How Gender Norms Influence the Experiences and Consequences of (In)Fertility of Women and Men in Kenya and Cameroon: A Qualitative Exploration

Elizabeth Larson, Center on Gender Equity and Health, UC San Diego
Dinah Amongin, Makerere University School of Public Health
Emma Woks, EVIHDAF
Lotus McDougal, Center on Gender Equity and Health, UCSD
Caroline Deignan, Matchboxology
Courtney McLarnon, GEH, UCSD
Peter Kisaakye, Makerere University
Symon Wandiembe, Makerere University
Paul Bukuluki, Makerere University
Jean Christophe Fotso, EVIHDAF
Junior Agbor, EVIHDAF
Caroline Teh Monteh, Independent consultant
Esther Spindler, Consultant, GEH/UCSD
Shannon Pryor, Save the Children
Madeleine Short Fabic, US Agency for International Development (USAID)
Sadia D Parveen, USAID
Rebecka I. Lundgren, University of California, San Diego

Sexual and reproductive health research and programming have neglected infertility in the African region despite the region’s disproportionate burden. This study begins to address this evidence gap by exploring infertility-related individual, community, social, and systems factors that influence reproductive agency and infertility-related behaviors in Cameroon and Kenya. Data were collected between September and October 2023 in four sites across Cameroon and Kenya. We conducted 56 in-depth interviews with ever sexually active women and men, 15 focus group discussions including social norms reference groups, and 22 key informant interviews with public and private sector health providers. Findings demonstrate infertility’s substantial impact on the lived experiences of people in Kenya and Cameroon and highlight the profoundly gendered experiences associated with infertility. Assumptions around women’s previous sexual and reproductive health behavior, and contraceptive use in particular, is often blamed for a couple’s infertility. Fear and stigma surrounding infertility limit contraceptive acceptability and subsequent contraceptive choices and constrain the reproductive agency of women and couples in these settings. Gender-transformative programming is necessary to shift the narrative surrounding infertility to enable individuals and couples to achieve their self-determined reproductive goals.

Keywords: Fertility, Sexual and Reproductive Health and Rights, Gender Dynamics

See extended abstract.