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Current Women`s Health Reviews

Author(s): Paula Remoaldo, Maria de Fátima da Silva Vieira Martins*, Juliana Patrícia Alves Faria and Paula Veiga

DOI: 10.2174/1573404814666171207154544

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Access to Infertility Consultations “What Women Tell Us About it”?

Page: [75 - 83] Pages: 9

  • * (Excluding Mailing and Handling)

Abstract

Background: Infertility has been considered as a serious public health problem. Nevertheless, it is still very difficult to assess the epidemiology of this individual and public health problem. On the other hand, promotion of access to infertility treatments must be treated as a priority to national and regional policies.

Objective: The aim was to evaluate the perception of women concerning the barriers and access to infertility consultations.

Methods: Socio cultural and economic access to infertility consultations is detached and three municipalities of the northwest of Portugal were chosen as an example of a peripheral country. A quantitative/qualitative study was done with 60 women.

Results: Three dimensions were evaluated: geographic and structural and functional access, economic access and sociocultural access. The main barriers were mainly identified in the last two dimensions. The economic access was less well evaluated by women bearing the cost of treatment (medication, and concentration of costs in a short period) which is difficult to bear.

Conclusion: This can justify a greater involvement of the Portuguese Government, by developing policies for the reimbursement of part of the costs. Also, some changes in structural and functional access must be done with special regard to the separation of the infertility consultations from the reproductive medicine section. The setting of the teams, with a follow-up by the same team of health professionals is also needed.

Keywords: Infertility, perception, women, care, access, equity.

