Abstract

Infertility refers to the inability of a couple to conceive after 12 months of regular sexual intercourse without the use of contraceptives. It therefore affects approximately 60-80 million couples worldwide (Boivin J et al 2007), Infertility is of two types; primary which is a condition in which a couple that have never had a child are still unable to conceive while Secondary refers to couple who have had at least one child but are unable to conceive again?  Objective: To investigate adults’ knowledge on infertility and knowledge on the preventive measures of infertility in Bokova community; specific objectives: To investigate adult’s knowledge on infertility; To investigate adult’s knowledge on the causes of infertility and To investigate adults’ knowledge on the preventive measures of infertility. Method and Material:  The study was a cross sectional research design, with a sample population of 100 participants who were selected using a random sampling technique, the instrument for data collection was a well-structured questionnaire. Results: Sample sizes of 100 participants were used in the study were 43 (43%) were male and 57 (57%) were females. The age group ranges from 21- 40years.  Based on objective one, only 36 (36%) participants out of 100 rightly gave the definition of infertility and 52 (52%) had knowledge on signs and symptoms of infertility in female, based on the second objective, 55 (55%) gave the correct causes of infertility in female and on the other hand, only 46 (46%) participants out of 100 had knowledge on causes of infertility in male. Based on the third objective, out of 100 adults, 39 (39%) of the respondents had knowledge on the preventive measures of infertility. Conclusion:  Adults had little knowledge on infertility; they also had knowledge on the causes of infertility but lack knowledge on the preventive measures of infertility.  It was recommended that further research should be done to compare adults’ knowledge on the risk factors of infertility and on the various methods to prevent infertility. Also, more sensitization programs should be carried out by the health professional so as to educate the public on infertility.

CHAPTER ONE

INTRODUCTION

This chapter presents; the background of study, statement of problem, objectives, research questions, significance of study, scope of study and definitions of terms.

1.1 Background of Study

Infertility has been a major medical and social preoccupation since the dawn of human existence; women have always been the symbol of infertility. In Egyptian society, women were equal to men and difficulty with conception was not considered divine punishment but an illness that had to be diagnosed and treated (U. Larsen, 1994). As far back as 1900 BC, there are recorded documents discussing the treatment of Gynaecologic disorders. Although the Egyptian understanding of anatomy was somehow sketchy, there are reference to the female reproductive tract (J . Menken et al 1992) and sperms were considered to originate in the bones. Male infertility was also discussed in Egyptian records since it was important to tell if a woman was fertile or not, the Egyptians developed elaborate methods of diagnosis. Examinations were based on the concept that the genital organs were in continuity with the digestive system. This way of thinking remained in place for hundreds of years and was adopted by Hippocrates and many medieval physicians (ORC Macro 2004). In 1752, Smellie was the first to carryout experiments and described the fertilization process. Despite the progress that was made during this time, infertility was almost synonymous with the female; and it was rare that the husband was considered as the caused.  Even during this age of enlightenment, a real ambiguity existed. . Many Romans physicians believed that conception took place right after menstruation. The period prior to menstruation was infertile because the uterus was overloaded. Galien (130-200 AD, believed that the phases of the moon had an effect on the feminine cycle. There was little advancement in the treatment of infertility during Romans time. In 1562, Bartolomeo recommended that husbands should put their finger in the vagina after intercourse to encourage conception. This was the ancestor of the idea of artificial insemination.

