INFORMATION AND DECISION MAKING ON ASSISTED REPRODUCTIVE TECHNOLOGIES AMONG FAMILIES EXPERIENCING INFERTILITY IN KENYA

ABSTRACT
This study sought to explore the information on infertility and information on Assisted Reproductive Technologies available in Kenya and how it was packaged and disseminated; to find out whether those suffering infertility had fertility awareness; and also find out how the different levels of infertility and Assisted Reproductive Technologies information influenced decision to take up in-vitro fertilisation among families experiencing infertility in Kenya. To achieve the objectives the study adopted a case study research design for which qualitative data was collected using in-depth interviews with participants and key informants in Nairobi County. The target population for the study was individuals who had suffered infertility and had taken up in-vitro fertilisation treatment; and key informants who come into contact with couples in infertility situation as they journey towards in-vitro fertilisation. Ten female participants were interviewed as primary respondents, and four experts drawn from four categories of key informants were also interviewed: a gynaecologist; a fertility expert; a counselling psychologist; and a legal expert. To tie the study into theory and strengthen the work, two theoretical frameworks; the Health Belief Model and the Bio-psychosocial Theory were used. The qualitative data was then subjected to thematic analysis from which relevant information was extracted and findings interpreted by focusing on the research objectives. The results obtained indicated that there was not adequate information on infertility out there though information on Assisted Reproductive Technologies was noted to be available especially in the last 5 years; however, packaging and dissemination in both cases was found to be poor, with no standardised packaging of the information for dissemination. Another notable finding was that there was generally lack of fertility awareness, with actions taken and/omissions by the participants coupled with lack of information during their youth having detrimental effects on their future fertility. The study also found that lack of biomedical information and delayed diagnosis caused a subsequent delay in decision to take up Assisted Reproductive Technologies; while psychosocial consequences served to hasten the decision making on Assisted Reproductive Technologies. Finally, the study found that there was no legal framework to guide implementation of Assisted Reproductive Technologies in Kenya, and also that the legal and ethical issues in Assisted Reproductive Technologies were not considered in decision making on in-vitro fertilisation, though after the successful uptake of in-vitro fertilisation the legal and ethical issues came to light especially with regard to the right of the child born out of in-vitro fertilisation. The study recommends that more efforts be made in hastening the passing of the Assisted Reproductive Technologies Bill 2019 for proper regulation of Assisted Reproductive Technologies, fertility awareness creation among the youth, and incorporation of fertility awareness programmes in the Ministry of Health and Ministry of Education.