O-117 Challenges
Authors: Simopoulou M 
Published: June 2023

Fertility awareness is heavily charged “meaning” different things to different people, from how to avoid pregnancy, to how to have children, but this should not be the only focus. Fertility awareness should employ the life course approach to improve reproductive health and facilitate decision-making in family planning among adolescents, people of reproductive age, primary healthcare, education professionals, and policymakers through development, evaluation, and dissemination of inclusive educational resources. Fertility and reproductive health education are distinct but intertwined. As raising awareness on fertility means that reproductive health should be covered, the International Fertility Education Initiative (IFEI) recently changed our name to the International Reproductive Health Education Collaboration (IRHEC). The work that IRHEC has done with schools, highlights that covering the life course of reproductive health is important for all, irrespective of attitudes.

Finding the right language to communicate harbors risks on unintended negative effects such as dissonance and anxiety. The IRHEC’s recent publication focuses on 5 recommendations: 1) to frame fertility awareness messages with (reproductive) autonomy in mind aiming for inclusion of those who do not represent the traditional nuclear family; 2) ensure fertility health messages are empathetic and steer clear of blame; 3) avoid scaremongering and offer a positive angle; 4) address both women and men in fertility health messaging; and 5) tailor messages to particular contexts and audiences and develop resources in close collaboration with the target groups.

The measurable impact of all educational resources should be evaluated. This is challenging owing to lack of standardized education and of specific benchmark for satisfactory knowledge gain, along with the challenge of developing evaluation standards. The IRHEC has identified the need to systematize recommendations and describe the best evidence on effectiveness.

Examining evidence of knowledge, attitudes and behavior in different countries to identify knowledge gaps is key. Research indicates that key ways to educate is in schools, using digital technology, social media and health professionals. For schools, curriculum vary in different countries from teaching nothing, to teaching how to prevent a pregnancy. Reproductive health education in schools will ensure that young adults will be well-equipped towards informed decision-making. The IRHEC has been working towards understanding how to best teach reproductive health, with work done in the UK, and repeated in Belgium and Greece. A teacher’s guide in a “train-the-trainers” mentality has been produced to help teachers deliver reproductive health education. The challenge of an effective multidisciplinary collaboration between policymakers and educators is well acknowledged.

Research on education employing social media is valuable to establish who is influencing reproductive health education, what is their impact, what information they are posting, and how effective it is. Data can help to indicate how to best use social media to deliver fertility education.

A “one-size-fits-all” philosophy for reproductive health education is out of the question. Studies have indicated that target audience may perceive the education as guided and feel obligated to comply with societal pressures. This, in turn, may generate misconceptions and backlash resulting in questioning, suspicion and skepticism. Cultural, religious and socioeconomical factors complicate further, as does the role of social media in perpetuating misconceptions. The problem posed by lack of tailored information is showcased considering the paradigm of addressing the LGBTQ+ community, as there is limited data in literature, while the community may be rendered vulnerable because of marginalization, and normative pressure.

To address challenges, multidisciplinary should evolve to interdisciplinary. The future should hold recommendations and guidelines. Data highlights the significance of establishing government-sponsored fertility education programs, across all countries and for all ages, however Governments’ approval pauses a conundrum. The way forward features personalized education, whilst aiming for high-quality robust evidence.