Hindawi
BioMed Research International
Volume 2019, Article ID 6140285, 9 pages
https://doi.org/10.1155/2019/6140285
Research Article
Perceived Barriers of Child Adoption: A Qualitative Study
among Women with Infertility in Northern Ghana
Gilbert Ti-enkawol Nachinab ,1 Ernestina S. Donkor,2 and Florence Naab2
1Department of Midwifery, School of Allied Health Sciences, University of Development Studies, Tamale, Ghana
2Department of Maternal and Child Health, School of Nursing, College of Health Sciences, University of Ghana, Ghana
Correspondence should be addressed to Gilbert Ti-enkawol Nachinab; gilbertnaknab@gmail.com
Received 13 March 2019; Revised 7 May 2019; Accepted 20 May 2019; Published 9 June 2019
Academic Editor: Jose Guilherme Cecatti
Copyright © 2019 Gilbert Ti-enkawol Nachinab et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Background. Having a child is important among married women in Northern Ghana. Among married women, infertility is the
main factor causing childlessness. Child adoption provides an alternative for married women to have children. The purpose of the
study was to explore the perceived barriers of child adoption amongwomenwith infertility.Methods.The study used an exploratory
qualitative approach to understand barriers of child adoption. The study was conducted among 15 women attending fertility clinic
in a mission hospital in Northern Ghana. Participants were purposively recruited and data collected by individual face-to-face
in-depth interviews. The interviews were audio-recorded, transcribed, and analysed using content analysis. Data were collected
between January and March, 2016, in an office in the hospital. Results. The results suggest that barriers of child adoption include
negative reaction of husbands, psychological dissatisfaction, and family dynamics. It was realised that husbands’ reaction includes
preference for biological children and marrying of second wives. Child adoption was psychologically dissatisfying to participants
with some suggesting that it will make no difference and is a sign of acceptance of defeat in the quest to have biological children.
The study findings also suggested that family dynamics that could hinder the practice of child adoption includes high value for
blood relations, blaming of the woman, unpredictable family influence, discrimination against the adopted child, and family not
allowing the adopted child to inherit property. Conclusion. The preference for biological children is by far an outstanding barrier
and amajor influence of all the emanating barriers associated with child adoption.There is the need for public education and special
counselling session for husbands and other family members on child adoption as an alternative solution for infertility.
1. Introduction than one year of unprotected intercourse, while secondary
infertility is the failure to bear a child which can be a result
Infertility is a reproductive disorder and a global public of being unable to become pregnant or carry a pregnancy to
health problem that can affect both men and women and live birth after having a child [4].
has no predilection for national, ethnic, racial, and religious In a typical African society, people normally start a family
background [1]. Infertility is the inability to attain a successful by getting married and giving birth to their own children.
pregnancy after at least 12 months of unprotected or more Childbirth is an expectation of marriage; hence couple who
of appropriate timed unprotected intercourse or therapeutic are unable to achieve this come under intense pressure
donor insemination [2]. Infertility is a global problem affect- to conceive and this increases their anxiety significantly
ing between 50 million and 80 million people translating regardless of their educational or economic status [5, 6].
into 8% to 12% of couples worldwide [3]. In Africa, studies For women with infertility who are of rural background
suggest that the burden of infertility is about 30–40% [3].The and lower income status, finding medical help could be
WHO has classified infertility into two categories: primary challenging. Child adoption could therefore be an alter-
and secondary. Primary infertility is the inability to bear a native for women with infertility who desire children [7,
child in a couple who have never had a child after more 8].
