{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:13:14Z","timestamp":1788315194892,"version":"build-2803163510"},"reference-count":26,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T00:00:00Z","timestamp":1727395200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["raf.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,27]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The Gambia, West Africa, has made recent progress on infertility, a component of sexual and reproductive health that is lagging behind others. Since 2016, there is favourable policy environment stemming from infertility research and partnership building with national stakeholders and local civil society organisations focussing on infertility. Here, we report outcomes from a participatory workshop on infertility policy implementation in The Gambia and provide insights on setting national priorities for fertility care in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a participatory workshop involving 29 participants from Gambia\u2019s public and private health sectors. Using selected participatory group work tools, stakeholders identified and prioritised key activities within the framework of five pre-defined areas of action, including (i) creating guidelines\/regulations; (ii) recording\/reporting data; (iii) building public\u2013private partnerships; (iv) training health providers; and (v) raising awareness and health-seeking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 17 prioritised activities were proposed across the five action areas, according to short-, medium-, and long-term timeframes. Three were further prioritised from the overall pool, through group consensus. A group model building activity helped to envision the complexity by elucidating links, loops, and connections between each activity and their expected outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The participatory workshop identified actionable interventions for fertility care in The Gambia, with stakeholders setting a clear path ahead. Despite challenges, the continued engagement of Gambian policymakers, practitioners, researchers, and activists in efforts to move beyond policy creation to its implementation is essential. Improving fertility care in The Gambia and other low- and middle-income countries is feasible with effective collaboration and financial support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Lay Summary<\/jats:title>\n                    <jats:p>In The Gambia, a partnership of stakeholders from various domains, including research, grassroots activism, clinicians, and policymakers, contributed to an increased awareness of infertility. This, in turn, led to the inclusion of infertility in the national reproductive health strategic plan. An in-country participatory workshop involving participants from both public and private health sectors was held in October 2023 with the objective of identifying priorities for moving beyond planning to implementation, within the context of resource constraints. The top three identified priorities were: (i) training about infertility for health providers; (ii) harmonisation of data collection; and (iii) the development of clinical guidelines for infertility management. It is important for the Gambian Ministry of Health to implement these proposed locally relevant fertility care activities. Despite current and future challenges, having a clear vision and pathway will help establish fertility care in the country, with Gambia potentially leading the way among many other countries<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/raf-24-0029","type":"journal-article","created":{"date-parts":[[2024,9,27]],"date-time":"2024-09-27T14:34:53Z","timestamp":1727447693000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-13","source":"Crossref","is-referenced-by-count":1,"title":["FERTILITY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Implementing fertility care: insights from a participatory workshop in The Gambia"],"prefix":"10.1530","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0306-6705","authenticated-orcid":true,"given":"Anna","family":"Afferri","sequence":"first","affiliation":[{"name":"School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Dierickx","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Research Centre Gender, Diversity and Intersectionality \u2013 RHEA, Vrije Universiteit, Brussel, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Bittaye","sequence":"additional","affiliation":[{"name":"Ministry of Health, Banjul, The Gambia"},{"name":"School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Marena","sequence":"additional","affiliation":[{"name":"Ministry of Health, Banjul, The Gambia"},{"name":"School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sainey M","family":"Ceesay","sequence":"additional","affiliation":[{"name":"Safe Haven Foundation, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haddy","family":"Bittaye","sequence":"additional","affiliation":[{"name":"Medical Research Council \u2013 MRC Unit The Gambia at LSHTM, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan A","family":"Pacey","sequence":"additional","affiliation":[{"name":"School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-8465","authenticated-orcid":true,"given":"and","family":"Julie Balen","sequence":"additional","affiliation":[{"name":"School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, United Kingdom"},{"name":"Medical Research Council \u2013 MRC Unit The Gambia at LSHTM, Fajara, The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"BMC Health Services Research","first-page":"1127","article-title":"Availability of services for the diagnosis and treatment of infertility in the Gambia\u2019s public and private health facilities: a cross-sectional survey","volume":"22","author":"Afferri","year":"2022a","unstructured":"Afferri AAllen HDierickx SBittaye MMarena MPacey A & Balen J 2022a Availability of services for the diagnosis and treatment of infertility in the Gambia\u2019s public and private health facilities: a cross-sectional survey. 