Asemota Obehi A, Klatsky Peter
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The Albert Einstein College of Medicine, Bronx, New York.
Semin Reprod Med. 2015 Jan;33(1):17-22. doi: 10.1055/s-0034-1395274. Epub 2015 Jan 7.
Infertility in resource-poor settings is an overlooked global health problem. Although scarce health care resources must be deployed thoughtfully, prioritization of resources may be different for recipient and donor countries, the latter of whom focus on maternal health care, prevention, and family planning. For women and couples with involuntary childlessness, the negative psychosocial, sociocultural, and economic consequences in low-income countries are severe, possibly more so than in most Western societies. Despite the local importance of infertility, few resources are committed to help advance infertility care in regions like sub-Saharan Africa. The worldwide prevalence of infertility is remarkably similar across low-, middle-, and high-income countries. The World Health Organization (WHO) recognizes infertility as a global health problem and established universal access to reproductive health care as one of the United Nation's Millennium Developmental Goals for 2015. Currently, access to infertility care is varied and is usually only attainable by the very wealthy in low-income countries. We provide an overview on the current state of access to infertility care in low-income countries such as in sub-Saharan Africa and a rationale for providing comprehensive reproductive care and possible solutions for providing cost-effective infertility services in these settings.
资源匮乏地区的不孕症是一个被忽视的全球健康问题。尽管稀缺的医疗资源必须谨慎调配，但资源的优先分配在受援国和捐助国可能有所不同，后者侧重于孕产妇保健、预防和计划生育。对于非自愿无子女的妇女和夫妇来说，低收入国家在心理社会、社会文化和经济方面的负面后果很严重，可能比大多数西方社会更甚。尽管不孕症在当地很重要，但撒哈拉以南非洲等地区用于推进不孕症治疗的资源却很少。不孕症在低收入、中等收入和高收入国家的全球患病率非常相似。世界卫生组织（WHO）将不孕症视为一个全球健康问题，并将普及生殖健康护理确立为联合国2015年千年发展目标之一。目前，在低收入国家，获得不孕症治疗的机会各不相同，通常只有非常富有的人才能得到。我们概述了撒哈拉以南非洲等低收入国家获得不孕症治疗的现状，以及在这些地区提供全面生殖护理的理由和提供具有成本效益的不孕症服务的可能解决方案。
