Knowledge, Attitudes and Socio-Demographic Factors Associated with Malesâ Involvement in Fertility Treatment in Ghana

Abstract

Background: Infertility in developing countries often raises distinct and complex issues as compared to developed countries. Infertility affects an estimated 15% of couples globally with several socio-cultural implications. Many studies have reported that, males have poor health seeking behaviour when it comes to infertility treatment as they do not involvement themselves strongly due to varied factors. Therefore, this paper sets the pace by exploring how knowledge level, attitudes of men and their socio-demographic backgrounds influence their involvement in infertility treatment in Ghana. The paper was underpinned by the ancient Social Learning Theory which is still instrumental in modern social science research. Methods: The study adopted a quantitative approach using a cross-sectional study design. The study population was married men selected using a simple random sampling technique from 8 clustered demarcation to obtain 423 respondents using the formula N=z2pq/d2. A structured questionnaire was administered and data were analysed using STATA 15. Statistical significance for all testing was set as p<0.05 with 95CI. Result: The study found that, the mean age for the participants was 38.35 ± 0.48 and 92.67% were involved in monogamous marriage. Again, 57.45% had secondary/vocational education, 97.40% active employment with greater number of them earning less than GHC 600. It was noted that 84.16% of respondents agreed that, female partners are always the cause of childlessness in an infertile relationship. Misconceptions on infertility being caused by witchcraft, curses, or other supernatural powers were also noted (58.39%). It was also found that, married men in polygamous marriages were 6 times more likely to be involved in a fertility treatment than married men in monogamous marriages (Adjusted OR=6.210, 95%CI=3.153-7.232). Moreover, married men with primary and tertiary education were 0.517 less likely (Adjusted OR=0.517, 95%CI=0.319-0.819) and 0.597 less likely (Adjusted OR=0.597, 95%CI=0.153-0.732) to be involved in fertility treatment respectively as compared to those with secondary education. Again, married men who were employed were 3 times more likely (Adjusted OR=3.331, 95%CI=2.193-3.304) to be involved in infertility treatment as compared with those who are self-employed. Moslems were 4 times more likely (Adjusted OR=4.036, 95%CI=1.420-4.304) to be involved in infertility treatment as compared to Christians. Finally, traditionalists were 0.331 less likely (Adjusted OR=0.331, 95%CI=0.193-0.364) to be involved in infertility treatment as compared to Christians. Conclusion: The study concludes that, fertility declines with age coupled with factors such as the consumption of excessive alcohol, use of anabolic steroids, untreated sexually transmitted diseases, excessive stress, and among others. Also, the general attitudes of men towards infertility treatment were good as majority of them perceive infertility treatment to be the responsibility of both couples. However, the ability to achieve this orientation is positively influenced by the males’ socio-demographic factors such as marriage type, level of education, employment status and religious inclinations towards infertility issues. Recommendation: The study recommends that, men should seek for infertility treatment together with their wives so that it can be wholly managed for the couples. Again, the National Health Insurance Scheme in Ghana (NHIS) should cover infertility treatment and the charges of Private Fertility Treatment Centres should be regulated to prevent them from charging exorbitant fees. Moreover, educational forum on issues related to infertility and fertility should be undertaken by the community health unit of District Hospitals to sensitize the public.