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Available at: https:\/\/www.cia.gov\/the-world-factbook\/countries\/gambia-the\/."},{"key":"bib10","series-title":"Reproductive Health","first-page":"151","article-title":"\u2018I am always crying on the inside\u2019: a qualitative study on the implications of infertility on women\u2019s lives in urban Gambia","volume":"15","author":"Dierickx","year":"2018","unstructured":"Dierickx SRahbari LLongman CJaiteh F & Coene G 2018 \u2018I am always crying on the inside\u2019: a qualitative study on the implications of infertility on women\u2019s lives in urban Gambia. Reproductive Health 15 151. 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(https:\/\/doi.org\/10.1371\/journal.pone.0284765)"},{"key":"bib12","series-title":"Global Reproductive Health","first-page":"1","article-title":"The fertility care gap in the Global South: lessons from The Gambia, West Africa, and ways forward to establish fertility care for all","volume":"8","year":"2023","unstructured":"FertilityCare in theGlobalSouthNetwork 2023 The fertility care gap in the Global South: lessons from The Gambia, West Africa, and ways forward to establish fertility care for all. Global Reproductive Health 8 1\u20134. (https:\/\/doi.org\/10.1097\/grh.0000000000000073)"},{"key":"bib13","series-title":"The Gambia Demographic and Health","year":"2021","unstructured":"The Gambia Bureau of Statistics & ICF 2021 The Gambia Demographic and Health Survey 2019\u201320. (https:\/\/dhsprogram.com\/pubs\/pdf\/FR369\/FR369.pdf)"},{"key":"bib14","series-title":"International Journal of Environmental Research and Public Health","article-title":"Community group model building as a method for engaging participants and mobilising action in public health","volume":"17","author":"Gerritsen","year":"2020","unstructured":"Gerritsen SHarr\u00e9 SRees DRenker-Darby ABartos AEWaterlander WE & Swinburn B 2020 Community group model building as a method for engaging participants and mobilising action in public health. International Journal of Environmental Research and Public Health 17. (https:\/\/doi.org\/10.3390\/ijerph17103457)"},{"key":"bib15","series-title":"PLoS One","first-page":"e0255723","article-title":"Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia","volume":"16","author":"Jatta","year":"2021","unstructured":"Jatta JWBaru AFawole OI & Ojengbede OA 2021 Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia. PLoS One 16 e0255723. (https:\/\/doi.org\/10.1371\/journal.pone.0255723)"},{"key":"bib16","series-title":"A World Where Everyone Can Lead a Health and Fufilling","year":"2020","unstructured":"Merck Foundation 2020 A World Where Everyone Can Lead a Health and Fufilling Life. (https:\/\/merck-foundation.com\/merckfoundation\/public\/uploads\/page_content\/Merck_Foundation_Overview_English.pdf)"},{"key":"bib17","series-title":"National","year":"2022","unstructured":"Ministry of Health &SocialWelfare, T. G. 2022 National, Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCAH) Strategic Plan 2022\u20132026. The Gambia."},{"key":"bib18","series-title":"PLoS One","first-page":"e0295219","article-title":"Trend and determinants of home delivery in Gambia, evidence from 2013 and 2020 Gambia demographic and health survey: a multivariate decomposition analysis","volume":"18","author":"Nigatu","year":"2023","unstructured":"Nigatu SG 2023 Trend and determinants of home delivery in Gambia, evidence from 2013 and 2020 Gambia demographic and health survey: a multivariate decomposition analysis. PLoS One 18 e0295219. (https:\/\/doi.org\/10.1371\/journal.pone.0295219)"},{"key":"bib19","series-title":"Assessment of the","author":"Sine","year":"2019","unstructured":"Sine JSaint-Firmin P & Williamson T 2019 Assessment of the Health System in The Gambia. Overview, Medical Products, Health Financing, and Governance Components. Washington, DC. (http:\/\/www.healthpolicyplus.com\/ns\/pubs\/17372-17674_GambiaHealthSystemAssessment.pdf)"},{"key":"bib20","series-title":"Public Health Research and Practice","first-page":"1","article-title":"Group model building: a participatory approach to understanding and acting on systems","volume":"25","author":"Siokou","year":"2014","unstructured":"Siokou CMorgan R & Shiell A 2014 Group model building: a participatory approach to understanding and acting on systems. Public Health Research and Practice 25 1\u20134. (https:\/\/doi.org\/10.17061\/phrp2511404)"},{"key":"bib21","series-title":"Patient Education and Counseling","first-page":"29","article-title":"Infertility in the Gambia: traditional and modern health care","volume":"31","author":"Sundby","year":"1997","unstructured":"Sundby J 1997 Infertility in the Gambia: traditional and modern health care. Patient Education and Counseling 31 29\u201337. 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