Impaired infertility is a well- known public health issue in Africa.  Central Africa, regions around Lake Victoria and Lake Chad and various other locations have been characterised by particularly high levels of childlessness and subfertility (H.page and A. Coale et al 1983). However, a recent study of about 17 African countries, on infertility found out that, infertility is prevalent in all these countries (U.Larsen, 1994). Another study of six countries, show that the level of infertility appears to be either declining (in Cameroon, Nigeria and Sudan) or remaining stable (Ghana, Kenya and Senegal). There is evidence suggesting that women who engaged in sexual activities in their early and mid- teens are particularly likely to suffer from infertility (J  Menken,  N.  Kisekka). Given that health facilities are limited in Africa, infertility is difficult and costly to treat, and that resources are scares, future efforts are therefore focused on preventing infertility (WHO, J-Khanna et al 1992). Furthermore, the prevalence of infertility in Cameroon and Nigeria is high relative to that in most other African countries for which data is available and the prevalence decline during the 1980s (U. Larsen, 1994). Finally, the findings have broad ranging implications because Cameroon and Nigeria count a total population of about 100 million. Infertility affects approximately 60-80 million couples around the world and is still increasing (Adamson Pc, 2011, Boivin J, 2007, et al). A demographic study in 2002 by the world health organisation (WHO) on developing countries (except China) indicated that 186 million women have been infertile (ORC Macro USA 2004). The prevalence of current infertility in developed and less developed countries, based on a systematic review, was between 3.5-16.7% and 6.9-9.3% respectively (Boivin J, et al 2007). Infertility is not only a health problem but also a social and emotional problem, especially in some cultures and some time it leads to divorce (Bhalti LI, Zeng Y, et al 2000). Another study has reported the prevalence of primary infertility in developed and less developed countries at 6.6-26.4% and 5-25.7% respectively (Volgsten H, et al 2008). The prevalence of infertility has been reported in China 9%, in America 10-15%, in Siberia about 16% and in Australian 19% (Zeng Y, 2000) .  In most African cultures, the true meaning of marriage is fulfilled if the couple conceive and bear children (Dyer SJ, Abraham N et al 2004). African considers their children to be a source of power or pride and children act as insurance for their parents in old age. The most important aspect of bearing children is an assurance of family continuity; Anthropological and Sociological studies bear testimony to the considerable suffering associated with involuntary childlessness due to negative psychological consequences such as marital instability, abuse and stigmatization (Dyer SJ, Abraham N et al, 2004, Gerrity DA, 2001).  Studies have revealed that the most common cause of male infertility is due to a problem in sperm production process in the testes. About two- third of infertile men have sperm production problem which may be low in number or sperm do not work properly (McLachian R, 2007). Studies have shown that among women aged 30-34, the proportion of infertility ranges from 11% in Burundi to 34% in Cameroon. Therefor there is evidence suggesting that females who engage in to sexual activities in their early and mid- teens are likely to suffer from infertility (J Menken, N. Kisekka et al, 1992).  In Cameroon, the prevalence of infertility is highly associated with a woman’s age at first sexual exposure. For example, infertility ranges 15% among women who had intercourse before the age of 13 but only 4% ranges among women who postponed sexual activities until after their 19th birthday. Moreover, the prevalence of infertility in Cameroon is as follows; north and extreme North region is 28.4%, the Centre region is 28.1%, the Eastern region is 18.6%, the North West region is 13% and the South West region is 15%.

This study on investigating adults knowledge (21-40 years’) on infertility and prevention of infertility in Buea municipality case study Bokova community, as its scope, will be carried out from May  2019 to February 2020. This study is geographically limited within the Bokova community found in the south west region of Cameroon, Fako division and Buea sub division. The targeted population were both Men and women aged 21-40 years at home.

1.2 Statement of problem

Infertility is one of the major health problem in all societies world-wide especially the developing countries with an average prevalence 3.5-6.7% in the developed countries and 6.9-9.3% in developing countries (Boivin  J, et al 2007). This has therefore let to a high rate of childlessness and sterility in many homes in our societies today, like a case I witnessed who was a closed relative of mine, has been childless for more than 5 years of marriage and because of her condition many of her friends and some other family members now turns to neglect her.  So, because of the burden infertility has placed on many families and the health system in resource-constrained countries, inequalities turn to be exuberated in our societies where those who are infertile turn to be neglected, abandoned, divorced, insulted and low power in the society. With all these problems, I deem it necessary to come out with this research topic investigating adults age 21-40 years’ knowledge on infertility and the preventive measures of infertility. Bokova was therefore chosen because the majority of the population were young and sexually active adults, and many of which were married before 25 years with very low level of education.

1.3 General Objectives

To investigate adults’ knowledge (21-40years) on infertility and the preventive measures of infertility.

1.3.1 Specific objectives

1. To investigate adults’ knowledge (21-40years) on infertility.
2. To evaluate adults’ knowledge (21-40 years) on the causes of infertility.
3. To asses’ adults’ Knowledge (21-40 years) on the prevention of infertility.

1.4 Research questions

1. What knowledge does adults’ age 21-40 years have on infertility?
2. Do adults’ age 21-40 years have on the causes of infertility?
3. What knowledge does adults’ age 21- 40 years have on the prevention of infertility?