PSYCHOSOCIAL AND CULTURAL EFFECTS OF INFERTILITY IN EASTERN AND SOUTHERN AFRICA: A NARRATIVE REVIEW
Background: Infertility is a major reproductive health crisis with significant consequences. Despite being treated predominantly as a medical problem, a wide range of psychosocial and cultural effects have been documented. Although men and women have been documented to endure this burden, women are observed to bear the bigger burden. Advancement of treatment options has been observed over several decades. However, the lack of understanding of the social context of infertility has prevented a holistic approach in managing infertility, especially in Sub-Saharan Africa. A synthesised review of the existing literature will help to identify the existing gaps and provide a direction for better implementation practice and future research. Aim: This study sought to explore the psychosocial and cultural effects of infertility for both men and women in Eastern and Southern Africa and analyse available support services for these effects. Methods: This is a desk review of existing literature identified from four electronic databases. Eighteen relevant papers on psychosocial and cultural effects of infertility and support services/programs from Eastern and Southern Africa that met the inclusion criteria were identified and thoroughly examined. A modified conceptual framework from White et al. 2016 was used to understand the lived experiences of infertility at different levels of social interaction. Results: The findings from the selected papers show a wide range of negative psychosocial effects such as feeling of worthlessness, loss of purpose in life, divorce/abandonment, intimate partner violence and stigmatisation. Most of these effects were observed among women, especially those affected by primary infertility. A wide range of severity of consequences was presented across the papers, including extremes of suicidal thoughts and attempts. There is a notable gap of availability of psychosocial support for those affected by infertility owed to a lack of understanding of the social and cultural influence on infertility experiences. Conclusion: Infertility is regarded as a deviation from the norm and creates immense suffering for those who remain childless. Infertile individual/couples are faced by an increased risk of psychological problems because of the stigma/challenges associated. Women carry the most burden, but men should not be side-lined. This study provides several recommendations, including a community approach in recruitment process, increased awareness of infertility and provision of counselling services.