Date of Award

12-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr Tazeen Saeed Ali

Second Advisor

Dr Sameen Siddiqi

Third Advisor

Dr. Mohammad Asim

Department

Community Health Sciences

Abstract

Background: Infertility is the issue of both male and female partners; however, the prevalence of male infertitly is about 10% in adult population. Most of the previous studies focused on females and explored the factors associated with female infertility. Infertility, regardless of the cause, is equally a stressful and potentially upsetting experience for men. Infertility as described by men is an emotional journey, with many feelings helpless or marginalized during interactions with healthcare providers.
Aim (s): The aim of this study was to assess the perceptions and myths regarding male infertility and to explore the gaps in the provision of health services regarding male infertility by health care service providers in Province Balochistan, Pakistan.
Methods: A sequential exploratory mixed method study design was used to explore this phenomenon. Data was collected from infertile males who were married for more than one year in Balochistan through In-depth Interviews (IDIs) using semi[1]structured interview guide. Probing questions were used with those males who came to the hospitals for seeking health care services. Interviews with stakeholders such as health care providers, managers like DHO, and medical super-intendent of the health facilities were conducted. The quantitative part was collected from all the HCPs working in the selected field side to enquire about the availability of the infertility services and triangulated was done with the qualitative interviews.
Results: The results indicated that the health care system of Balochistan was poorly developed for men’s reproductive health. The community, society and family did not consider male infertility as a disease rather there was a strong negative notion and stigmatization being attached to it seeing it as a question to masculinity. Moreover, about 94.6% of participants recognized the unavailability of trained health care providers at all levels of hospitals and delivery of services. Almost 99% participants acknowledged that there were no fertility centers for male consumers and shared that health care system neglected a major portion of the community. Most of the affected male did not look for medical treatment but preferred quacks, practitioner of herbal medicine (hakim) and religious healer (mullas). Private fertility services were too costly to be afforded by the common person.
Conclusion: The study concluded that the unavailability of male infertility services and reproductive health clinics to treat male infertile patients. Major obstacles in the management of infertile patients were low budget, lack of reproductive health experts, human resources, and diagnostic services at facility level. However, the lack of understanding, denial of infertility as a disease and stigmatization and easy access of quacks and non- professionals’ healers like hakim, Mullas were also some of the important factors. Discussion: This study was one of the most important types of evidence about the perceptions, and myths about male infertility in our population due to cultural and societal barriers. The findings were useful for development of policies and programme for further advancement in male fertility issues by the public health professionals and policymakers. Keeping socio-cultural and economic contexts in view can also be used to reach the goals defined by international organizations on the prevention of infertility and reproductive health.

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