Basic Tool 3: Societal Barriers




  1. Identify and reduce socioeconomic, demographic, religious and cultural barriers: Cultural, religious and socioeconomic barriers can limit access to care. When these barriers are identified, it is often possible to take some steps to reduce their impact on limiting access to infertility care, and to identify treatments that can be provided.
  1. Identify and manage competition of infertility with other sexual and reproductive health conditions: Infertility has to compete with other reproductive health problems considered to be more important from a public health perspective. Nevertheless, it is usually possible to share physical resources if healthcare personnel are adequately trained.
  1. Facilitate the patient’s journey through healthcare networks: In general, there is little communication between Primary Health Care (PHC) clinics and referring hospitals where infertility is diagnosed and treated. Strategies must be developed to bridge the gap between these two in order to provide efficient referrals and treatments.
  1. Identify and improve education on risk factors and encourage male partner involvement: Implementation of sex education in schools can reduce the incidence of STIs and unwanted pregnancy. Furthermore, involving males can improve the quality of family life and the outcomes of fertility treatment.
  1. Identify Healthcare Providers to develop community education programmes: Health Care Providers should be trained to educate the community regarding prevention and treatment of infertility. The interconnection between infertility and sexual health and general health should be emphasized.
  1. Identify the infertile and develop protocols to transition between primary and advanced care: By identifying fertile and infertile couples, couples with normal fertility can be educated and advised to wait so as to avoid unnecessary interventions, while others can be treated or referred.
  1. Evaluate the psychosocial impact of infertility in the family: The large impact of infertility on the patient, her partner and their families should be assessed and used to help the patients and other affected/involved individuals.
  1. Identify organizations that can encourage infertility awareness and influence decision-makers: Identify (women) leaders, lawmakers and others who are sensitive to those suffering from infertility. These leaders can be encouraged to find solutions to improve access to quality infertility care.
  1. Provide training to diagnose and treat low and middle complexity infertility in the primary health care setting: Develop the capacity to deal with less complex treatments at the primary healthcare level by training health providers, such as nurses and midwives, and bridge them with their referral centre.
  1. Promote public/private partnerships to provide better access to complex treatments: Strengthening cooperation between public and private networks can provide more cost-effective treatments in the public clinics and can be instrumental in increasing access to health care.