The knowledge, attitude and practice of child adoption among infertile Nigerian women

Abstract

To determine the knowledge, attitude and practice of child adoption among infertile Nigerian women we undertook a questionnaire survey of 279 consecutive infertile women seen in three tertiary care centres in South Eastern Nigeria within a 9-month period. The data were analysed by means of simple percentages and descriptive and inferential statistics, using t -tests, chi-square tests and regression equations at the 95% confidence level. Two hundred and sixty-four questionnaires were analysed. Although 228 (86·4%) of the respondents were aware of child adoption, only 72 (27·3%) knew its correct meaning. Fifty-seven (21·6%) women knew how to adopt a baby while the rest did not; 183 (69·3%) respondents expressed their unwillingness to adopt a baby while the remaining 81 (30·7%) were willing. Twelve (14·8%) of these 81 respondents (or 4·5% of all respondents) had either adopted or made an effort to adopt a child at the time of the study. The major reasons given by the 183 respondents unwilling to adopt a child were: adoption not a solution to their infertility (84 respondents); adoption psychologically unacceptable (78 respondents); fear of unknown parental background (75 respondents) and abnormal behaviour in the child (75 respondents). Univariate analysis showed six factors significantly associated with a favourable attitude to child adoption: a correct knowledge of the meaning of adoption ( P =0·00007), duration of infertility >5 years ( P =0·0002), previous orthodox specialist treatment ( P =0·0002), tubal infertility ( P =0·002), no living child ( P =0·02) and maternal age >35 years ( P =0·03). In a multiple logistic regression involving these six factors, with attitude to adoption as the dependent variable, two factors were associated significantly with a favourable attitude to adoption: correct knowledge of the meaning of adoption (OR=1·9, P =0·04) and previous orthodox specialist treatment (OR=2·9, P =0·05). Although the majority of infertile Nigerian women have heard of child adoption, only a minority knew its real meaning, its legality and the process it entails. Approximately one-third of them were disposed favourably to adoption as a treatment option for their infertility. The Nigerian experience was compared and contrasted with the experiences of other countries. Factors associated with a favourable attitude to adoption were presented and discussed. In the presence of such factors, especially when the probability of cure of infertility is small, child adoption as a treatment option should be offered early so that willing couples can initiate the processes.