Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Department of midwifery, School of Nursing & Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
Global Health. 2020 Oct 23;16(1):104. doi: 10.1186/s12992-020-00617-9.
Infertility has recently become a salient but neglected global issue. Policies to address the sexual and reproductive health and rights (SRHR) are vital, especially in lower middle and middle-income countries (LMICs). Hence, the aim of this study was to compare the national infertility policies in the selected countries (LMICs comparing with high-income) to determine gaps or to confirm desirable policies in the given health systems.
This study has executed a comparative policy analysis of infertility services using the universal health coverage framework (financial protection, population coverage, and service features) in three scopes (prevention, treatment, and supportive care). Seven countries that had infertility programs in their health sectors were selected.
The results showed that financial protection was good in high and middle-income countries, but in a lower middle income, and in one high-income country was poor. The findings also showed that health systems in the same countries had no infertility services for men. Preventive and supportive care services were neglected in LMICs by governments.
The findings indicate that income is not the only factor that fulfills universal health coverage for infertility care services. Perhaps to achieve equity in infertility care services, it should be seen as a universal human right to accomplish the right to have a child and to have a life with physical and mental health for all men and women.
不孕不育问题近来已成为一个突出但被忽视的全球性问题。解决性与生殖健康和权利(SRHR)的政策至关重要,特别是在中低收入国家(LMICs)。因此,本研究旨在比较选定国家(LMICs 与高收入国家相比)的国家不孕不育政策,以确定在既定卫生系统中存在的差距或确认理想政策。
本研究采用全民健康覆盖框架(财务保护、人口覆盖和服务特征),在三个方面(预防、治疗和支持性护理)对不孕不育服务进行了比较政策分析。选择了七个在卫生部门有不孕不育项目的国家。
结果表明,高收入和中等收入国家的财务保护较好,但在一个中低收入国家和一个高收入国家则较差。研究结果还表明,同一国家的卫生系统没有为男性提供不孕不育服务。预防和支持性护理服务在 LMICs 中被政府忽视。
研究结果表明,收入并不是实现不孕不育护理服务全民健康覆盖的唯一因素。或许为了实现不孕不育护理服务的公平,应将其视为一项普遍的人权,以实现所有人享有生育和身心健康生活的权利。