KNOWLEDGE AND PERCEPTION OF INFERTILITY AMONG ADULT MALES IN IBADAN, NIGERIA.

E.O. Oluwole1, D.O. Fakayode1, E.O. Olufela1, O.J. Akinsola1, O.Y. Ojo2

  1. Department of Comm. Health and Primary Care, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria.
  2. Department of Community Medicine and Primary Care, Federal Medical Centre, Abeokuta, Nigeria.

Abstract

Background: Infertility is a public health problem with significant social and psychological distress of the affected men due to the inability to achieve the desired social role of fatherhood. Men with infertility may experience lower life satisfaction, heightened distress and anxiety. This study assessed the knowledge, perception and factors influencing knowledge and perception of infertility among adult males in Ibadan, Nigeria.

Method: Cross-sectional descriptive survey was conducted among 388 adult males between April and November 2019 in the selected communities. Respondents were interviewed using a pretested structured questionnaire. Data was analysed with SPSS version 22. Descriptive and bivariate analyses were conducted. Level of significance was set at p<5%.

Result: The mean age of the respondents was 45.74±10.76 years. Majority were married 310(80%) and had tertiary education 234(60%). Less than half (48.7%) understood the correct meaning of infertility, 170(44%) agreed that witchcraft could cause infertility while 230(59%) disagreed that infertility could be prevented. Two hundred and sixty (67%) and 283 (73%) of the respondents had good knowledge and perception towards infertility respectively. Religion, education and income were statistically significant with knowledge of infertility (p<0.05). In addition, knowledge and perception of infertility showed statistically significant association (p<0.001).

Conclusion: Knowledge and perception of respondents towards infertility was suboptimal in this study. Some cultural beliefs persist despite the high level of education of respondents. Community-based education on infertility to increase the knowledge and perception of men towards infertility is recommended.

Keywords: Knowledge, Perception, Infertility, Adult males, Nigeria

Correspondence:

Dr. E.O. Oluwole
Dept. of Comm. Health and Primary Care,
College of Medicine,
University of Lagos,
Surulere, Lagos
Email: oluester2005@yahoo.com

Introduction

Infertility is a medical and social condition which poses a serious problem worldwide.1 Generally, a couple is generally considered clinically infertile when there is no pregnancy occurring after a minimum of twelve months of regular unprotected sexual activity.2 It is considered as a major life crisis with the potential to threaten the stability of individuals and relationships.3 Infertility has been documented to affect 10–15% of couples having to seek specialist fertility care at least once during their reproductive lifetime.4,5 Over 80 million couples suffer from infertility globally, majority of which reside in developing countries.6,7 The rate of infertility in Africa was documented to range between 8.6 to 21.5% in 2003.8

Infertility is a public health problem with significant social and psychological distress of the affected men due to the inability to achieve the desired social role of fatherhood.9,10,11 Also, men with infertility has been documented to have lower overall life satisfaction, heightened distress, and higher treatment-related anxiety.12

Male infertility defined as the inability of a male to cause pregnancy in a fertile female account for 40– 50% of infertility.1 Inability to bear a child has been associated with raised anxiety, low self-esteem, mood instabilities, or depression in males.10

Some beliefs about causes of infertility include, witchcraft and possession by evil spirits, and these affect the management of infertility negatively.13 In a previous study on an adult population in Pakistan, evil forces and supernatural powers were widely held as causes of infertility.9 Another study in Kuwaiti found that most educated participants felt infertility is caused by nutritional, marital, and psychosexual factors, while the non-literates mentioned supernatural causes, such as evil spirits, witchcraft, and God’s vengeance as causes of infertility.14

Knowledge about infertility is insufficient in many parts of the world and it has been reported that husbands lost interest in their wives because of infertility, while some have had to marry another wife because of children.7 A study in Ile-Ife, Nigeria found a prevalence of divorce (38.9%) among the respondents because of infertility.15 Children in a family represent old age insurance and guarantors for generational continuity. In African settings especially, land sharing is commonly based on the number of children after a man’s death.16 Among the Yoruba ethnic group in Nigeria, the number of children is usually considered in the distribution of properties after a man’s death.7

Good knowledge and perception of infertility is very crucial among men as it may help to prepare their minds when they are having difficulty in having children. Knowledge of infertility may also help society to understand and help infertile couples with a reduction in social and psychological burden. A study confirmed that infertility is a major life-altering problem in sub-Saharan Africa, and that community mechanisms including family structures will go a long way toward mitigating the effects.17 Knowledge of the factors influencing infertility among men may help to design a focused and strategic intervention among the target population. This study was conducted to assess the adequacy of knowledge and perception of the target population and also, to identify factors that influences knowledge and perception of infertility among adult males in Ibadan city, Nigeria.