Failures in reproductive health policy: overcoming the consequences and causes of inaction

J Public Health (Oxf). 2019 Jun 1;41(2):e209-e215. doi: 10.1093/pubmed/fdy131.

Abstract

It is assumed that long-established research findings and internationally accepted evidence should, and will, be translated into policy and practice. Knowledge about what prevents harm and promotes health has, in fact, guided and resulted in numerous beneficial public health actions. However, such is not always the case. The authors examine three notable, and unwelcome, exceptions in the UK-all in the field of reproductive health and all focused on the period prior to pregnancy. The three examples of counterproductive inaction discussed are: fortifying flour with Vitamin B9 (folic acid); preventing foetal alcohol spectrum disorders; and reducing risks and better regulating a highly teratogenic medication (valproate). The adverse consequences, as well as the causes, of inaction are analysed for each example. Reasons for optimism, and recommendations for overcoming inaction, are also offered, in particular, greater priority should be accorded to preconception health, education and care.

Keywords: (public) health policy; evidence-based policy; fetal alcohol spectrum disorders (FASD); folic acid; preconception health; pregnancy; prevention of birth defects; reproductive health; valproate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Female
  • Fetal Alcohol Spectrum Disorders / prevention & control
  • Flour
  • Folic Acid / administration & dosage
  • Food, Fortified
  • Health Policy*
  • Humans
  • Informed Consent
  • Neural Tube Defects / prevention & control
  • Pregnancy
  • Reproductive Health*
  • Teratogens / toxicity
  • United Kingdom
  • Valproic Acid / therapeutic use
  • Valproic Acid / toxicity

Substances

  • Teratogens
  • Valproic Acid
  • Folic Acid