WOREC in support of Swiss Network for International Studies and Graduate Institute of International and Development studies Geneva conducted National Advocacy Workshop on Infertility: Causes and Consequences dated January 27, 2020. The main objective of the workshop was to explore the perception of infertility, its causes and consequences and health-seeking behavior among women and their husbands in order to develop a strategy for action and policy setting.
The national workshop started with the welcome speech and objective sharing from Mr. Lubha Raj Neupane, the Executive Director of WOREC. He stated that globally, 60 to 80 million couples at some point in their reproductive life suffer from infertility problems whereas, in the context of Nepal, the available data shows that 7.4 percent of women have an infertility problem. WOREC has conducted research on infertility in two districts of Nepal, i.e. Dang and Udayapaur and the workshop aimed to share the key findings of the study.
The founder Chairperson of WOREC and also a lead investigator of the research Dr. Renu Adhikari moderated the session. She said that the workshop is represented by the policymakers, parliamentarians, representatives from the Health Ministry, National Planning Commission, Public Health Professional and civil societies who are working in the field of sexual and reproductive health rights and overall human rights. This is the appropriate platform to share the key findings of the research among these professionals to take forward the issue of infertility at both the policy and the implementation level.
Dr. Aditya Bhardwaj, Professor of Graduate Institute of International and Development Studies shared the issue of infertility is emerging worldwide and there is a multiple reasons of infertility in South Asia which has become a major public health concern. There is a need to find the etiology and epidemiology of infertility in Nepal, thus the research has been conducted in coordination with WOREC. Among all causes of infertility in the global south, it has been seen that 50 percent of the problem lies within men whereas 90 percent of burden is borne by the women. Further, he added, infertility has become a concern worldwide and better preparedness is required for the future in the issue of fertility and sub-fertility.
Ms. Rajni Gupta, Researcher of WOREC shared the study findings on infertility which was conducted in Dang and Udayapur districts of Nepal.
Ms. Mana Kumari GC, Member of the Parliament-Education and Health Committee said infertility is a sensitive issue that was unaddressed to date and was not discussed among the parliamentarians and was not put into the major agenda of discussion.
Rekha Kumari Jha, Member of the Parliament mentioned that state should be held accountable for the problem of infertility among its population. The issue of infertility is overlooked and is limited in the narrow space. “I am from the Terai region and I have seen many cases of child marriage and those couples who could not conceive within 1-2 years of their marriage they are considered as infertile.”
Ms. Binjwala Shrestha, Faculty of Institute of Medicine shared that there is a lack of data and evidence of infertility in Nepal so she insisted that this research report by WOREC needs to be published soon.
Dr. Saroj Dhital, Surgeon of PHECT shared infertility has various dimensions like bio-medical, social, science and technology. The issue of infertility should not be left alone with bio-medical treatment rather it should go clubbing with a social dimension too.
Ms. Ira Sharma, President of Bhudhanilkantha Chapter of Business Professional Women Nepal shared her study findings in “perception of infertility” which they conducted in 2018. She shared that men are also victimized because of infertility and considered impotent (Napunsak). Further, infertility is a pretext of polygamy in all ethnicity whereas the social stigma of infertility is high among Brahmin and Chetteri.
Depression and suicidal attempts are high in infertile women and I would like to recommend on this floor that “Please do not ask any couple when are we going to hear good news? When I will get the chance to become an Aunt or Uncle and so on”.
Dr. Adhikari mentioned that infertility has a various dimension but the burden of social dimension is very high compared to the bio-medical dimension, therefore we should take this issue forward in the area of reproductive health rights.
Ms. Prabina Bajracharya, Advocate of Center for Reproductive Rights, reproductive rights do not come alone but it also incorporates other various human rights components that is “right to enjoy the health facility, right to health and others”. Safe Motherhood Act 2075, has also incorporated the issue of infertility as one of the reproductive morbidities. She added the current policies have a provision that the violence against women on the basis of infertility is a crime. “Now we have the amended Safe Motherhood Act but there is no regulation till date. Hence, there is enough room for the advocacy for the formation of regulation and the implementation plan”.
Dr. Sharad Onta, People Health Movement Coordinator stated that policy should address the prevention of infertility and treatment should not be commercialized.
Dr. Ahikari said that the commercialization of the treatment of infertility has already started. Women have faced violence in the name of surrogacy.
Dr. Laxmi Tamang, President of MIDSON stated the psychosomatic illness of women needs to be treated at first because it has impacted on the fertility of women. There is a focus on the curative part since it is a profitable business but preventive measures are not taken into consideration since there is no profit. We should take forward the preventive, promotive and social dimensions.
Deputy Mayor of Ghorai Municipality of Dang said that the agenda of infertility has been in a shadow as “ we have been working in the various issue of health but the problem of infertility was never a priority”. She committed to take up this issue at the local level.
Dr. Bikash Devkota, Director Chief of Ministry of Health and Population shared that immediate action should be taken on the medical and social aspects, the both individuals and states are responsible for the prevention of infertility. The program “Swastha ma Sajhedhari” has been launched by the GoN and is ready to collaborate with civil societies to work on the prevention of infertility.
Dr. Usha Jha, a member of the National Planning Commission stated that she committed to include childlessness and infertility as a variable in a CBS.
Concluding the workshop, Dr. Adhikari highlighted that the issue of infertility should need a continuous advocacy to take up this issue from the grassroots to the national level. She further added the issue of infertility and subfertility should be included in the government’s health policy and programs and also create an environment where people could understand that infertility is not an alone women’s issue.