Family Planning Interventions and Infertility in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis Protocol

Abstract

Background: Infertility as a global reproductive health issue is often overlooked, despite accounts of its individual and systemic burden in populations. In LMICs, in particular, the personal and systemic factors that combine to present infertility as a significant health challenge are underinvestigated. Knowledge on the availability and access to infertility mitigating interventions is also inadequate. Furthermore, the challenges that constrain infertility-targeted interventions are often disjointly perceived as an individual problem, with scarce systemic outlook and intervention. This study seeks to explore the availability and accessibility of infertility interventions, their outcomes and challenges, as well as the regulatory and policy framework within which they operate. Method: This review will follow the PRISMA guidelines for reporting on systematic reviews and meta-analyses. We will conduct searches of relevant MeSH terms in major electronic journal databases and grey literature of relevant organizational websites. Duplicate independent title and abstract reviews will be conducted to firstly eliminate irrelevant studies. This will be followed by full-text screening to select studies that satisfy our inclusion criteria. All selected full-text studies will be assessed for their quality using the Joanna Briggs Institute (JBI) critical appraisal checklist suitable for each methodological design. A thematic analysis of the included studies will be conducted to characterize the socio-cultural construction of infertility from individual and systemic viewpoints, as well as the outcomes and challenges of infertility interventions. Suitable quantitative studies will undergo meta-analysis using a random-effects model in the relevant software. Studies without a quantitative component will undergo only a qualitative synthesis.Discussion: The qualitative findings will be presented as a framework demonstrating the linkages between the socio-political constructs of infertility, interventions in place to mitigate infertility and the individual and systemic challenges posed to these interventions. We anticipate the use of this framework in guiding future family planning studies targeted at addressing infertility. Findings will be published in a peer-reviewed journal and disseminated among research communities, especially in LMICs. Trial Registration: This review protocol is registered in PROSPERO with code CRD42019130784.