Merck More than a Mother

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Together we can create a culture shift

In many cultures, childless women suffer discrimination, stigma and ostracism.

An inability to have a child or to become pregnant can result in being greatly ostracized, isolated, disinherited or assaulted. This may result in denial access to family traditions, divorce or physical and psychological violence. (1)

Merck More than a Mother Concept and Objectives

According to WHO data more than 180 million couples in developing countries (which one in every four couples) suffer from primary or secondary infertility. Infertility in Africa is caused by infections in over 85% of women compared to 33% worldwide which emphasize the importance of prevention programs in Africa. The social stigma of childlessness especially for infertile women still leads to isolation and stigmatization in many cultures.

"Merck More than a Mother" initiative is very important for Africa, as it is well known that the consequences of infertility are much more dramatic in developing countries and can create more wide ranging social and cultural problems compared to western. societies, particularly for women.

A central difficulty associated with infertility is that it can transform from an acute, private distress into a harsh, public stigma with complex and devastating consequences

In some cultures, childless women still suffer discrimination, stigma and ostracism. An inability to have a child or to become pregnant can result in being greatly isolated, disinherited or assaulted. This may result in divorce or physical and psychological violence.

Through the “Merck More than a Mother” initiative, All stakeholders together including Women leaders, policy makers, parliamentarians , Academia, fertility experts, community and media will challenge the perception of infertile women, their roles and worth in society, both within and beyond the medical profession in order to achieve a systemic shift in the current culture of gender discrimination in the context of fertility care in African societies and address solutions for change of mindset and upgrading the health care services .

Objectives of “Merck More Than a Mother “Campaign


"Merck more than a Mother" initiative will not only provide medical education and training for medical students and embryologists respectively, but it will also support Governments to define policies to improve access to safe and effective Fertility care and address the need for interventions to reduce stigmatization and social suffering of infertile women and the necessity for a team approach to family building among couples.

Through this initiative, we will address together the key challenges that are associated with resource constrained settings such as prevention of infertility, education & self-development, ART/IVF regulation, geographic barriers, and limited resources arguments.

Differences between the developed and developing world are emerging because of the different availability in safe, effective and equitable infertility care & different sociocultural value surrounding parenthood and procreation.

The UN universal declaration of human rights, stated that access to adequate comprehensive reproductive health services, including infertility care, is a basic human right regardless of the economic circumstances in which individuals are born into. Therefore,"Merck more than a Mother"campaign will contribute to identifying and implementing strategies to improve access to effective, safe and regulated fertility care in Africa and to define interventions to decrease social suffering from infertility and childlessness.

It is very important to take into consideration that accessible infertility treatment can only be successfully introduced in developing countries if socio-cultural, economic essentials and needed skills are fulfilled and governments are ready to support their introduction.

In order to achieve this objective successfully ,a discussion with the relevant authorities will be needed to discuss the strengthening of infertility services, education, auditing, regulation, community awareness and the need to integrate them with Mother and Child, HIV prevention and Family planning programs, which already exist in the health infrastructure.

"Merck more than a Mother" Advisory Board has defined five year clear strategy and structured objectives:

"Merck more than a Mother" Strategy and Objectives:

  1. Create a culture shift to de-stigmatize infertility and to respect and appreciate infertile women in Africa.

  2. Raise awareness about infertility prevention & management and male infertility by integrating it into healthcare infrastructure that already exist , such as HIV, maternal health and mother and child programs.

  3. Education and training for African embryologists since the lack of trained and skilled staff is a big challenge.

  4. Supporting policy makers to define ART policies to improve access to regulated fertility care.

  5. Building advocacy and open dialogue and work closely with governments, policy makers, parliaments, healthcare providers, fertility experts and media to define interventions to reduce the social suffering and improve access to regulated, effective and safe fertility care in Africa

  6. Empowering infertile women socially and economically throng access to awareness, health and change of mindset and empower women who cannot be treated anymore through starting a small business for them to build their independent and happier lives through Empowering Berna"project.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mothers or Nothing; A culture to be changed.

