A call has gone to the Federal Government of Nigeria to give special consideration to the treatment of infertility under the National Health Insurance Scheme (NHIS) in order to reduce the burden of individuals affected by the health issue.
Professor of Obstetrics and Gynaecology at the University of Ilorin, AbdulWaheed Olajide Olatinwo, made this call last Thursday while delivering the 178th Inaugural Lecture of the University, entitled “Help for the Helpless and Hope for the Hopeless: The Medicine of Reproductive Possibility
The Inaugural Lecturer, who is also the Chief Medical Director (CMD) of the University of Ilorin Teaching Hospital (UITH), made this submission submitted that infertility should be made a public health issue given its intersection across medical and social realms particularly in a clime like Nigeria where significant emphasis is placed on childbearing which is often seen as a most important determinant of marital success and social acceptability.
“Infertility is thus far from being a medical problem alone, it is also a social, emotional and cultural problem”, Prof. Olatinwo averred, pointing out that it is the “leading health problem where the non-medical consequences are worse than the medical implications of the disease.”
According to the renowned clinician, teacher of medicine and hospital administrator, “the socio-cultural and emotional implications of infertility have led, in many instances, to stigmatization, marital disharmony, personal dissatisfaction and feeling of inadequacy and depression, and it has led to in-laws becoming ‘monsters in-law’ due to untold pressure. Many times, things fall apart and the once happy conjugal union ends in divorce due to childlessness.”
Prof. Olatinwo added that “for others, the untold hardship leads to behavioural disorders including anxiety, depression, suicidal tendency, taking solace in the use of alcohol or psychoactive drugs to ‘wipe away the sorrow’ – all of which have been shown to increase the likelihood of developing additional sexual dysfunction thereby worsening the situation”.
The don further stated that “restoring hope for these hopeless individuals and ending their helplessness is not through a trial-by-error approach; rather, it involves intentional evidence-based scientific methods in restoring hope.”
While identifying Assisted Reproductive Technology (ART) as a widely adopted and successful measure towards confronting the challenge of infertility, Prof. Olatinwo lamented the inaccessibility of this technology to large sections of the population in low-resource settings due to the exorbitant cost of fertility treatment.
Putting forward his recommendations, the Inaugural Lecturer advocated a public financing of In-Vitro Fertilisation (IVF), which he noted, could be achieved through integrating the investigation and treatment of infertility into the existing reproductive health services.
He further pointed out that under his leadership as the CMD of the University’s teaching hospital, the UITH ART/IVF Centre, was “conceived out of the passion to provide ‘hope for the hopeless’ and ‘help for the helpless’ through the medicine of Assisted Reproductive Technology (ART).”
Prof. Olatinwo called on the Federal Government to “make efforts to improve infrastructures particularly in the area of stable power supply”, adding that “government can support the private sector firms, which are currently the main providers of IVF services, by way of reducing or even waiving taxes on equipment for IVF, drugs, and consumables.”
According to him, “this would significantly reduce the cost of treatment, thereby making IVF services more affordable”. He then canvassed for strong regulatory bodies to regulate every aspect of the ART practice in order to enhance efficiency and promote safety.
While calling for a speedy passage of the Bill on the establishment of the “Nigerian Assisted Reproduction Authority” presented by the Association of Fertility and Reproductive Health (AFRH-Nigeria) to the National Assembly, Prof. Olatinwo enjoined Nigerian universities with relevant postgraduate medical programmes to consider starting subspecialty training in infertility.
To achieve this, he said, “Collaboration with local IVF centres and foreign universities should be sought so that trainees can spend valuable time in such centres to improve their knowledge and skills in ART services”, adding that “to address the personnel and training needs of the region, IVF centres should seek accreditation and begin training programmes for the various categories of personnel needed in this highly specialised field of medicine.”
The CMD also called for increased educational and socio-economic empowerment of women, pointing out that these are necessary preconditions for the reduction of maternal morbidity and mortality.
While urging the government to provide free maternal and child health care services for pregnant women and their children under the age of five years as a way of curbing avoidable deaths among women and children, Prof. Olatinwo further charged the authorities to expedite action towards “achieving universal health coverage for the citizens as a vehicle for achieving qualitative healthcare for all.”
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