2 BioMed Research International
Child adoption started as a way to preserve family 2.2. Study Setting. The study was carried out in a Mis-
lineage, secure inheritance, and forge alliances but has pro- sion Hospital Northern Ghana. The hospital has a perma-
gressively evolved into a process for meeting the needs of nent obstetrician/gynaecologist and operates a fertility clinic
adults who need children of their own [9]. In Ghana, there which enabled the researchers to have access to women with
are two forms of child adoption which include customary infertility.
adoption and formal adoption. Customary adoption is an
informal transfer of the care of a child to another relative. 2.3. Target Population and Sampling Technique. Selection of
In the formal adoption process, legal requirements must participants in qualitative research is normally based on
be met and a formal procedure followed. The requirements unique knowledge, experiences, or views of the participants
and process of formal adoption are contained in the 1998 on the subject under investigation [23]. The study targeted
Children’s Act [10]. In some situations health personal women who have been married for at least a year, engaged in
department encourages people to adopt children that are unprotected sexual intercourse, and not using contraceptives
abandoned in hospitals. Children adopted this way are yet unable to become pregnant. They were also women who
not captured in the government statistics making it quite could speak Kusaal, Mossi, or English language. Purposive
difficult report accurately on the rates of child in Ghana sampling technique was used to select participants who met
[11]. the inclusion criteria. Data saturation (a point at which no
One key benefit that comes with child adoption is the new information emerges from the interviews) was reached
provision of an alternative for having children by couples by the time 15 women were interviewed.
suffering from infertility [12–14]. Child adoption could bring
joy and fulfillment to couples with infertility [15]. In other 2.4. Data Collection Tool. Data were collected using a
African societies, most issues that will lead to child adoption semistructured interview guide which was developed by
include infertility and desire for heir for a lineage [14]. the researchers based on the objective of the study. The
In Africa, child adoption is gradually becoming known participants were asked questions such as “what are some
in most countries but culture is posing a seeming setback to of the things that will make it difficult for you to practice
its acceptability and practice among various ethnic groups child adoption? What will be your husbands’ position if you
[16–18]. Aside from cultural implications, studies have also suggest child adoption to him? What will be the reaction of
pointed to other militating factors against child adoption your family members if you decide to adopt a child? How do
such asmisconceptions, stigmatization, financial burden, and you think an adopted child will be treated in your family and
procedural bottlenecks [12, 19]. community?”
Certain deeply ingrained traditional beliefs tend to
influence societal attitude towards child adoption [16]. For 2.5. Data Collection Procedure. The principal investigator
instance, in the Yoruba land of South-Western Nigeria the obtained formal permission from the authorities of the
belief that “ori omo lo npe omo wa’ye” which means an Mission Hospital. Two nurses working in the consulting
adopted child usually attracts yet to be born children to room of the obstetrician/gynaecologist first contacted and
come to the physical realm could positively influence the explained the study to potential participants and those who
practice of child adoption [8]. In some communities, both agreedwere referred to the principal investigator in a separate
the adopted child and the adoptive parents are stigmatized room in the facility. The participants were then further
because the cultural belief considers the child as a second best screened to ensure that they met the inclusion criteria and
and the parents as being unrelated to the child genetically once they voluntarily accept to participate, the time and date
[15, 20, 21]. was scheduled for data collection.Depending on participants’
Cost of child adoption and the waiting period are notable preference, some interviews were done on the same day of
challenges of formal child adoption in Ghana. In some cases contacting the participants while others were on subsequent
prospective adoptive parents will have to wait for up to visits. Data were collected between January and March, 2016,
years [11]. Though child adoption can help meet the need of in an office in the hospital. Each interview lasted 35-45
couples for a child, there is dearth of studies on the associated minutes and with participants’ permission the interviews
factors such as attitude and perception on the uptake of child were audio-recorded and field notes taken. The interviews
adoption in Ghana. The purpose of this study was therefore were conducted face to face in Mossi, Kusaal, Frafra, or
to explore the barriers of child adoption among women with English Language. The interviews that were done in Kusaal
infertility. andMossi were transcribed in English based on the meaning
of the statements. The transcripts were discussed with an
2. Methods expert in Kusaal and Mossi language and confidentiality wasensured in the process.
2.1. Design. A qualitative approach helps in revealing subjec-
tive realities and truths about themeaning and expressions of 2.6. Data Analysis. The data was analysed using Thematic
participants [22]. The study used an exploratory qualitative Content Analysis (TCA). TCA is descriptive presentation of
approach to explore the perceived barriers of child adoption. data and the most foundational of qualitative data analysis.
