2.Identify and manage competing demands of infertility with other sexual and reproductive health conditions: Infertility has to compete with other reproductive health problems considered more important from a public health perspective. Nevertheless, it is usually possible to share physical resources if healthcare personnel are adequately trained.
Infertility has to compete with other reproductive health problems considered as having higher priorities, such as the prevention of maternal death and childcare, unwanted and adolescent pregnancies, prevention and management of STIs and prevention of cancer. Worldwide, public health strategies for the prevention of death will always find more acceptance than those directed towards the generation of new life and are interfered with by demographic, social and moral judgments. In this way, economic and human resources required for the management of infertility are postponed when they compete with resources allocated to other health areas considered higher priority or more importanct. (Vayena, 2001)
Although the reality of these competing demands constitutes a serious difficulty for the management of infertility in low resource settings, this barrier is primarily due to lack of trained personnel capable of educating, providing counselling and managing infertility. Overall, most of the facilities and equipment used for maternal care, prevention of sexually transmitted infections (STIs) and cancer can be efficiently shared in the diagnosis and treatment of multiple causes of infertility. It is the time allocation of human resources that is the most difficult challenge. This problem can be overcome by training nurses, midwives and other mid-level providers in simple infertility management care that can be integrated into other women’s healthcare programmes. (Zegers-Hochschild, 2011)