ZIO MWALE, Lusaka
ON AVERAGE, Zambia enjoys high fertility rates, but the challenge of infertility among couples and individuals is a real one, causing them untold misery.Infertility is actually a major public health concern because it affects one’s mental well-being, disrupts social bonding, lowers economic productivity of those affected and erodes their self-confidence.
Though rarely discussed, infertility is a serious challenge that comes with devastating social, cultural, emotional, economic, and medical consequences for affected persons.
It seems to be a “third rail” for social conversation – creates confusion, hurts feelings and elicits mixed emotions of persons involved.
With few private hospitals in the country providing fertility services, only the privileged few can afford them, therefore excluding the poor from accessing such services.
Records at the University Teaching Hospital (UTH) show that about 30 percent of women that seek gynaecology services at the facility have fertility problems.
But things are expected to change in the not so distant future when the poor will also have access to government-owned fertility clinics.
Minister of Health Chitalu Chilufya has announced that Government will soon introduce public fertility clinics in all the provinces in its drive to provide universal reproductive health services.
The clinics will be constructed with support from the Saudi Arabian fund.
Fertility clinics are health centres that assist couples, and sometimes individuals, who want to become parents but for medical reasons have been unable to achieve this goal via the natural course.
Dr Chilufya noted that infertility is not only a public health challenge but a socio-cultural and emotional issue that triggers gender-based violence, including property grabbing of childless widows.
In certain instances, childless spouses resort to having multiple sexual partners in search of children, therefore putting themselves at risk of contracting HIV and other sexually transmitted infections.
“Infertility accounts for 10 to 15 percent of outpatient gynaecology clinic attendance in Zambia, yet access to fertility services is seriously limited due to the high cost of services,” Dr Chilufya said.
He said this calls for great investment in comprehensive reproductive health, including fertility services.
The government-run fertility clinics will offer diagnostic tests and, sometimes, advanced medical treatment to achieve conceptions and pregnancies.
To achieve all this, Merck Foundation, a global humanitarian organisation, has partnered with the Zambian government to train fertility experts and link the Ministry of Health to the network of stakeholders dealing with infertility equipment.
Lusaka Invitro Fertilisation (IVF) and Fertility Clinic is one of the few private clinics that offer fertility and maternity services since 2015 in Lusaka’s Woodlands area.
It offers diagnostic and treatment services to both men and women. The clinic has on display pictures of some of their successful stories, but the images of beneficiaries show that it is not a clinic for the poor.
Gilbert Ahimbisibwe, a doctor at Lusaka IVF and Fertility Clinic, says the challenge of infertility is a real one in Zambia. He has observed that infertile persons, though, are normally seen at public hospitals by resident gynaecologists.
“On average, we see about 40 new consultations per month and most of these individuals and couples are referred to us by public hospitals. We offer advanced infertility treatment called invitro fertilisation. This is what sets us apart from other centres,” he said.
“It’s the level of expertise and specialisation that differs. We are a highly specialised and experienced team of fertility specialists operating at Lusaka IVF Clinic.”
Dr Ahimbisibwe lauded the idea to introduce public fertility clinics, saying this will benefit many people who cannot afford such services at a high cost.
He hopes that the public fertility clinics will be equipped with medical specialists.
UTH’s Department of Obstetrics and Gynaecology registrar Whyson Munga notes that infertility is a huge problem in Zambia.
Dr Munga said hospitals need to be equipped with advanced technology to offer comprehensive treatment of infertility, especially through artificial insemination.
Artificial insemination is the deliberate introduction of sperm into a female’s uterus or cervix for the purpose of achieving a pregnancy through vivo fertilisation, other than by sexual intercourse.
Dr Munga shared that out of every 100 women that visit UTH seeking gynaecology services, about 30 of them have infertility problems.
He said medical personnel normally investigate causes of infertility to help women achieve conception. Infertility is categorised in two forms – primary and secondary.
“Primary infertility is where you have failed to conceive from the word go, while secondary infertility is where later in life, a woman fails to conceive,” Dr Munga said.
“The investigations [of infertility] involve both male and female. Those that are manageable, we have been able to handle them.”
He said the common causes of infertility for women are blocked fallopian tubes, failure to ovulate due to hormonal problems and advancement in age. For men, low sperm count is the common cause of infertility.
“When people meet for the sake of conception, the man is supposed to release at least 15 million sperms per ejaculation, but there are some males who have less sperms, while others do not have a single sperm but just semen,” Dr Munga said.
He said the planned introduction of fertility clinics around the country was timely and a good idea.
“We are hoping that this introduction will come with advanced centres for fertility where we will be able to go beyond the routine [fertility investigations] that we have been doing,” Dr Munga said.
ZIO MWALE, Lusaka