Experience of infertility-related stigma in Africa: a systematic review and mixed methods meta-synthesis

Infertility is a significant reproductive health issue with high prevalence rates in Africa, where it is often stigmatized. This systematic review characterizes the experience of infertility stigma in Africa. A systematic search of relevant studies was conducted across PubMed, MEDLINE, CINAHL, PsycINFO, Global Health, Scopus and Web of Science, covering publications from their inception to March 2025. The search incorporated subject headings and keywords related to 'infertility' and 'stigma' in combination with terms specifying all African countries. A mixed methods approach was employed for data analysis, using the convergent thematic QUAL synthesis method. A total of 1987 records were identified, with 48 studies ultimately meeting the inclusion criteria. The analysis revealed four overarching themes in the experience of infertility stigma: mechanisms of stigma-factors that drive or perpetuate stigma surrounding infertility; stigma marking-the social markers and identifiers that distinguish individuals as stigmatized; manifestations of stigma-the varied forms through which stigma is expressed; and consequences-the psychological, behavioural, relational and health-related repercussions for individuals experiencing infertility stigma. Infertility stigma was widespread, with a prevalence as high as 64%. However, no interventions were developed and implemented to mitigate this issue. Infertility stigma in Africa is deeply embedded within cultural norms and social structures, significantly impacting the lives of those affected. This review emphasizes the critical need for culturally tailored interventions to alleviate stigma and enhance access to reproductive health services.