This allowed the researchers to follow up on emerging views TCA allows researcher to peruse and group the entire textural
on the perceived barriers of child adoption. data into a list of common themes that gives a voice or
BioMed Research International 3
true representation of the entire data set [24]. The audio- was done by tracing some of the participants to confirm the
recorded interviews were transcribed verbatim taking into accuracy of transcribed data and emerging themes.
consideration field notes. The transcripts were read severally
by the researchers to understand the world of the participants 2.8.4. Transferability. This refers to the ability to move the
regarding the issues raised. The key ideas in the form of findings of the qualitative study to other contexts with sim-
phrases, sentences, or paragraphs emerging were assigned ilar groups [30]. Transferability was ensured through thick
codes. Labels for initial codes containing several thoughts description which involves a rich and thorough description
emerged. These codes were sorted into themes based on how of the research setting, the context where interviews were
they were related and linked. Each of the three researchers conducted, and the processes throughout the investigation.
coded the data individually and several group discussions
were held to agree on main themes and emerging subthemes.
The main themes and subthemes were revised repeatedly 3. Results
until being suitable for presentation of findings.The data was 3.1. Demographic Characteristics of Participants. Table 1
managed manually. shows that the study participants were 15 married women
between the ages of 24 and 40 years. Nine of them had
2.7. Ethical Consideration. Ethical clearance for a broader primary infertility and the rest had secondary infertility.
study from which this paper is drawn was obtained from Among the participants with secondary infertility, four of
Ethics Review Board of Noguchi Memorial Institute for them had one child each, another had two children, and
Medical Research, University of Ghana (NMIMR-IRB CPN the other had three children. Five participants were in
013/15-16). Participants gave informed consent to participate polygamous marriage. Ten of the participants were Muslims
in the study. Participants were informed that participation and five were Christians.
was voluntary. Anonymity was ensured by labelling each Table 2 shows a thematic presentation of the findings
participant’s information with a pseudonym. Pseudonyms which include three major themes with their corresponding
used were names in languages spoken in southern part of subthemes
Ghana; hence none of the names in the transcribed data is
related to any of participants. 3.2. Negative Reaction of Husbands. All women recognized
the role of their husbands in taking a decision like child
2.8. Methodological Rigour. “Rigour of a qualitative study is adoption.Thewomen had different reasons why they thought
the extent to which the identified meanings represent the their husbands would not agree to practice child adoption.
perspectives of the participants accurately” [25, pp. 68]. It can Reasons for not accepting child adoption include marrying a
be argued that without rigour the research conducted can second wife and preference for a biological child
become fictional and worthless in adding knowledge [26].
According to Grove et al. [25], the degree of rigor of a study 3.3. Husbands Prefer Marrying a Second Wife. According to
findings is determined by the extent to which the findings the women, their husbands perceive that marrying a second
are credible, transferable, dependable, and confirmable. The wife will increase their chances of getting a child. Husbands
four criteria for ensuring rigour according to Guba [27] were having children or hoping to have childrenwith a secondwife
followed. was a reason why husbands will not accept child adoption.
Child bearing in marriage perhaps was seen as something to
2.8.1. Dependability. Dependability refers to the study yield- satisfy the need for a biological child by the husband.
ing similar results with other groups in a similar context [28].
To ensure dependability, the method used for data collection “For my husband he will not agree. He has
and analysis is captured in the report. Nonparticipants with children with my rival so he will not agree to bring
similar experiences were also contacted to validate findings in a child that is not his. If he had no child and I
of this study. was the only wife, maybe we could talk about it
but as it stands he will just disagree” (Adwoa).
2.8.2. Confirmability. This refers to the extent to which other “My husband has married another wife so he will
researchers can review the audit trail and agree that the not agree for us to adopt a child because he knows
authors’ conclusions are logical [29]. To ensure this the that my rival will start having children soon”
researchers kept an audit trail comprising of field notes, audio (Serwa).
recordings, analysis notes, and coding details.
