Access to infertility care in Brazil: validation of a questionnaire for a bioethical discussion

Autores da FMUP

• Maria Francisca Melo Pojal Da Silva Rego

  Autor

• Rui Manuel Lopes Nunes

  Autor

Participantes de fora da FMUP

• Oppenheimer, D
• Caldas, CP

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

BackgroundThe World Health Organization characterizes infertility as a disease since 2009; however, in many countries, reproductive health is not prioritized. Characterizing a target population and knowing the barriers to accessing reproductive care may allow for a broadening of the discussion on how to provide equal opportunities. The objective of this study was to develop and validate a questionnaire that seeks to identify socioeconomic and cultural characteristics of Brazilian infertile couples to open the discussion on the principle of fair access to health.Methods(1) literature review in the main databases, (2) questionnaire elaboration by researchers within the areas of human reproduction and bioethics, concerned with content adequacy and comprehension, using the Google Forms online platform, (3) pilot study - the questionnaire was applied to 54 couples, over 18 years of age, that were seeking treatment for infertility and accepted to participate in the study and (4) statistical analysis - for continuous numerical variables, mean, standard deviation and 95% CI of the means were presented. For discrete numerical variables, median, interquartile range, minimum and maximum were presented.ResultsForty-four questionnaires were fully completed and with adequate answers. The questionnaire proved to be objective and easy to understand. It was possible to obtain information on education, race of the couple, the impact of infertility on the couple's life, socioeconomic conditions, and the main difficulties in accessing medical care for treatment of infertility.ConclusionThe questionnaire proved to be feasible in collecting appropriate information to characterize a target population and the only limitation was that there was no academic expert evaluation prior to the pilot test. Although infertility has been considered a disease by the World Health Organization since 2009, there is still much disparity in access to care and in governmental policies to guarantee patients may be treated, especially in developing countries. In this study, we sought to raise awareness to this issue in Brazil, by validating a questionnaire that allows patients to express their difficulties in accessing treatment. We hope this allows for future studies that will, in time, lead to development of policies to guarantee access to reproductive care in a developing country.

© 2023. The Author(s).

Keywords

• Infertility; Medical infertility access; Questionnaire validation