Graphical Abstract

[1]
Bushnik T, Cook JL, Yuzpe AA, Tough S, Collins J. Estimating the prevalence of infertility in Canada. Hum Reprod 2012; 27(3): 738-46.
[2]
World Health Organization. Infertility is a global public health issue. Available from:. http://www.who.int/ reproductivehealth/ topics/infertility/perspective/en/ (Accessed on: December 28, 2016).
[3]
Cousineau TM, Domar AD. Psychological impact of infertility. Best Pract Res Clin Obstet Gynaecol 2007; 21(2): 293-308.
[4]
Connolly MP, Hoorens S, Chambers GM. The costs and consequences of assisted reproductive technology: an economic perspective. Hum Reprod 2010; 16(6): 603-13.
[5]
Macaluso M, Wright-Schnapp TJ, Chandra A, et al. A public health focus on infertility prevention, detection, and management. Fertil Steril 2010; 93(1): 16.e1-16.e10.
[6]
Machado H, Remoaldo PC. Incomplete women and strong men – accounts of infertility as a gendered construction of well-being. In: Harris B, Gálvez L, Machado H (Eds.). Gender & Well-being in Europe: Historical and Contemporary Perspectives. London: Ashgate Publishing 2009; 223-42.
[7]
Dondorp W, Wert G, Pennings G, et al. Oocyte cryopreservation for age-related fertility loss. Hum Reprod 2012; 27(5): 1231-7.
[8]
Ombelet W. Is global access to infertility care realistic? The Walking Egg Project. Reprod BioMedic Online 2014; 28: 267-72.
[9]
Wellons MF, Lewis CE, Schwartz SM, et al. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA women’s study. Fertil Steril 2008; 90(5): 1640-8.
[10]
Chambers GM, Hoang VP, Zhu R, Illingworth PJ. A reduction in public funding for fertility treatment - an econometric analysis of access to treatment and savings to government. BMC Health Serv Res 2012; 12: 142-57.
[11]
Premkuma BJ, Agarwal A. Female infertility and assisted reproduction: Impact of oxidative stress-An update. Curr Womens Health Rev 2012; 8: 183-207.
[12]
Ombelet W. The walking egg project: Universal access to infertility care – from dream to reality. Facts Views Vis ObGyn 2013; 5(2): 161-75.
[13]
Ombelet W. False perceptions and common misunderstandings surrounding the subject of infertility in developing countries. ESHRE Monog 2008; 2008: 8-11.
[14]
World Health Organization. Progress Report in Reproductive Health Research. No. 23. Geneva: Switzerland;. 2003.
[15]
Kessler LM, Craig BM, Plosker SM, Reed DR, Quinn GP. Infertility evaluation and treatment among women in the United States. Fertil Steril 2013; 100(4): 1025-32.
[16]
Domar A, Gordon K, Garcia-Velasco J, et al. Understanding the perceptions of and emotional barriers to infertility treatment: a survey in four European countries. Hum Reprod 2012; 27(4): 1073-9.
[17]
Sundby J. Infertility in public health: The case of Norway. Facts Views Vis ObGyn 2010; 2(3): 177-81.
[18]
Sanchez RM, Ciconelli RM. Conceitos de acesso à saúde. Rev Panam Salud Publica 2012; 31(3): 260-8.
[19]
Andersen RM, McCutcheon A, Aday LA, Chiu GY, Bell R. Exploring dimensions of access to medical care. Health Serv Res 1983; 18(1): 49-74.
[20]
Gulliford M, Figueroa-Muñoz J, Morgan M. Meaning of ‘access’ in health care. In Gulliford M, Morgan M (Ed.). Access to Health Care. Routledge: London 2003; 1-12.
[21]
Marmot M, Allen J, Bell R, Bloomer E, Goldblatt P. WHO European review of social determinants of health and the health divide. Lancet 2012; 380(9846): 1011-29.
[22]
Chapman JL, Zechel A, Carter YH, Abbott S. Systematic review of recent innovation in service provision to improve access to primary care. Br J Gen Pract 2004; 54(502): 374-81.
[23]
Nachtigall RD. International disparities in access to infertility services. Fertil Steril 2006; 85(4): 871-5.
[24]
Paez A, Mercado RG, Morency C, Roorda C. Accessibility to health care facilities in Montreal Island: An application of relative accessibility indicators from the perspective of senior and non-senior residents. Int J Health Geogr 2010; 9: 52-67.
[25]
Figueroa Pedraza D, Cavalcanti Costa GM. Accessibility to public health services: The vision of the users of the Family Health Program in Campina Grande, state of Paraiba, Brazil. Enfermeria Global 2014; 13: 267-78.
[26]
Chambers GM, Hoang VP, Illingworth PJ. Socioeconomic disparities in access to ART treatment and the differential impact of a policy that increased consumer costs. Hum Reprod 2013; 28(11): 3111-7.
[27]
Chambers GM. The impact of consumer affordability on access to assisted reproductive technologies and embryo transfer practices. An international analysis. Fertil Steril 2014; 101(1): 191-8.
[28]
World Health Organization. WHO Evaluation of National Health Plan Portugal (2004-2010). 2010. Available from:. http://pns. dgs.pt/files/2010/02/WHO-E.pdf (Accessed on: December 12, 2016).
[29]
Direção-Geral da Saúde. Plano Nacional de Saúde 2012 – 2016- Eixo Estratégico-Qualidade em Saúde. Lisboa: DGS. 2012.
[30]
Entidade Reguladora da Saúde (ERS). Estudo do Acesso aos Cuidados de Saúde Primários do SNS. Lisbon: GGS. 2009.
[31]
Bardin L. Analyse de contenu Paris: PUF; 2013.
[32]
Instituto Nacional de Estatística. Classificação Portuguesa das Profissões 2010. Lisboa: INE;. 2011.
[33]
Thonneau P, Bujan L, Multigner L, Mieuss R. Occupational heat exposure and male fertility: A review. Hum Reprod 1998; 13(8): 2122-5.
[34]
Augusto A. Infertilidade e Reprodução Medicamente Assistida em Portugal: Dos problemas privados aos assuntos públicos [PhD Tesis]. Beira Interior: Universidade da Beira Interior; 2004.
[35]
Moutinho S. Tudo por um Filho Viagem ao Mundo da Infertilidade em Portugal Porto: Publicações Dom Quixote 2003.
[36]
Silva S, Barros H. Perspectives on access to in vitro fertilization in Portugal. Rev Saude Publica 2012; 46(2): 344-50.
[37]
Silva S. Médicos, Juristas e “Leigos” – Um estudo das representações sociais sobre a reprodução medicamente assistida [Sociology Thesis]. Porto: University of Porto – Faculty of Letters 2008.
[38]
Aldana JM, Piechulek H, Al-Sabir A. Client satisfaction and quality of health care in rural Bangladesh. Bull World Health Organ 2001; 79(6): 512-7.
[39]
Faria J. Acesso aos tratamentos de infertilidade no Centro Hospitalar do Alto Ave [Master thesis] Braga: Universidade do Minho 2013.