3.4. Husbands Prefer a Biological Child. In Northern Ghana,
2.8.3. Credibility. This involves the confidence of the reader children normally bear names of the father or the family as
about the extent to which the researcher has produced results their surname and this is exclusively reserved for biological
that reflects the participants view [29]. The researchers con- children. Some participants also explained that their hus-
ducted a face-to-face interview to enable probing and getting bands will prefer their own biological because of preference
more important information. Data was audio-recorded and for blood relations. With this perception, the participants felt
transcribed verbatim taking into consideration field notes. To that their husbands will not see adopting a child as a solution
ensure that the study findings were credible a member check to their childlessness.
4 BioMed Research International
Table 1: Sociodemographic characteristics of participants.
Pseudonym Age Level of education Number of wives of the husband Years of marriage No. of children Occupation Years of searching for a child Religion
Abena 28 None 1 13 3 Housewife 4 Muslim
Adwoa 40 None 2 16 None Farming 16 Muslim
Akosua 29 None 1 10 2 Trading 2 Muslim
Ama 26 Tertiary 1 5 None Teacher 5 Muslim
Afia 34 Primary 2 12 None Trader 10 Muslim
Akua 30 Secondary 1 7 1 Trader 3 Christian
Agyeiwaa 24 Tertiary 1 13 months None Teacher 1 Muslim
Boatemaa 25 Tertiary 2 2 None Teacher 2 Muslim
Araba 31 None 1 4 None Housewife 4 Muslim
Asantewaa 30 None 1 5 None Housewife 3 Muslim
Fosuaah 27 Tertiary 1 6 1 Nursing 2 Christian
Ohema 37 Tertiary 1 9 None Civil servant 8 Christian
Serwa 34 None 2 7 1 Housewife 5 Muslim
Owusuaa 31 None 1 5 None Civil servant 4 Christian
Yaa 28 Tertiary 1 6 1 Nursing 2 Christian
BioMed Research International 5
Table 2: Main themes and subthemes.
Main themes Subthemes
Negative reaction of husbands Husbands prefer marrying second wife
Husbands prefer biological children
Psychological dissatisfaction Adopting a child will not make any difference
Child adoption is a sign of accepting defeat
High value for blood relations
Blaming of the woman
Family dynamics Unpredictable family influence
Discrimination against the adopted child
The family will not allow the adopted child to inherit property
“My husband will not agree because he will think and think you have been told that you can no
the adopted child does not have his blood. In a longer deliver and that is why you are bringing a
family here, they want their own blood; if not they child to satisfy yourself ” (Serwa).
will not see you as part of them” (Asantewa).
“You can only adopt if only you know you will not
Husbands approval which is vital in child adoption was seen be able to get pregnant at all. If not, you have to
by some participants as a major obstacle. wait till you get pregnant. As a Christian I have
faith that no matter how long it takes I will get
“It will be difficult to convince my husband. It will pregnant” (Ohema).
take him time to accept the idea. This is because
of denial which I think is normal. Everyone wants
his own child andmen aremore serious with that” 3.8. Family Dynamics. Family influence plays an important
(Yaa). role when it comes to child adoption. Family dynamics whichwas one of the main themes described the high value placed
on blood relations, blaming of the woman, unpredictable
3.5. Psychologically Dissatisfaction. Psychological dissatisfac- family influence, discrimination against the adopted child,
tion was seen as one of the most notable barriers to child and family not allowing the adopted child to inherit property.
adoption.Thewomen explained that adopting a child will not
come with the required psychological satisfaction associated
with having a biological child and will even indicate an 3.9. High Value on Blood Relations. Most of the participants
acceptance of the plight of infertility. explained that their families will not accept the adopted childbecause of the high value placed on blood relations.
3.6. Adopting a Child Will Not Make Any Difference. Some “Their (referring to the husband) tribe will not
participants thought that they simply need their own children accept a child that is not carrying their blood.They
while others thought that adopting will not let the family will refer you to others who are not having their
recognise them as people with biological children. own but have not adopted a child” (Boatema).
“Nothing will change in my life if I adopt a child. “The family will not treat an adopted child well
You will feel like you have a child but deep down because they like blood relations. They will see the
your heart it will not feel like it is your own child to be an alien and not part of them. The
child. The people in the family will not see you as way people will treat the child you will be having
somebody with her own child” (Adwoa). problems with them always” (Afia).