The agony of infertility in resource- constrained settings and the social suffering:

The central difficulty associated with infertility in developing countries is that infertility transforms from an acute, private agony into a harsh, public stigma with complex and devastating consequences.

Although male factors contribute to about half of all cases of infertility, women are also overwhelmingly perceived as being the party responsible for a couple's infertility, and subsequently the social suffering associated with infertility tends to be greater for them than their husbands.

Disproportionately having an effect on women, the burden of infertility is often assumed to fault the woman, as pregnancy and childbirth are manifested in the woman.(3)

Discrimination against the infertile woman may include that a girl will never pass into womanhood (regardless of age) if she never becomes pregnant, will no longer be marriageable and becomes viewed as a burden on families, communities or societies.

Violence: Intimate partner violence (IPV), gender-based violence (GBV) and domestic violence have been shown to have significant associations with individuals and couples suffering from infertility.(1)

Mental health: High rates of clinically significant symptoms of depression and anxiety, suicidal tendencies, and a strong conceptualization of grief affects infertile individuals.

Key Issues:

Lower levels of development are thought to be associated with higher levels of non-genetic and preventable causes of infertility such as poor nutrition, untreated sexually transmitted infections (STIs), unsafe abortion, consequence of infections caused by the practice of female genital mutilation, exposure to smoking and exposure to leaded petrol and other environmental pollutants. Hence Prevention Awareness is very important.

Public education on fertility awareness and prevention should be integrated within HIV prevention, family planning and mother care programs.

These programs have to include not only prevention of sexually transmitted diseases (STDs) and pregnancy-related infections but also life style factors, iatrogenic infertility, environmental pollution and contamination.

Reproductive Rights:
Addressing “reproduction” within the public health sphere of reproductive health is important in order to fully address reproductive rights.

“People have the capability to reproduce and the freedom to decide if, when and how often to do so.”As defined by the International Committee on Population and Development, ICPD.

Continuum of Care and Reproductive Rights:
Providing care to couples before and between pregnancies improves the chances of mothers and babies to be healthy. Pre-pregnancy, and specifically that associated with subfertility/infertility care, has been a crucial weak link in the continuum of care in reproductive health when addressing Universal Access to Reproductive Health (MDG5b) and long term maternal morbidities and disabilities. (5)

Motivations for parenthood and the perceived meaning of children vary among cultures:
In broad terms, in high-income countries the desire for parenthood is expressed as a wish for personal happiness and fulfilment and children are said to be valued as they enhance the relationship and are enjoyable. (4)

In resource-poor settings, additional reasons are identified for the wish to have children: the continuation of the family line, compliance with religious and societal expectations, and assurance of security in old age.(3) In a review of studies relating to the value of children in African countries – insights from studies on infertility found that ‘children secure conjugal ties, offer social security, assist with labour, confer social status, secure rights of property and inheritance, provide community through re-incarnation and maintaining the family lineage, and satisfy emotional needs.’(6)

Next to interventions increasing access to biomedical infertility care, interventions to decrease stigmatization and social suffering from infertility and childlessness are needed.

“Merck More than a Mother” Highlights and Latest News

Join the conversation and reduce the stigma of infertility

Merck launched the More than a Mother campaign in partnership with the Kenya Women Parliamentary Association, the University of Nairobi and the Kenya Fertility Society to address the need for interventions to reduce stigmatization and the social suffering of infertile women. The campaign was launched in Nairobi by Belén Garijo, CEO Merck Healthcare.

“Providing access to infertility care is important, but it is even more important to intervene to decrease stigmatization and social suffering arising from this condition,” said Belén Garijo during the launch of the campaign.

The initiative addresses key challenges that are associated with resource-constrained settings such as prevention of infertility, education and self-development, assisted reproductive technology (ART) and in vitro fertilization (IVF) regulation, geographic barriers, reproductive rights and over-population and limited resources arguments.

