ArticleBMC health services research2024
'It's about time': policymakers' and health practitioners' perspectives on implementing fertility care in the Gambian health system.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Systematic review of challenges and prospective recommendations of medically assisted reproductive technology in developing countries.Frontiers in reproductive health · 2025Pooled it
- How declines in fertility rates are informing responses within health systems: a protocol for a scoping review.BMJ open · 2026Article
- A realist evaluation of the development, implementation and outcomes of the first public ART Centre in Morocco.PLOS global public health · 2026Article
- FERTILITY CARE IN LOW- AND MIDDLE-INCOME COUNTRIES: Training in assisted reproduction in South Africa.Reproduction & fertility · 2025Article
- FERTILITY CARE IN LOW- AND MIDDLE-INCOME COUNTRIES: Public sector access to medically assisted reproduction in South Africa: a case study.Reproduction & fertility · 2025Review
- Perceptions of Health System Professionals on Integrating Fertility Care into Reproductive Health Policy in China.Healthcare (Basel, Switzerland) · 2025Article
- FERTILITY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Implementing fertility care: insights from a participatory workshop in The Gambia.Reproduction & fertility · 2024Review
- Policy action points and approaches to promote fertility care in The Gambia: Findings from a mixed-methods study.PloS one · 2024Article
Corrections and comments
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Authors and funding
7 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundInfertility is a major health issue worldwide, yet very few examples of interventions addressing infertility in the Global South have been documented to date. In The Gambia, West Africa, infertility is recognised as a burden and the health authorities have included it in several health policies and the new National Reproductive Health Strategy however, a detailed operationalisation plan for fertility care has not yet been established. Here, we aim to understand and document the factors that influence the implementation of fertility care in The Gambia.
methodsWe conducted 46 semi-structured interviews with policymakers, implementers, and health practitioners in both the public and private sectors from July to November 2021. The interviews were transcribed, anonymised and analysed with NVivo Pro version 1.6.1. The analysis was initially inductive, with themes arising from the coding categorised according to the WHO health systems building blocks framework.
resultsThis study identified several barriers to a successful implementation of fertility care in The Gambia, including (i) a lack of routinely collected infertility data; (ii) an absence of financial protection mechanisms for patients, and/or a specific budget for infertility; (iii) limited cooperation between the public and private sectors in the provision of fertility care; and (iv) gaps in fertility care training among health practitioners. Conversely, enablers included: (i) strong national infertility leadership; and (ii) the integration of infertility care within public reproductive health services.
conclusionThe Gambian health system is not yet in the position to support a comprehensive fertility care package in its public health facilities. Several aspects of the implementation of fertility care must be considered in operationalising the health strategy including the systematic collection of infertility data, fertility awareness, and the provision of specialised fertility care training. Furthermore, a stronger partnership between the public and private sectors must be developed. Given the increasing availability of assisted reproductive technologies in the sub-Saharan Africa region, and the tendency to locate these technologies in the private sector, further research is needed to understand and identify the processes underlying the implementation of fertility care and to foster better integration with the existing health system.
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