|
|
|
|
|
Kate Miller, MPH PhD, Ibis Reproductive Health, 2 Brattle Square, Cambridge, MA 02138, 617-349-0043, kmiller@ibisreproductivehealth.org
Demand for infertility treatment is high in both developed and developing countries. The psychosocial consequences of infertility range from depression, isolation, and divorce through violence, poverty, and death. Women in high-fertility developing countries are most likely to suffer the severe consequences, but in all contexts women disproportionately bear these burdens as compared to men. Yet subfecundity is an under-recognized public health problem, in part because it is difficult to measure due to computational complexity, increasing contraceptive use, and competing priorities. Accurate and consistent measurement is a fundamental step toward addressing any public health issue, eventually informing advocacy, public education, planning, and program evaluation. This conceptual paper introduces a proposed new population-based measure of “undesired subfecundity” that is simple to field and interpret. The method differs from previous measures by 1) redefining subfecundity as partly a psychosocial state, dependent on the awareness and reproductive intentions of the bearer, and 2) employing a multistate life table to provide a life-cycle approach, recognizing that subfecundity is a state that individuals may enter and exit repeatedly. This permits estimates of undesired subfecundity over the reproductive life span and yields several easily-interpreted statistics that give a fuller picture than simple prevalence. Unlike existing measures of biological subfecundity, this approach can handle any pattern of contraceptive use, heterogeneity in fecundity, and coital or marital behavior. From a policy perspective, this measure is specifically designed to indicate the negative psychosocial consequences and demand for infertility services that may arise in any population due to undesired subfecundity.
Learning Objectives: At the conclusion of this session, the participant will be able to
Keywords: Reproductive Health Research, Methodology
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.