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Infertility: Confronting stigma, bridging healthcare gaps

Infertility affects millions of people worldwide, yet it remains a stigmatized and often misunderstood condition. In West Africa, many individuals experiencing infertility face significant challenges, including limited access to healthcare, cultural stigma, and financial constraints. ABUJAH RACHEAL explores the complexities of infertility in West Africa, shedding light on the stigma surrounding it and the urgent need to bridge the existing healthcare gaps

In the quiet corners of African villages, women carry a hidden pain. While many are celebrated for bringing life into the world, those who are unable to conceive are often left in the shadows.

Male infertility: Sperm damage

For women like Mrs. Chollom Pam, infertility is not just a medical condition; it is a societal verdict that comes with emotional trauma, isolation and rejection.

“Every day, I was reminded of my failure as a woman, friends who once supported will gradually pulled out; even within my marriage, the tension is constant,” Pam would always share her burden with emotions.

In West Africa, where motherhood is often equated with womanhood, infertility is a silent epidemic that leaves many women grappling with feelings of inadequacy and social rejection.

untreated infectious diseases, such as Sexually Transmitted Infections, account for up to 85% infertility cases in Africa

In Mali, Mrs. Fatouma Amadou faced years of ostracisation by her in-laws after multiple failed attempts to bear children. “They see me as less of a person, as if my worth is tied to my ability to have children,’’ Amadou noted.

How obesity causes male infertility. Image credit: ResearchGate

Her husband, Mr. Oumar Amadou, says: “The pressure isn’t just on my wife. As a man, I also feel the weight of society’s expectations’’.

This pressure extends beyond individual families. Across West Africa, cultural beliefs deeply rooted in gender stereotypes that often place the blame for infertility solely on women, in spite of research showing that male infertility accounts for nearly 50 per cent of cases.

“Infertility is often viewed as a curse or punishment from the gods,’’ explained sociologist, Mr. Seydou Traoré of Mali. Traoré said that this perception drives many women, especially in rural areas, to seek spiritual solutions rather than medical care.

For Mrs. Sophia Ampadu, a 40-year-old woman from Eastern Region, Ghana, the journey to acceptance and healing was long and arduous. Ampadu said that after years of struggling with infertility, she finally sought medical help.

Causes of female infertility“In spite of financial challenges, she and her husband were able to undergo vitro fertilisation (IVF) treatment.

“Unfortunately, the first IVF cycle was unsuccessful. The disappointment was crushing, but I refused to give up. With the support of my husband and a supportive community, I persevered and underwent a second IVF cycle,’’ she narrated.

Infertility is often viewed as a curse or punishment from the gods

To her immense joy, the second IVF cycle was successful. She became pregnant and gave birth to a healthy baby girl. She said that the experience transformed her life, filling her with a sense of purpose and fulfillment. Her story is a testament to the resilience of the human spirit.

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In spite of immense challenges, she was able to overcome infertility stigma, navigate the complexities of healthcare, and ultimately achieve her dream of becoming a mother.

Traditional healers to the rescue
Traditional healers, such as Chief Ogundele Adeoye, a Nigerian, continue to play a significant role in treating fertility issues. Adeoye said that while they offer centuries-old herbal remedies, their presence perpetuates the belief that infertility is solely a woman’s issue.

Female infertility
Biological causes of female infertility. Image credit: ZIVA Clinic

“Many couples come to us when modern medicine fails. But we cannot ignore the wisdom passed down by our ancestors,’’ he said.

This reliance on traditional methods, while part of the cultural fabric, often delays proper medical interventions. As a result, many women suffer in silence, facing social isolation and even physical violence while access to modern fertility treatments is limited, observers note.

While IVF is available in some urban centres, the cost is prohibitive for most people. In rural areas, access to even basic fertility care is virtually non-existent

Dr. Adanna Eze, a fertility specialist in Nigeria, highlighted the stark disparities, saying: “While IVF is available in some urban centres, the cost is prohibitive for most people. In rural areas, access to even basic fertility care is virtually non-existent’’.

Eze said that this gap is particularly troubling, given that untreated infectious diseases, such as Sexually Transmitted Infections (STIs), account for up to 85 per cent of infertility cases in Africa.

“Without proper healthcare infrastructure, many women are left untreated, further deepening the crisis’’, she said.

According to a 2020 meta-analysis, infertility affects 49.91 per cent of couples in Africa, with West Africa contributing 41.57 per cent of this figure. In spite of these staggering numbers, infertility remains a taboo subject, shrouded in stigma and shame.

infertility
Reasons why couple can’t achieve pregnancy

More Than a Mother/Father campaign
Fortunately, efforts to address this issue are gaining momentum. The Merck Foundation’s “More Than a Mother’’ campaign is one of the leading initiatives aimed at empowering infertile women. Through education, awareness, and access to healthcare, the programme challenges the stigma around infertility.

“Our goal is to provide training for fertility specialists and embryologists across Africa, the efforts go beyond medical solutions, we must shift societal perceptions; this is not just a woman’s problem.

According to a 2020 meta-analysis, infertility affects 49.91% of couples in Africa, with West Africa contributing 41.57% of this figure

“The twin campaign, More Than a Father, aims to raise awareness about male infertility, emphasising the shared responsibility between men and women in the journey to parenthood,’’ said Dr. Rasha Kelej, the Chief Executive officer of the Merck Foundation.

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Sen. Ipalibo Banigo, Chair of the Senate Committee on Health, is pushing for a bill to improve reproductive healthcare access for all women, especially those dealing with infertility.

“Infertility is a silent epidemic in our communities. We must make reproductive healthcare more accessible, particularly for low-income families,’’ Banigo explained.

Yet, barriers remain. Funding shortages, lack of trained healthcare professionals, and deep-rooted cultural beliefs continue to hinder progress, according to observers. But while the journey is long, hope remains. Advocacy groups such as the African Infertility Support Network, says it is providing counselling and legal support to affected women.

“Infertility is not just a medical issue; it is a societal one,’’ says Ms. Maryam Ogebe, an advocacy officer. We are working to include men in the conversation and educate communities about the true causes of infertility,’’ Ogebe said.

Funding shortages, lack of trained healthcare professionals, and deep-rooted cultural beliefs continue to hinder progress in fertility treatment

Fertility experts like Dr. Ibrahim Danladi, a reproductive health researcher, called for cultural shift in how infertility is perceived. “Our healthcare systems must prioritise both male and female infertility. Policy changes are essential to ensure that fertility treatments are accessible to everyone,’’ Danladi said.

Experts note further that infertility in West Africa is more than a medical condition; it is a deeply ingrained cultural challenge. They note that for women like  Pam and Amadou, it brings a painful collision between personal hopes and societal expectations. But, with growing advocacy, medical interventions, and societal awareness, there is hope for change

Tackling this issue requires a holistic approach; improving healthcare access, reducing stigma, and implementing policies that support all couples. Only then can West Africa begin to heal the silent wounds left by infertility, they observe. (NANFeatures)

Abujah Racheal
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