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Research Summary

Boivin, J (2013 - 2018) Global FertiSTAT: Adaptation of the Fertility Status Awareness Tool (FertiSTAT) for community health workers in developing and transistional countries. World Health Organisation. £15,315.

Most people have life plans that include having children but 9-15% will have problems conceiving spontaneously, more so in lower resource countries where prevalence can be as high as 30%. The World Disability Survey ranks infertility 5th in the list of moderate to severe disabilities within the global population under the age of 60. The World Health Organization (WHO) declared infertility a public health issue and one of its Millennium Development Goals (MDG5) is to 'achieve universal access to reproductive health' by 2015. Infertility has a significant impact on quality of life, especially in lower resource countries. Many causes of infertility can be avoided and most couples with fertility problems can be helped to achieve parenthood if they receive appropriate education and/or seek timely medical advice, even in lower resource/less developed countries. There is disparity between people in lower and higher resource countries in access to education about signs, symptoms and preventable causes of infertility. Lack of education undoubtedly contributes to significant difference between countries in prevalence of infertility. The ESRC Fertility Pathways Network (FPN) was funded to support interdisciplinary discussions about childbearing decision-making and reproductive success. It recommended that public understanding of fertility health to the level observed for other equally common diseases especially in lower resource countries where infertility due to preventable causes is high. The Fertility Status Awareness Tool was developed in the UK as a self-administered, multi-factorial 22-item tool that generates personalised fertility guidance based on empirically-tested and validated risk indicators for impaired fertility. The WHO was an observer to the ESRC FPN and has approved the adaptation of the FertiSTAT into a provider-counseling tool, which would create a mechanism by which community heath workers in low resource countries could support fertility awareness activities and [in one-to-one counselling] identify people with higher risk profiles so that education and preventative action can be taken to address fertility health issues. The proposed KEO activities (online exchanges, in person meetings, workshops, presentations) concern knowledge exchange among: (1) fertility medical and health experts in more and less developed countries about FertiSTAT risk indicators and its guidance about what can be done to safeguard fertility; (2) WHO experts and health psychologists about the theoretical and practical challenges of developing and adapting tools for less developed countries; and (3) WHO, scientists developing and evaluating fertility health tools and diverse stakeholders in lower resource countries (e.g., policy-makers, civil society, community leaders, service providers, users). These KEO activities would allow the (1) FertiSTAT to be adapted as mechanism by which to support one-to-one fertility counselling and wider initiatives directed at increasing public awareness offertility health issues, reducing exposure to preventable causes of infertility and increasing recognition of symptoms of fertility impairment so that people can better safeguard their fertility; (2) UK team and international medical experts to gain valuable knowledge of the WHO processes for tool development/adaptation and the challenges of raising fertility health awareness in lower resource countries (3) stakeholders in lower resource countries to learn about FertiSTAT (e.g., its evidence-base, validation, evaluation) and contribute valuable input to its adaptation by communicating the needs and perspectives of people in their country and (4) WHO to continue making progress toward the MDG5 goal of 'universal access to reproductive health', including infertility services, which would be an important step in eradicating disparity between lower and higher resource countries in access to pre-pregnancy fertility education and advice.