Infertility in Policy and Practices
Approximately 8-12% of all couples are infertile worldwide. Infertility rates vary among different countries ranging from less than 5% to over 30% (Kumar and Singh, 2015). A global review of infertility from the World Fertility Survey and others estimated infertility rates in South Asian countries including Bangladesh as 4% (Vaessen, 1984; Farely, 1988, cited in Kumar, 2007). Another estimate of overall primary and secondary infertility in South Asia, on the basis of women at the end of their reproductive lives in the age group 45-49 years, suggests an infertility rate of approximately 15% in Bangladesh (ibid), which is the highest among all South Asian countries. Bangladesh has an estimated population of 163.05 million and the country’s population growth rate or average annual change in the population is 1.37 percent. In Bangladesh about 3 million couples are infertile and about 24.51 million patients receive infertility advice or treatment. (F. Ashraf et all, 2017)
As Bangladesh is already overpopulated, controlling population priority is more on controlling the population and reproduction and fertility control dominates the focus of health policy (Nahar, 2018). For this reason, infertility never gets enough attention as a public health problem, even though people, mostly the women who are unable to have a child, face social exclusion. Therefore, in Bangladesh childlessness is much more than just medical illness (ibid).
Infertility study needs more attention. Infertility has a wide spectrum of physical, psychological and social effects, specifically on women. Like in many other countries motherhood is considered as an identity marker for women in Bangladesh. It is considered as ‘role failure’ if a woman fails to conceive even if her husband has a medical issue. Social stigmatization and isolation are the outcomes of such failure that may lead to physical and psychological abuse. On the other hand, men who have problems reproducing, also experience masculine crisis, they avoid seeking treatment of it which in turn expands the social dimensions of infertility. Gender diverse community, being in the margin of the society also have unheard stories regarding fertility and infertility. So, study on infertility in Bangladesh deserves special attention to address the gender related unfairness and prejudice while also making and implementing effective policy to address the issue. Although we know about the social and psychological effects of infertility and the factors associated with it in Bangladesh, there is a huge research gap both in social and public health aspects of it. Such research is a must if we want to develop an effective management system and address infertility while making treatment regime available and affordable and spreading awareness and empathy for the suffering people.
Download: Report on infertility