Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, Diepenbeek, Belgium
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recognised as a disease, and universal access to high-quality services for family planning, including fertility care, is one of the core elements of reproductive health ( WHO 2020 ). With this fact sheet, the WHO acknowledged that patients have a right to
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Introduction: The Gambia, West Africa, has made recent progress on infertility, a component of sexual and reproductive health that is lagging behind others. Since 2016, there is favourable policy environment stemming from infertility research and partnership building with national stakeholders and local civil society organisations focussing on infertility. Here, we report outcomes from a participatory workshop on infertility policy implementation in The Gambia and provide insights on setting national priorities for fertility care in resource-limited settings. Methods: We conducted a participatory workshop involving 29 participants from Gambia’s public and private health sectors. Using selected participatory group work tools, stakeholders identified and prioritised key activities within the framework of five pre-defined areas of action, including (i) creating guidelines/regulations; (ii) recording/reporting data; (iii) building public-private partnership; (iv) training health providers; and (v) raising awareness and health-seeking.
Results: 17 prioritised activities were proposed across the five action areas, according to short- medium- and long-term timeframes. Three were further prioritised from the overall pool, through group consensus. A Group Model Building activity helped to envision the complexity through elucidating links, loops, and connections between each activity and their expected outcomes. Conclusions: The participatory workshop identified actionable interventions for fertility care in The Gambia, with stakeholders setting a clear path ahead. Despite challenges, the continued engagement of Gambian policymakers, practitioners, researchers, and activists in efforts to move beyond policy creation to its implementation is essential. Improving fertility care in The Gambia and other LMICs is feasible with effective collaboration and financial support.
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and nursing staff were appropriately prepared, trained and if necessary redeployed. The British Fertility Society (BFS) and the Association of Reproductive and Clinical Scientists (ARCS) issued guidance concerning the care of fertility patients during
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NIHR Applied Research Collaboration Wessex, Southampton, UK
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NIHR Applied Research Collaboration Wessex, Southampton, UK
NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Complete Fertility, Princess Anne Hospital, Southampton, UK
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latter could be explained by the phenomenon of developmental origins of health and disease ( Barker 2007 ). Numerous reviews have highlighted the adverse effects both endometriosis and adenomyosis have on fertility and birth outcomes. Endometriosis
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Paediatric Oncology, Leeds Children’s Hospital, Leeds, UK
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, international guidelines recommend that cancer teams should discuss the impact of cancer treatment on future fertility with the patient ( Loren et al. 2013 , National Institute of Health and Care Excellence 2017 , Yasmin et al. 2018 , ESHRE 2020
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Paediatric Integrated Cancer Service, VIC, Australia
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.12.010 ) Garg D Johnstone EB Lomo L Fair DB Rosen MP Taylor R Silver B & Letourneau JM 2020 Looking beyond the ovary for oncofertility care in women: uterine injury as a potential target for fertility-preserving treatments . Journal of
Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK
Hewitt Centre for Reproductive Medicine, Liverpool Women’s NHS Foundation Trust, Liverpool, UK
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Hewitt Centre for Reproductive Medicine, Liverpool Women’s NHS Foundation Trust, Liverpool, UK
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Hewitt Centre for Reproductive Medicine, Liverpool Women’s NHS Foundation Trust, Liverpool, UK
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Liverpool Women’s NHS Foundation Trust, Member of Liverpool Health Partners, Liverpool, UK
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exercise despite data from two large observational fecundability studies showing that vigorous PA was associated with delayed time to pregnancy in women with a normal BMI not currently seeking fertility care ( Wise et al. 2012 , McKinnon et al. 2016
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infertility as high as 25% in China ( Zhou et al. 2018 ) and 31.1% in Nigeria ( Polis et al. 2017 ). Fertility care encompasses the prevention, diagnosis and treatment of infertility and is an important part of addressing the right of individuals and
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lack of access to health-care services, a lack of information and education about the benefits of contraception, and poverty ( Okonofua 2014 , Akamike et al. 2020 , Anyatonwu et al. 2023 ). Furthermore, low levels of female education, a strong
Department of Nutrition and Integrative Physiology, University of Utah College of Health, Salt Lake City, Utah, USA
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Department of Nutrition and Integrative Physiology, University of Utah College of Health, Salt Lake City, Utah, USA
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Department of Nutrition and Integrative Physiology, University of Utah College of Health, Salt Lake City, Utah, USA
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lifted the experimental label for OTC that can now be offered as a standard of care ( Medicine ECotASfR 2018 ). Traditionally in prepubertal females, OTC has been seen as the only option for fertility preservation which was generally completed under a
