The public sector's role in infertility management in India.

This objective of this paper is to explore the public sector's role in infertility management in India. It focuses on services available in the public sector, problems faced by and critiques of public sector providers. A postal survey was conducted with a sample of 6000 gynaecologists and in-depth interviews were conducted with 39 gynaecologists in four cities. The role of the public sector in infertility management is weak as even basic investigations and services were limited or incomplete. Inadequate infrastructure, inappropriate management including time management, lack of information and training, absence of clear protocols at all levels, private practice by public health doctors, pre-occupation with other health issues and lack of regulation were the main problems mentioned by providers. Amongst key recommendations are realistic and low-cost management, streamlining and regulating services, counselling of couples, providing information and raising awareness of patients, health personnel and policy makers.