According to World Health Organisation (WHO), more than 180 million couples in developing countries (one in every four couples) suffer from primary infertility. In Africa, infertility is caused by infections in over 85 per cent of women. The social stigma of childlessness, especially for infertile women, still leads to isolation in many cultures. Inability to have a child or to become pregnant can result in being greatly ostracised, isolated, disinherited or assaulted. This may result in denial access to family traditions, divorce or physical and psychological violence.
WHO describes infertility as a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of unprotected sexual intercourse. The couple must be non-contraceptive but male do present with sub-fertility which can be managed with specialist advice. A central difficulty associated with infertility is that it can transform from an acute, private distress into a harsh, public stigma with complex and devastating consequences.
Some infertile women endure stressful lifetime from their husbands or families that can cause them to suffer different diseases like hypertension or diabetes.
Empowering women with infertility should comprise providing medical education and trainings for healthcare providers and governments to define policies to improve access to awareness and safe, effective and fertility care. There is also need for interventions to reduce stigmatisation and social suffering of infertile women, as well as the necessity for a team approach to family building among couples.
Although male-related factors contribute about half of all cases of infertility, women are also overwhelmingly perceived as being the party responsible for a couple’s infertility, and subsequently the social suffering associated with infertility tends to be greater towards them than their husbands. With the fact that women are seen pregnant and giving birth, the burden of infertility is often assumed to fault them more than men.
Intimate partner violence (IPV), gender-based violence (GBV) and domestic violence have been shown to have significant association with individuals and couples suffering from infertility.
On the mental health aspect, high rates of clinical symptoms of depression and anxiety, suicidal tendencies and a strong conceptualisation of grief affect infertile individuals.
There are key challenges to be addressed which are associated with resource constraints such as prevention of infertility, education, self-development, in-vitro-fertilization regulation and geographic barriers. There are differences between the developed and developing world which emerge because of the difference in availability of safe, effective and equitable infertility care and different socio-cultural value surrounding parenthood and procreation.
The so-called modern woman in Africa appears to be the main tool for development, but also the illiterate one, infertile with no voice, not involved in research or scientific activities but suffers sexual harassment and genital mutilation. Traditionally, most of African societies are maintained by women but how can they develop without empowering their core and main pillar?
Africa’s GDP is said to grow at around 6 per cent. The development is changing traditional roles of women from home-based activities to income-generating tasks. Women can now drive, study sciences, start and maintain businesses and so on.
Empowering women doesn’t require extra care or use mystical power; it is simple and will start from changing daily activities to reversing discriminatory minds. Improving access to awareness of life opportunities is another good step. Women have to know that they can study, work, act, express their choices, and understand their health and rights. Easing access to health, education, financial means and agriculture opportunities is an ideal gear to Africa’s development. Women can be more than mothers if we can start by speaking to women the same way as we speak to men and fighting illiteracy.
The writer is a fifth year medical student at University of Rwanda