Health care services for infertility in Sub-Saharan Africa -the case of Moshi, Tanzania

Johanne Sundby, University of Oslo
Ulla M. Larsen, University of Maryland

The aim of this paper is to describe infertility services available in an African setting, and to suggest health systems interventions for infertility. The number of clients, care given and referral patterns was mapped through site visits, observations and key informant interviews in health care institutions for sexual and reproductive health in Moshi, Tanzania. In a sample of 125 couples that had experienced problems becoming pregnant, we analyzed care seeking patterns. A comprehensive approach for an infertility program was only found at the specialist tertiary level. The cost of a full infertility investigation is prohibitive. It is difficult for clients to evaluate what a good service consists of. Lack of male involvement exclude infertile couples from having a complete work-up. Modern ART is not available, and most resort also to traditional healers. Better coordination between various levels of health care institutions is needed. Public education on infertility prevention and care is needed.