9.Provide training to diagnose and treat low and middle complexity infertility in the primary healthcare setting: Develop the capacity to deal with less complex treatments at the primary healthcare level by training healthcare providers, such as nurses and midwives, and link them with their referral centre.
Nurses and/or midwives must be trained to deal with specific diagnostic categories and treatments in the PHC setting.
Training should include knowledge about infertility including its social and psychological impact and the reasons for treating it, steps of preventing and diagnosing infertility. Skills should include history taking and a physical examination.
The nurse and/or midwife should be trained to perform transvaginal ultrasound, to monitor controlled ovarian stimulation with clomiphene and possibly gonadotropins, and to identify complications of treatment.
The nurse and/or midwife should eventually serve as a bridge between the PHC and the referral hospital, where many patients might need referral.