The stigma that follows infertile women more often than not leads to complex and devastating consequences. These range from isolation, ostracism, discrimination, disinheritance, physical and psychological assault and even divorce.

www.merckmorethanamother.com

Front row: Prof. Koigi Kamau of the University of Nairobi, Belen Garijo, CEO Merck Healthcare, Joyce Lay Member of Parliament, Kenya, and Rasha Kelej (3rd right), Chief Social Officer, Merck Healthcare and international fertility experts during a session to contribute to building fertility care capacity at the University of Nairobi, Kenya

Together with policy makers, academia, fertility experts, the community and media, the initiative aims to challenge the perception of infertile women, their roles and worth in society, both within and beyond the medical profession in order to achieve a systemic shift in the current culture of gender discrimination in the context of fertility care in African societies.

Belén Garijo, CEO Merck Healthcare signs to show her support for Kenya’s IVF bill as Joyce Lay, a Member of Parliament in Kenya, and Prof. Koigi Kamau of the University of Nairobi look on

Joyce Lay the campaign Ambassador

During the Merck Africa Luminary held in November 2015 in Nairobi, Dr Karl-Ludwig Kley, Chairman of Executive Board and CEO Merck, appointed Joyce Lay as the ambassador for the campaign in Kenya for the period 2015-2016 in recognition of her contribution in reducing stigmatization on infertility in the country.

Dr Karl-Ludwig Kley, CEO of Merck congratulates Hon Joyce Lay, Member of Parliament for Taita Taveta, Kenya for her appointment as the ambassador for the “More than a Mother” campaign as Rasha Kelej, Chief Social Officer, Merck Healthcare looks on

Dr Kley also awarded Grace Kambini, a Kenyan woman who has openly shared her story of stigmatization and suffering for being infertile for her courage in creating awareness and sharing her devastating experience so that no other woman would suffer the same. Grace is the champion of the campaign.

Rasha Kelej, Chief Social Officer, Merck Healthcare shows her support for the IVF bill in Kenya as Prof Koigi Kamau of the University of Nairobi and Joyce Lay, Member of Parliament in Kenya look on

Improving fertility care

“In addition to creating awareness to reduce stigma of infertility, Merck through this initiative is working with stakeholders to develop and implement strategies to improve access to effective, safe and regulated fertility care in Africa,” said Rasha Kelej, Chief Social Officer, Merck Healthcare.

The "Merck more than a Mother" campaign is supporting the In vitro fertilization (IVF) bill which is a very important step in the Kenyan healthcare system. The IVF bill will regulate IVF and infertility treatment for the first time in the country. Joyce Lay is one of the sponsors of IVF bill in the Kenyan Parliament.

Join the conversation - Together we create a culture shift

Dear Readers,
Please join the "Merck more than a Mother" social media campaign to reduce stigma, create awareness and define interventions to improve access to better fertility care in Africa. Let your voice be heard.

Rasha Kelej
Chief Social Officer
Merck Healthcare



Links to TV interviews

Links to events

1Ombelet W.; Global access to infertility care in developing countries: a case of human rights, equity and social justice, ObGyn, 2012.

2.Dhont, S. Luchters, W. Ombelet, J.Vyankandondera, A. Gasarabwe, J. van de Wijgert, M, Temmerman. Gender differences and factors associated with tretment-seeking behaviour for infertility in Rwanda. Hum. Reprod. 2010

3van Balen, H.M.W, Bos. Infertility, culture and psychology in worldwide perspective. J. Reprod. Infant Psychol. 2004; 22:245-247

4F.E. Okonofua, D. Harris, A. Odebiyi, T. Kane, R.C. Snow. The social meaning of infertility in Southwest Nigeria. Health Transition Rev, 1997;7:2015-220

5S.Dyer. The value of children in African countries – insights from studies on infertility. J. Psychosom. Obstet. Gynaecol. 2007; 28:69-77

6S.J.Dyer, N. Abrahams, M. Hoffman and Z.M van der Spuy. Human Reproductive Vol. 17 No.6, 2002