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Infertility treatment financing in Nigeria

Background: In Nigeria, infertility treatment using assisted reproductive technology (ART) is perceived as an inconsequential health issue not demanding any public health intervention. ART is largely carried out by private health-care providers in city centres at an unaffordable cost. Objective: The objective is to determine ways to reduce the cost of in vitro fertilisation (IVF) to increase access to treatment. Materials and Methods: Google, Google Scholar and PubMed searches identified scholarly papers published between 1997 and 2013. The keywords used were combinations of ART, infertility treatment in developing countries, family planning and infertility, increasing ART success rate, male factor in infertility, fertility care financing, health insurance and cost of fertility treatment. Results: Infertility is not perceived as a disease the way malaria or typhoid is treated as such by most Nigerian men, and ART is expensive. Most African culture blame infertility on women who have restricted financial access. The current focus of family planning is female gender centric and favours contraception alone. The Nigerian National Health Insurance Scheme (NHIS) has excluded any ART treatment completely. Conclusion: The high cost of IVF is the greatest barrier to ART access both in the developed and underdeveloped world. This is also the most critical factor in accessing IVF care worldwide. This financial barrier is worse in low-resource settings like Nigeria. Low-cost technological innovation is still far from the country. Recommendations: Renewed advocacy with focus on men to understand that infertility is a disease deserving of utmost attention. Increase in the number of public-funded fertility clinics and partial inclusion of IVF into the Nigerian National Health Insurance Scheme (NHIS) needs to be implemented to bring down cost. Other innovations such as public–private partnerships, where financial institutions like banks can finance IVF treatment by giving loans whose repayment is spread over time to make it convenient, should also be considered.