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Title: Cultural adaptation of the Fertility Status Awareness Tool to Low and Middle Income Countries (Sudan) using survey, systematic review and meta-analysis and interview methodologies
Author: Bayoumi, Rasha
ISNI:       0000 0004 7426 6223
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2017
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Globally, fertility problems have severe negative consequences. In Low and Middle Income Countries (LMIC) like Sudan women especially bear the burden of the inability to achieve pregnancy and childlessness. The severity of these consequences coupled with the lack of fertility knowledge motivated the need to enhance fertility awareness in LMIC. Recently several fertility awareness tools have been developed. One such tool is the Fertility Status Awareness Tool (FertiSTAT), a short, one page self-administered tool that provides information about the signs, symptoms and preventable causes of fertility problems. This tool provides personalized risk knowledge that allows women to make informed decisions about their fertility. The FertiSTAT was developed and validated in the UK but it has utility as a cost-effective tool to enhance fertility awareness in LMIC where this simple tool could be embedded in existing (but resource limited) reproductive health services. The aim of the studies presented in this thesis was to culturally adapt the FertiSTAT to ensure that it was comprehensive in its coverage of risks and it is acceptable and feasible for use in Sudan. The potential new risk factors for inclusion in FertiSTAT were identified through literature search, expert consultations and survey. The risk factors were subjected to systematic review and meta-analysis. Results of the studies indicated that cultural adaptation would require cultural targeting to be inclusive of new risk factors relevant to Sudan and other LMIC and be linguistically and graphically culturally appropriate. The risk factors found to be associated with fertility problems were genital tuberculosis, HIV, bacterial vaginosis, female genital mutilation and consanguinity. Results of stakeholder meetings and patient interviews lead to recommendations about changes to language and presentation of materials to enhance acceptability and feasibility of FertiSTAT. These recommendations included the need for adding provider-administered versions of the FertiSTAT to enable cultural tailoring of information to each user’s level of literacy and cultural attributes. An integration of all knowledge acquired from these studies lead to two adapted versions of the FertiSTAT, a flipchart and a checklist. It is anticipated that these tools can be used to enhance fertility awareness in Sudan. The studies can also be used as an adaptation protocol such that the procedural knowledge gained from adaptation in Sudan can be transferred to other LMIC. Such undertakings can potentially help improve individual and, in time, societal awareness of fertility problems with the eventual aim to prevent fertility problems, alleviate individual suffering for the most vulnerable and aid in the global efforts to promote sexual and reproductive health equity where it is most needed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: BF Psychology