Knowledge and attitude towards child adoption among women in Zaria, northern Nigeria.

BACKGROUND: The success of marriages has largely been premeditated on child bearing in most African society and oftentimes women are at the receiving end of childlessness with possible psychological and physical torture.
OBJECTIVE: To assess the knowledge and attitude of women of reproductive age towards child adoption in Zaria, Northern Nigeria.
METHODOLOGY: A cross-sectional descriptive study, structured closed and open ended questionnaires was administered to 200 consenting consecutive women aged 15-49years to obtain information on socio-demographic characteristics, reproductive profile, knowledge and attitude towards child adoption. Data was analysed using SPSS V17 with p value set at 0.05.
RESULTS: The majority 89.4% of respondents have heard and are aware of child adoption and 77% agreed it is a good practice. The most prevalent source of information is the Mass media in 35.0% of respondents. The female gender is preferred by majority 64.2% of respondent if they will adopt. There is a strong association between numbers of living children and willingness to consider child adoption with P value < 0.05.
CONCLUSION: There is a high level of knowledge and acceptability of child adoption practices in our environment. Child adoption institutions should therefore be supported to meet the need of the infertile couples.

INTRODUCTION

The current fertility rate in Nigeria (5.7)1 is relatively high. However, infertility still affects 20% of Nigerians and is of public health concerns.2 In reality, infertility does not pose a threat to the physical health of people in the general population but it does impact strongly on the psychological and social well-being of couples.3 This is because majority of the traditional society in Nigeria places high premium on child bearing.4 Childlessness is known to be a cause of marital instability especially in the African culture just as marital success is based on the ability of a couple to procreate.5 Owing to the misconception associated with infertility, the women folk bear most of the burden and are often subjected to psychological torture and physical violence.26

In sub-Saharan Africa, infection-related tubal damage is the most common cause of infertility.7 Tubal surgery for infertility is not a common trend and sometimes it has poor outcome.8 However, the use of assisted reproductive techniques is known to treat more than 50% of infertility cases.9 The awareness rate of assisted reproductive technique in infertile women in northern Nigeria is as high as 76.5%,10 but the utilization of such service is limited by cost especially in low resource setting.1112 It, therefore, means that some infertile couple may have to live with infertility as a fate. The option of adoption thus provides an opportunity for infertile couple to have their own child/children.

Adoption is a legal process pursuant to a state statute in which a child's legal rights and duties towards its natural parents are terminated and similar rights and duties towards his adoptive parents are established.13 It is known that the practice of adoption has been an integral part of the history of human race, however, socio-cultural variables in different societies may affect the practice of child adoption.14 Majority of times, people who adopt children are between 18 to 44 years of age.15 Adoption in Nigeria is done either under statutory law or customary law but the procedures or rules differ from state to state.16 Current literature have shown that infertility is the main reason people seek to adopt children, another motivation is desire to provide shelter to homeless children.

The knowledge of child adoption in a study among infertile women in Enugu, southeast Nigeria, was 86.4% with only 27.3% knowing the true meaning of adoption.16 The prevalence of child adoption in another study in Enugu was 5.5%.13 In a study from southwest Nigeria, about 85.7% have heard of child adoption, and their main source of information about child adoption was the media 40.4%.2 Although, 65.5% of respondents in Enugu study were willing to adopt a child, they only considered it as a temporary solution to their infertility.13 Similar study in south-west Nigeria revealed that the only 33.7% of the respondents who were willing to adopt a child, complained that the practice will not remove the stigma of infertility.2

The purpose of this study is to assess the awareness and acceptability of child adoption in women of reproductive age in Zaria northern Nigeria.

MATERIALS AND METHODS

This was a cross-sectional descriptive study conducted at Ahmadu Bello University teaching hospital Zaria between February and April 2009. Structured (closed and open-ended) questionnaire was administered to 200 consecutive women who agreed to participate in the study after counselling. Information related to their socio-demographic characteristics, reproductive profile, knowledge and attitude towards child adoption were obtained. The data were processed using Statistical Package for the Social Sciences (SPSS) version 17 with the confidence limit set at 95%. Chi-square was used to analyse some of the results with the confidence limit set at 95%.

RESULTS

Socio-demographic characteristics

The socio-demographic characteristics of respondents are described in Table 1. The modal age group of the respondents was 24-29 years and the mean age 26.4 years ±2. Fifty-six percent of the subjects were married while 44.2% had no living child.

Table 1

Socio-demographic characteristics of respondents

Knowledge of child adoption

Majority of respondents (89.4%) have heard and are aware of child adoption. The source most prevalent for information is the mass media 35.0% followed by friends 31.3% and relatives 20.7%. Thirty-five percent of the respondents knew someone who had ever adopted a child. The orphanage home was the most popular place that 67.2% respondents knew that adoption can be done. About 62% of respondents are aware that there are laws governing child adoption in Nigeria representing the percentage or respondent that knows the true meaning of adoption.

Attitude towards child adoption

The majority of respondent (77%) accept child adoption as a good practice [Figure 1], Children aged 6 months and below and the female gender were preferred to their opposite counterparts by respondents who were willing to adopt a child (74.3% and 64.2%, respectively). Table 2 illustrates the relationship between willingness to adopt a child and the number of living children. Respondents with no living child are more willing to adopt a child compared to their opposite group (P < 0.05).

Figure 1

Respondent's acceptability of child adoption as good practice

Table 2

Relationship between respondent socio-demographic characteristics of parity, religion, tribe and willingness to consider child adoption

DISCUSSION

There is high level of knowledge of child adoption practices (89.4%) in this study. This compares with the findings from both the southeast and southwest Nigeria and may probably be due to the long standing history of practice of child adoption in most society.78 The mass media (35.9%) is the leading source of information on adoption as found in this study. Similar observation was made in Enugu except that the frequency was higher (49.0%).8

This underscore the fact that accurate and correct health and related information must be passed through the mass media to reach majority of the people. However, the percentage of respondents who got information from friends and relatives was also of important note accounting for 31.3% and 20.7%, respectively, probably implying some demonstration of concerns and information sharing among family members and friends. And because child adoption practices are govern by established laws, awareness of this represent the true knowledge of child adoption. The respondents that were aware of the existing laws regarding child adoption were 62% which was far and above those in Enugu of 27.3%. North and south Nigeria divide alone may not explain this huge difference but probably the different socio-demographic variables of the respondents.

The willingness to adopt a child in 75% of responded attest to the high level of acceptability of the practice compared to only 33.7% of southwest Nigeria. This probably may arise from their general feeling of dissatisfaction and psychological reason of not having the capacity to bear a child in the southwest Nigeria. In this study, children 6 months and below are the most favoured for adoption in 45.7% of respondents and 25.7% will prefer children of age range 6 months − 1 year. Issues of early bonding between the parent and adopted child may explain this preference.

Further, the female gender is most favoured for adoption in this study in 62.4%. Gender preference captured in most literature agrees with our findings of more female preference,17 this may probably be related to the general perception that with the female child, parental control is less tasking when compared to the male child.

CONCLUSION

There is a high level of awareness and acceptability of child adoption practices in the environment of this study. The number of living children is strongly related to the willingness to adopt a child. Although, technological advancement of assisted conception has provided hope for the infertile couple, child adoption is still a relevant and an acceptable option of infertility relief.