Addressing infertility as an overlooked priority in the reproductive health agenda in Africa

Friday Okonofua, Lorretta Ntoimo, Zainab Kwaru Muhammad-Idris, Rosemary Ogu

Abstract

Infertility is one of the great paradoxes of reproductive health in Africa. The continent has some of the world's highest fertility rate, yet it also carries a disproportionately high burden of infertility. Despite this, infertility remains one of the least prioritised components of sexual and reproductive health and rights (SRHR) on the continent, receiving far less attention than contraception, maternal health, HIV, sexually transmitted infections (STIs), abortion. and adolescent pregnancy. In 2026, 32 years after the 1994 International Conference on Population and Development (ICPD) included infertility as one of its platforms of action, this neglect is no longer defensible

Full Text:

PDF

References

UNDESA Population Division. World Population Prospects 2024 Online Edition. Washington DC: United Nations,

Department of Economic and Social Affairs, Population Division; 2024. Report POP/DB/WPP/Rev.204/GEN/F01/Rev.1.

World Health Organization. Infertility prevalence estimates, 1990–2021. Geneva: World Health Organization.

United Nations Population Fund. Programme of Action Adopted at the International Conference on Population and Development, Cairo, 5-13 September 1994. 2004.

Gedef GM, Taye EB, Mohammed OY, Abegaz MY, Asratie MH, Andualem F. Prevalence of infertility and its risk factors in Sub-Saharan Africa: a systematic review and meta-analysis. Contracept Reprod Med. 2025 Nov 17;10(1):73. doi:10.1186/s40834-025-00411-1

Wei J, Huang H, Fan L. Global burden of female infertility attributable to sexually transmitted infections and maternal sepsis: 1990–2021 and projections to 2050. Sci Rep. 2025 Apr 30;15(1):15189. doi:10.1038/s41598-025-94259-9

Okonofua FE, Ntoimo LFC, Omonkhua A, Ayodeji O, Olafusi C, Unuabonah E, et al. Causes and Risk Factors for Male Infertility: A Scoping Review of Published Studies. IJGM. 2022 Jul;Volume 15:5985–97. doi:10.2147/IJGM.S363959

Abebe MS, Afework M, Abaynew Y. Primary and secondary infertility in Africa: systematic review with meta-analysis. Fertil Res and Pract. 2020 Dec 2;6(1):20. doi:10.1186/s40738-020-00090-3

World Health Organization. Guideline for the prevention, diagnosis and treatment of infertility. Geneva: World Health Organization; 2025.

Okonofua FE, Harris D, Odebiyi A, Kane T, Snow RC. The social meaning of infertility in Southwest Nigeria. 1997.

Moyo I, Mpofu L. The Sociocultural Aspects of Infertility in African Countries: A Scoping Review. In: Wilder S, Blair SL, Scott CL, editors. In Pursuit of Parenthood: Infertility, Assisted Reproductive Technology, and Surrogacy [Internet]. Emerald Publishing Limited; [cited 2026 Sep 8]. p. 0. Available from: https://doi.org/10.1108/S1530-353520260000035003 doi:10.1108/S1530-353520260000035003

Elwell K. The social and cultural consequences of infertility in rural and peri-urban Malawi. African Journal of Reproductive Health/La Revue Africaine de la Santé Reproductive. 2022;26(7):112–26.

Bayouh FA. Socio-cultural Perceptions of Infertility and their Implications: A study of Women Experiencing Childlessness in South Gondar, Ethiopia. 2011.

Zou W, Tang L, Wallis C. “My Body is Betraying Me”: Exploring the Stigma and Coping Strategies for Infertility Among Women Across Ethnic and Racial Groups. Health Communication. 2025 Oct 15;40(12):2612–23. doi:10.1080/10410236.2025.2470984 PubMed PMID: 39991807.

McLarnon C, Amongin D, McDougal L, Deignan C, Woks NIE, Bukuluki P, et al. From blame to belonging: Social and behavior change strategies to address infertility-related stigma in sub-Saharan Africa. Global Public Health. 2026 Aug 10;21(1):2715813. doi:10.1080/17441692.2026.2715813 PubMed PMID: 42573400.

Ekpor E, Brobbey SS, Kumah CY, Akyirem S. Experience of infertility-related stigma in Africa: a systematic review and mixed methods meta-synthesis. Int Health. 2025 Nov 1;17(6):903–13. doi:10.1093/inthealth/ihaf060

Roomaney R, Salie M, Jenkins D, Eder C, Mutumba-Nakalembe MJ, Volks C, et al. A scoping review of the psychosocial aspects of infertility in African countries. Reprod Health. 2024 Aug 23;21(1):123. doi:10.1186/s12978-024-01858-2

Temitope L. A qualitative synthesis of the impact of infertility on the mental health of African women. African Journal of Reproductive Health/La Revue Africaine de La Santé Reproductive. 2022;26(12):49–57.

Frank O. The demand for fertility control in sub-Saharan Africa. Studies in family planning. 1987 Jul 1;18(4):181-201.

Bongaarts J. Trends in fertility and fertility preferences in sub-Saharan Africa: the roles of education and family planning programs. Genus. 2020 Sep 21;76(1):32. doi:10.1186/s41118-020-00098-z

Bongaarts J, Casterline J. Fertility Transition: Is sub-Saharan Africa Different? Popul Dev Rev. 2013;38(Suppl 1):153–68. doi:10.1111/j.1728-4457.2013.00557.x PubMed PMID: 24812439; PubMed Central PMCID: PMC4011385.

Cleland J, Machiyama K, Casterline JB. Fertility preferences and subsequent childbearing in Africa and Asia: A synthesis of evidence from longitudinal studies in 28 populations. Population Studies. 2020 Jan 2;74(1):1–21. doi:10.1080/00324728.2019.1672880 PubMed PMID: 31694465.

Bell SO, Karp C, Moreau C, Gemmill A. “If I use family planning, I may have trouble getting pregnant next time I want to”: A multicountry survey-based exploration of perceived contraceptive-induced fertility impairment and its relationship to contraceptive behaviors. Contraception: X. 2023 Jan 1;5:100093. doi:10.1016/j.conx.2023.100093

Adofo E, Dun-Dery EJ, Kotoh AM, Dun-Dery F, Avoka JA, Ashinyo ME. Fear of infertility limits contraceptive usage among first-time mothers in Ghana: A cross-sectional study. Sage Open Medicine. 2021 Jan 1;9:20503121211021256. doi:10.1177/20503121211021256

Sedlander E, Yilma H, Emaway D, Rimal RN. If fear of infertility restricts contraception use, what do we know about this fear? An examination in rural Ethiopia. Reprod Health. 2022 Jun 13;19(1):57. doi:10.1186/s12978-021-01267-9

Barden-O’Fallon J, Speizer IS, Calhoun LM, Moumouni NA. Return to pregnancy after contraceptive discontinuation to become pregnant: a pooled analysis of West and East African populations. Reprod Health. 2021 Jul 2;18(1):141. doi:10.1186/s12978-021-01193-w

Okonofua FE. The case against new reproductive technologies in developing countries. British Journal of Obstetrics and Gynaecology. 1996;103(10):957–62.

Refbacks

  • There are currently no refbacks.