Determinants of infertility among married women attending health facilities in Rajasthan, India: a cross-sectional study

The International Conference on Population and Development (ICPD) Program of Action (POA) in 1994 acknowledged infertility as a key aspect of Sexual and Reproductive Health and Rights (SRHR). It emphasized the importance of integrating infertility into SRHR interventions globally. In India, the policy focus has been on curbing the population growth, with less attention on infertility. Hence, this descriptive cross-sectional study investigated the prevalence of childlessness among married women and attempted to assess SRHR services at the 27 local sub-centres in Rajasthan, India. An interview survey was administered to 20,098 Currently Married Women (CMW) aged 18–49 years who were registered at the local health sub-centres in Alwar district. Data on socio-demographic variables, family planning, and reproductive history were collected. Descriptive statistics were used for analysing the data. Findings showed childlessness (1.74%) among the currently married women. On the service provision side, only a few sub-centres were addressing Reproductive tract Infections (RTIs)/Sexually Transmitted Infections (STIs), which are major preventable causes of infertility. The study recommends enhancing the capacities of the community health workers called Accredited Social Health Activists (ASHA) in estimating the number of childless couples, facilitating early screening of infertility, its associated factors, and ensuring appropriate referrals within the health system for early diagnosis and management.