Infertility remains one of Botswana’s most unspoken yet profoundly heart-wrenching health challenges. Despite ongoing progress in maternal and child healthcare, countless women and couples across the nation continue to grapple silently with the pain of conception’s elusive promise. At the forefront of this fight is Dr. Ntshonga-Taylor, a 2022 graduate of the Merck Foundation’s MSc in Sexual and Reproductive Health program. Her journey is one marked by unwavering dedication, empowerment, and an unwavering mission to rekindle hope within families.
Dr. Ntshonga-Taylor’s passion for fertility care was born from her clinical experiences in the gynecological ward at Letsholathebe Memorial Hospital. There, she witnessed firsthand the profound struggles patients endured in accessing timely infertility treatment. After managing acute conditions—ranging from post-abortion complications to severe pelvic pain—she frequently referred patients for further fertility evaluation. Yet, with just a single gynecologist serving the facility, women faced agonizing waits averaging two years for consultation. The heartbreak was compounded by the time-sensitive nature of conception and the increased risks linked to advanced maternal age. Many essential fertility treatments, such as in vitro fertilization (IVF), remained either unavailable or financially out of reach for the average Motswana.
These obstacles ignited Dr. Ntshonga-Taylor’s resolve to deepen her expertise, prompting her to enroll in the Merck Foundation program. The education she received was transformative, equipping her with sophisticated skills to manage an extensive spectrum of infertility cases. Today, she confidently treats many patients independently, ensuring they receive timely, appropriate interventions. For those requiring specialist care, she now conducts all necessary diagnostics upfront, accelerating the pathway to diagnosis and treatment.
Serving in a primary healthcare clinic, Dr. Ntshonga-Taylor continues to see infertility patients daily, frequently going above and beyond to support those in need. Her dedication has not gone unnoticed; colleagues now routinely refer clients to her. She intends to formally petition for the allocation of at least one afternoon each week exclusively for infertility consultations, aiming to offer more focused and structured care.
Despite this progress, challenges persist. Limited resources delay effective management—basic tests like hormonal profiles can take up to six weeks to process, while vital diagnostic procedures such as hysterosalpingograms (HSG), which detect fallopian tube blockages, remain inaccessible in Maun. Staffing shortages further strain the capacity to devote adequate attention to infertility cases. Although the local hospital has introduced sperm analysis and certain imaging services for male infertility, a significant hurdle endures: the lack of male participation. Given that male factors contribute to nearly half of all infertility cases, the fact that most women attend clinics alone complicates efforts to achieve comprehensive and accurate diagnoses. This highlights an urgent need to raise public awareness and education about infertility as a shared responsibility.
The Merck Foundation program also inspired Dr. Ntshonga-Taylor to critically evaluate healthcare delivery in Botswana. Her research, centered on reducing mortality from unsafe abortions in developing countries, fostered a mindset that challenges the status quo—urging her to consider whether current practices are truly evidence-based, community-focused, and cost-effective. She advocates for data-driven decision-making paired with continuous evaluation as the cornerstone for improving healthcare outcomes.
Dr. Ntshonga-Taylor remains steadfast in her commitment to expanding infertility services and calls upon the Merck Foundation and its partners for ongoing support in capacity building, mentorship, and clinic development. While acknowledging the obstacles ahead, she firmly believes that meaningful progress starts with optimizing existing resources. She also looks forward to engaging actively in alumni-led initiatives, mentoring future cohorts, and participating in public awareness campaigns designed to destigmatize infertility and promote access to reproductive health services.
She adds a thoughtful critique of the Merck Foundation course, noting that its strong emphasis on IVF might overwhelm healthcare workers new to fertility care. She suggests balancing the curriculum with greater focus on accessible management options to enhance its relevance and practicality across diverse healthcare settings.
Though infertility often goes unspoken, its impact resonates loudly in the lives of many Batswana. With devoted professionals like Dr. Ntshonga-Taylor leading the charge and supported by initiatives such as the Merck Foundation, hope grows that no woman or couple in Botswana will ever have to endure this journey alone or in silence.
About Merck Foundation
Merck Foundation, the philanthropic division of Merck KGaA Germany, is committed to advancing health and wellbeing throughout Africa and other developing regions. Through its “More Than a Mother” initiative, it confronts infertility stigma and provides training for healthcare providers to enhance fertility care services. Botswana has been a proud beneficiary of these programs, with numerous professionals awarded scholarships across various disciplines.
