ASSISTED REPRODUCTIVE TECHNOLOGIES (ART) EQUITY, JUSTICE AND AUTONOMY IN GHANA

ABSTRACT Restrictive legislation, which is the main barrier to some assisted reproductive technology (ART) services in many countries, is non-existent in Ghana. However, ART services are concentrated in the capital cities of only four out of the sixteen regions, serving predominantly middle- and upper-class individuals. There is limited evidence about the factors preventing broader access to ART services in Ghana, and this study aims to document these barriers. A cross-sectional survey was conducted in July 2024 across all 22 fertility centers in Ghana, using two structured questionnaires administered via Google App to 61 ART personnel and 104 treatment defaulters. Results showed that mentorship from senior colleagues (65.57%) was the most common way for ART professionals to acquire skills. Almost all (91.80%) professionals offered a full range of ART procedures, but 86.89% advocated for regulated practice. They identified high treatment costs (70.49%) and lack of awareness (16.39%) as the most significant barriers. Among treatment defaulters, 88.47% had sought ART services based on word-of-mouth recommendations, compared to only 4.8% influenced by traditional or social media. More than half (50.96%) of the women were in their thirties, and 48.08% required in vitro fertilization (IVF). While 58.65% sought treatment within five years of infertility, 70.2% discontinued due to high costs, and 35.57% due to partner non-availability. Despite the absence of restrictive policies for ART services in Ghana, Prohibitive costs, partner non-availability, and lack of awareness limit access. However, ART professionals expressed the need for regulated practices.