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Participatory Workshop: A Roadmap for Transforming Fertility Care in The Gambia

On 26th October 2023, the second joint participatory stakeholder workshop on fertility care took place in The Gambia. The workshop brought together multiple stakeholders from the Ministry of Health, public and private health facilities throughout the country, Gambian civil society, UN agencies including UNFPA, and Gambian and international research partners. The aim of the workshop was to launch the new Fertility Care Roadmap, disseminate research findings and co-create an implementation strategy to transform fertility care in The Gambia.
Participatory Workshop Group Picture

The workshop was the culmination of a project based upon a partnership between the Gambian Ministry of Health, MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Safe Haven Foundation, and international researchers based in the UK and Belgium. The team, led by Professor Julie Balen, from Canterbury Christ Church University, Kent, UK, and Dr Susan Dierickx, from Institute of Tropical Medicine, Antwerp, Belgium, began researching infertility in The Gambia in 2016. As part of the research programme, a recent study was completed on the inclusion and implementation of fertility care in the Gambian health system within the framework of Dr Anna Afferri’s PhD research, supervised by Prof. Balen, Dr Dierickx and Prof. Allan Pacey from the University of Manchester, UK, with support from Dr Mustapha Bittaye, Director of Health Services, and Dr Musa Marena, Project Manager of the Reproductive, Maternal, Newborn, Child and Adolescent Health Programme (RMNCAH).

Involuntary infertility is an important reproductive health issue worldwide. Professor Balen stated that the most recent statistics report that 1 in every 6 couples worldwide are affected by infertility and around 17.5% of the adult population experiences infertility in their lifetime. Despite the severity of the problem, it is often neglected in national and international health agendas. This is partly due to the high costs of some types of infertility treatment and also because infertility is a highly stigmatised issue due to cultural and societal taboos. Ms Sainey Ceesay, the CEO of Safe Haven Foundation, a Gambian NGO that supports people with infertility, spoke about how difficult infertility is in Gambian society and shared harrowing personal stories of how Gambian women with infertility are victimized.

Dr Afferri and Ms Haddy Bittaye presented findings from infertility research they had conducted in The Gambia over the past years. Dr Afferri’s study included a survey of 38 public and private health facilities throughout the country which showed that less than half of them (42%) had any form of infertility treatment available for patients seeking care. Those offering treatment were mostly private clinics. Screening and diagnosis of infertility was slightly more common being offered in 66% of the facilities. Assisted Reproductive Technology, the most sophisticated form of infertility treatment, was not available anywhere – but Ms Bittaye’s study highlighted that medical students and health providers showed a willingness to introduce it into The Gambia. Throughout the course of the study, participants expressed that improving the availability and access to fertility care in The Gambia was both timely and important.

Dr Musa Marena and Dr Mustapha Bittaye noted that fertility care was recently included in the country’s National Reproductive Health Strategic Plan 2022-2026. They highlighted that infertility was more common than people realized and stressed that now was the time to move ahead with the agenda and Fertility Care Roadmap. 

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