with negative consequences. Loss of social status, social isolation and marital instability for both men and women define the social outcomes. Psychologically, women lose their 'womanhood' and sense of gender identity when they cannot conceive; men are not considered to be a 'man' if they do not have a child.14-16 Compared to western societies, infertile couples in Third World countries feel a deeper depth of guilt, shame, worthlessness and depression if they cannot conceive. 10 In addition to the financial burden of expensive treatment, families may take away a woman's social security, as well as any gifts or inheritance she might have received during marriage, if she cannot bear a child.17 In some nations, men are forced out of work, which further contributes to the cycle of poverty.18

Organisations such as Planned Parenthood, and programmes such as infertility support groups, have not been established in most developing countries, so circumnavigating the social, psychological and economic costs of infertility can be lonely and debilitating. These resources are meant to educate couples, provide family planning services, and increase knowledge of reproductive health options and infertility treatments. …

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