“Adopting a child will only be like trying to clean 3.10. Blaming the Women. Our participants explained that
your tears but this will not relieve the pain of the woman is often blamed for the situation of childlessness
childlessness” (Afia). in the marriage. To solve the problem, the family will suggest
that themanmarries more wives in an attempt to increase his
3.7. Adopting aChild Is a Sign of AcceptingDefeat. Thewomen chances of getting a child.
presence at the fertility clinic was strongly backed by the hope
that they will find a solution to the problem of infertility. “In Islam a man can marry more than one wife
Adopting a child was therefore seen as creating an impression so the family will prefer my husband going for a
that one had been told that you will never have your own second wife. This is because the local people never
children. think that the problem could also be coming from
the man. They always think it is the woman. So if
“Well, adopting a child will not satisfy me in my you are not conceiving another wife has to come”
mind that I have delivered. People will look at you (Agyeiwa).
6 BioMed Research International
“Just look at this clinic and you will realise that we “After the death of you, the parents, they will not
are all women. Our husbands are at home and we allow the adopted child to inherit your property.
are here trying to solve the problem alone. They That is when they will start saying “you are a
think it is only the woman who has a problem” bastard, go to your father or go and find your
(Afia). parents.” To let such a poor child go through this
kind of treatment, it is better I stay away from
3.11. Unpredictable Family Influence. It was underscored that adopting a child” (Agyeiwa).
inability to attain childbirth is an issue of concern to the
family of the affected person and seeking solution is often
a collective responsibility. In this direction, family members 4. Discussion
maymake suggestions as to where to obtain help in achieving
conception. The women were of the view that adopting a The study explored the perceived barriers of child adoption
child will demand their husbands discussing it with family as an alternative solution for infertility. The study found that
members and this makes it even more difficult to what the women considered a decision to adopt a child as a very
reaction will be. important one that centres on the approval of the husband. In
Northern Ghanaian society, the man is considered the head
“That one I can’t tell whatmy husbandwill say. He of his nuclear family and takes all the important decisions on
will like to discuss it with his family members and behalf of the family.
with that it will even be difficult to predict what The study finding suggests that polygamy is used by
will happen” (Fosuah). husbands in an attempt to get biological children rather than
seeking treatment together with the first wife. This concurs
3.12. Discrimination against the Adopted Child. Some partici- with the study findings that women with infertility are most
pants thought the family and community at largewill not treat likely to find themselves in polygamous marriages because
the child well. The adopted child will receive insults and this their husbands are encouraged by relatives to marry second
will hurt the adoptive parents as well. wives so as to produce children for continuity of the family
“. . . . . . . . . . . . . . ...if it is a boy who has to be a [31]. Perceived negative reaction of husbands towards child
member of the family without leaving, there will adoption was based on the desire or presence of a second
be problems. The family will not treat the child wife and this can be connected to the religious background of
well. They will insult him “sankpase” (bastard) the couple.This is because polygamy is allowed in the Islamic
especially if he is a boy. You will always have religion; thus in this study all those in polygamous marriages
problems with them because of how they will treat were Muslims.
