Enhancing cultural sensitivity in the implementation of the Fertility Quality of Life Tool in Sudan: a science diplomacy perspective

• Published in: Frontiers in public health 2024-08, Vol.12, p.1375643
• Main Authors: Bayoumi, Rasha R, Koert, Emily, Boivin, Jacky, McConnell, Margaret, Wolde, Betelhem, Siddiqui, Fatima, Elmusharaf, Khalifa, Viswanath, Kasisomayajula
• Format: Article
• Language: English
• Subjects: Adult; Cultural Competency; cultural considerations; Female; Fertility; FertiQoL; Humans; infertility; Infertility - psychology; Male; methodological considerations; Public Health; Quality of Life; Sudan; Sudan - ethnology; Surveys and Questionnaires
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2024.1375643

Infertility is a global health challenge impacting quality of life, particularly in low and middle-income countries such as Sudan. The Fertility Quality of Life (FertiQoL) tool, a standardized questionnaire, is pivotal in assessing fertility-related quality of life. However, existing research on its utility has primarily been conducted in Global North and High-Income Countries, highlighting the need to shift away from neocolonialism to promote truly inclusive research and effective healthcare practices. Science diplomacy, through the adaptation and culturally sensitive implementation of research tools, can serve as a catalyst for addressing health disparities on a global scale. This study aims to assess methodological and cultural considerations that impact the implementation of the FertiQoL tool in Sudan, framed within the context of science diplomacy and neocolonialism. By investigating the challenges and opportunities of utilizing this tool in a non-Western cultural setting, we seek to contribute to the broader discussion on decolonizing global health research. Utilizing an explanatory sequential design involving surveys and interviews, we conducted a study in a Sudanese fertility clinic from November 2017 to May 2018. A total of 102 participants were recruited using convenience sampling, providing socio-demographic, medical, and reproductive history data. The Arabic version of FertiQoL was administered, with 20 participants interviewed and 82 surveyed (40 self-administered and 42 provider-administered). We applied descriptive statistics, one-way ANOVA, thematic analysis, and triangulation to explore methodological and cultural nuances. Most participants were educated women who lived in urban areas. While the ANOVA results revealed no statistically significant differences in FertiQoL scores based on the mode of administration [core score ( (2,99) = 1.58,  = 0.21,  = 0.03) and domain scores: emotional ( (2,99) = 1.85,  = 0.16,  = 0.04); mind/body ( (2,99) = 1.95,  = 0.15,  = 0.04); relational ( (2,99) = 0.18,  = 0.83,  = 0.04); and social ( (2,99) = 1.67,  = 0.19,  = 0.03)], qualitative insights unveiled vital cultural considerations. Interpretation challenges related to concepts like hope and jealousy emerged during interviews. Notably, the social domain of FertiQoL was found to inadequately capture the social pressures experienced by infertile individuals in Sudan, underscoring the importance of region-specific research. Despite these challenges, parti