Developing an Infertile Hospital
For people who struggle with infertility, it can be emotionally and physically demanding. It can also be a very stressful time for family and friends. The good news is, there are treatments available to help women and men have healthy pregnancies and become parents. In Central New York, our women’s health specialists offer the latest therapies, including fertility treatments and assisted reproductive technology.난임병원
Despite the fact that infertility is a worldwide problem, a number of countries still do not prioritize diagnostic and treatment interventions. Often, these services are not included in national population and reproductive health policies and strategies and are poorly covered through public health financing. Moreover, in some cases, the costs of medicines used to treat infertility are high.
The World Health Organization (WHO) is addressing these problems by developing and continuously revising guidelines on prevention, diagnosis and treatment of male and female infertility. It is working with governments and global partners to strengthen political commitment, availability and health system capacity in the area of fertility care.
WHO is also facilitating the integration of infertility care within referral hospitals by establishing a global framework for service integration, identifying and supporting the development of local expertise, and developing models for institutionalization. It is also developing and implementing a range of normative products that support quality assurance in the field of fertility care, including laboratory manuals for examination and processing of semen and protocols for the diagnosis and management of fertility disorders.
In Rwanda, RII worked with a government-owned hospital, RMH, and Rwanda Social Security Board to develop and implement a full-service infertility center within the maternal health department. The project required high-level commitment by all parties and a pragmatic approach to solving challenges. These included a negotiated allocation of a building in the existing maternal health wing; provision of donated new and used clinical and IVF laboratory equipment and initial supplies; and a mutually agreed upon business understanding to reclaim expenses for foreign experts and staff seconded from other departments, based on patient consultation numbers.
Within 6-12 months, RMH physicians were proficient in the performance of basic infertility assessment and diagnosis, ultrasound, intrauterine insemination, and oocyte retrieval. Laboratory staff mastered standard operating procedures for the analysis of semen and developed technical competence in interpreting results. The oocyte retrieval and ET teams were supervised by senior gynecologists with private infertility clinic experience.
The project was a success, although it has had to adapt to the frequent changes in leadership at RMH (five leaders in five years). To sustain this work, implementation of mechanisms such as performance-based financing or binding contracts, and support for staff retention will be essential. In addition, national guidelines and professional societies will need to be revised to ensure adherence to appropriate practices, particularly in the area of embryology. Lastly, to address the current high cost of infertility treatments, new financing systems must be put in place. These include payment estimates based on the government tariff and patients’ copayments for infertility services as well as coverage of some of the necessary medicines.서울아이앤여성의원