State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, No.101 Longmian Road, Nanjing, 211166, China.
Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
BMC Public Health. 2022 Jul 19;22(1):1378. doi: 10.1186/s12889-022-13802-9.
Infertility has troubled millions of people worldwide while always being an ignored issue. The high cost of treatment or lack of services placed a barrier to the alleviation of infertility status. Governments play a significant role to promote infertility-related policies for better access to infertility services and comprehensive supports for infertile people.
Data of infertility status indicators and infertility-related policies in ten representative countries were collected. An infertility-related policy system was established, then classification and quantification were processed according to specific criteria, and different policy implementation patterns were identified. The effectiveness of specific infertility-related policy and various patterns on infertility prevalence relief between 1990 and 2017 were evaluated via generalized linear models and analyses of covariance for the first time.
Economic support policies would be less prioritized compared with social security policies, while economic support policy had a significant positive role in the decline of female infertility prevalence (β = -2·16, p = 0·042). In detail, insurance coverage and economic reward policies were crucial (β = -3·31, p = 0·031; β = -4·10, p = 0·025) with adjusted with covariates. The effect of economic support-oriented pattern was relatively better than other patterns for both male and female infertility prevalence relief. Nevertheless, the effectiveness of gradual-promotion pattern seemed preferable for male infertility prevalence relief while was similar with simultaneous-promotion pattern for females.
Our data-driven analysis revealed that insurance coverage and economic reward policies played the pivotal role in moderation of female infertility status. Economic support-oriented pattern and gradual-promotion pattern were preferable when promoting infertility-related policies.
不孕症困扰着全球数百万人，而它一直是一个被忽视的问题。高昂的治疗费用或缺乏服务成为缓解不孕症状况的障碍。政府在促进与不孕症相关的政策方面发挥着重要作用，以更好地获得不孕症服务和为不孕人群提供全面支持。
收集了十个具有代表性的国家的不孕症状况指标和不孕症相关政策的数据。建立了一个不孕症相关政策体系，然后根据具体标准进行分类和量化，并确定了不同的政策实施模式。首次通过广义线性模型和协方差分析评估了特定的不孕症相关政策和各种模式在 1990 年至 2017 年期间对缓解不孕症流行率的效果。
与社会保障政策相比，经济支持政策的优先级较低，而经济支持政策对女性不孕症流行率的下降具有显著的积极作用（β=-2.16，p=0.042）。具体而言，保险覆盖和经济奖励政策至关重要（β=-3.31，p=0.031；β=-4.10，p=0.025），并进行了协变量调整。对于男性和女性不孕症流行率的缓解，经济支持导向模式的效果均优于其他模式。然而，对于男性不孕症流行率的缓解，逐步推进模式的效果似乎优于同时推进模式，而对于女性，这两种模式的效果相似。
我们的数据驱动分析表明，保险覆盖和经济奖励政策在调节女性不孕症状况方面发挥了关键作用。在促进与不孕症相关的政策时，经济支持导向模式和逐步推进模式是可取的。
