Asian Population Association (APA) Scientific Group (SG)
Theme: Bringing Fertility Services into Focus: A Forgotten Pillar of Family Planning in Asia

Rationale:

Since 2020, many Asian countries have experienced fertility rates below the replacement level. However, few have incorporated fertility services into their programs to assist infertile couples and enhance overall fertility levels. Additionally, infertility is not widely recognised as a gender issue, and there is limited governmental support to help underprivileged women overcome this challenge. Moreover, infertility remains heavily stigmatised in many Asian societies, particularly for women, impacting their long-term mental health (Unisa, 1999; 2010; Nahar, 2022; Bagade et al., 2022). Limited data on infertility prevalence, poor documentation, and definitional ambiguities have hindered advocacy efforts for infertility services, making them weaker compared to other reproductive health issues (WHO, 2023). Additionally, couples often spend substantial amounts on treatment, and those unable to afford it face significant socio-cultural and psychological challenges (Rozee & Unisa, 2016; Njagi et al.,2023). 

Source of data: https://population.un.org/dataportal/data/indicators/

Infertility Rate and Fertility Services in Government Health Facilities

a: Better Health Channel; b: WHO-based estimates; c: Various studies and estimates; d: Based on ICMR & WHO estimates; e: Limited national data; f: Various studies and estimates

Furthermore, infertility diagnosis and treatment are primarily available in private hospitals in many countries. Couples seeking these services often face high out-of-pocket expenses, as government funding does not cover these treatments.  In a few countries with partial services, the out-of-pocket costs can still be significant. Consequently, access to infertility care can be limited for those who cannot afford private healthcare. Therefore, a strategic and unified advocacy effort is needed to drive for better support and funding for infertility treatments, ensuring more equitable access to these essential services.

Aim:

To promote awareness, advocate for policy changes, and collaborate with healthcare providers to improve the accessibility of infertility diagnosis and treatment, while strengthening research and public health integration of fertility services.

Objectives:

1. To build a collaborative, multidisciplinary network of professionals dedicated to advocating for equitable and ethical fertility care within public health systems.
2. To raise awareness among policymakers and public health stakeholders about the importance of integrating comprehensive fertility services into national healthcare systems.
3. To engage and support early-career researchers in investigating the causes, prevalence, and societal impacts of infertility and childlessness.
4. To provide training for researchers in standardised methodologies for collecting and analysing data on infertility and assisted reproductive technologies (ART).
5. To examine and compare ART and surrogacy practices across Asian countries, focusing on their accessibility, costs, legal frameworks, and associated socio-psychological dimensions.

 Activities:

1. Advocacy and Consultation: Create country-specific advocacy papers and conduct national and international consultation meetings with public health officials and program personnel.
2. Workshops and Webinars: Organise workshops to develop proposals on infertility and ART-related issues, host webinars, and publish an edited book of presented papers.
3. Public Awareness and Policy Influence: Launch public awareness campaigns via social media, traditional media, and community events, and develop policy briefs and reports to influence policymakers on integrating fertility services into public health systems.
4. Follow-Up and Sustainability Planning: A regional task force will be developed to follow up after the consultation meeting with policymakers.
5. Leverage Digital Platforms: Creating an online repository or platform for sharing resources, case studies, and ongoing research to maintain momentum and encourage cross-country collaboration.

Output:

1. Comprehensive reports and recommendations aimed at policymakers for integrating infertility care into public health systems.
2. Published studies and datasets analysing infertility prevalence, diagnosis gaps, and treatment accessibility across different demographics.

Outcome:

1. A well-structured, impactful approach to addressing fertility care and ART-related issues within public health systems.
2. Comprehensive studies leading to a deeper understanding of infertility trends and influencing global policy discussions.

Team Members:

Potential Funding:

Wellcome Trust, UNFPA, WHO, ICSSR, ICMR, Country level or institutional level Support