the child” (Akua). Delivering a child in every marriage is often seen as an
important achievement and a sign that the marital relation-
Participants also explained that adopting a child will attract ship is full of blessings and thus psychologically satisfying
negative comments from community members towards both to the couples. The women indicated that there was a psy-
the woman and the adopted child. chological dichotomy between having a biological child and
“The child will suffer in our community because getting a child by adoption. This finding concurs with that
theywill keep calling the child “tampiire” (a person of a study in Iran which cited psychological dissatisfaction
without father). Even when a woman delivers out as a militating factor against child adoption [32]. Another
of wedlock and has to leave that child with her important psychological dissatisfaction reported in our study
biological parents, they will be insulting the child was that some women thought that adopting a child will
like it is the child’s fault. An adopted child will create an impression that you have lost the struggle to get
suffer worse insults” (Yaa). your own child.This stance seems to agree with the Christian
maxim that “with God all things are possible” which inspire
3.13. The Family Will Not Allow the Adopted Child to Inherit followers that they should never give up in any situation in
Property. The adopted child will also suffer future uncer- life because God will answer them in due course. This urges
tainties such as denial of the opportunity to inherit the them on to continue struggling for their own children rather
adoptive parents’ property.The decision regarding legitimacy than going in for child adoption
to inherit property is taken by the family and is normally The study findings show that there is high premium on
given to biological male children. biological parenting. In northern Ghanaian society a familyis defined by how the members are related by blood or
“On the part of my husband’s family, it is going to throughmarriage. A person who is not connected to a family
be a problem if you adopt a child. Not now but by blood or marriage is there not considered a member
years to come. They will tell you all sort of things of the family. The participants were generally aware of this
and the child will have problems in the future stand and thought that one will have problems if you try
especially with property. They will be using that to bring adopted child into family. They further indicated
one against you so that the child will know he is that the child will not enjoy any sense of belonging in the
not their blood and should not come near anything family and will be treated as an alien. Similarly, a study in
belonging to the man” (Boatema). South-Eastern Nigeria established that child adoption was
BioMed Research International 7
not accepted there because the culture does not create room is influenced by cultural and religious background of the
for the adopted child to step into the shoes of adoptive parents people. Though women suffering infertility go through a lot
as if he is a biological child [17]. in an attempt to find a solution, the decision to adopt a child
The study findings suggest that women are blamed for the largely depends on the husband and his family. Awareness
childlessness situation in the marriage putting them under creation on the viability of child adoption as an alternative
pressure to make efforts to ensure that they get pregnant. solution for infertility should therefore involve husbands, key
This position of the family could result in the family urging family members, and religious leaders in the community.
the man to marry another wife if the woman fails to get Also, the study findings indicate that women in childless
pregnant. The assumption that the woman is responsible for marriages are blamed for the situation. Women are under
childlessness shows that there is little literacy on the causes pressure to find a solution to the childless situationwhile their
of infertility and the fact that it could affect men as well. husbands are encouraged to marry again to increase their
Another evidence of the blame of childlessness being put on chances of getting a child. This shows lack of knowledge on
thewomanwas by the fact that the fertility clinic was attended causes of infertility. There is the need to educate the public
by only women. This is in consonance with the study finding on the causes of infertility and to let people understand that
that women are those who mostly report at fertility centres infertility could occur in any of the genders.
and undergo most of the invasive procedures making them
bare greater part of the psychological distress associated with
infertility [33]. 5.1. Limitations of the Study
The participants indicated that adopting a child was (i) The study is the first to explore the barriers of child
a major decision that could receive unpredictable family adoption as an alternative solution for infertility in
influence. They pointed out that the decision to adopt a child Ghana. Hence, other studies can be done to gain a
will not rest entirely on their husbands but the family as well. holistic picture of the barriers and what can be done
In the Ghanaian context, the coming of a child into a family to facilitate the utilistaion of child adoption.
is often regarded as an important event; hence child adoption
which makes the child a permanent member of the family (ii) The study did not include husbands of the women
will demand consent from the family members.The husband so that the ideas on barriers could represent both
and wife are thus not considered independent to take the husbands and wives as an entity.
decision to adopt a child. Sami and Ali [34] reported that
the decision to consider child adoption does not only depend (iii) The small size of the study participants does notmake
on husbands but depends on other family members as well. the study findings generalizable to other settings in
In typical Ghanaian tradition, child upbringing is considered Ghana.
a responsibility of the entire family and hence the need to
consult and agree with family before child adoption. Data Availability
The findings indicated that an adopted child will not be
treated well but will rather suffer discrimination. Participants The original transcripts from which the paper emanated are
of the Kusasi tribe stated that the child will suffer a lot of available upon request.
insults and may even be referred to as “tampiire” (a person
without known biological parents) or “sankpase” (bastard).
Similarly, the unacceptability of child adoption in Eastern Consent
Nigeria is influenced by the indigenous ideology of “onye- All the authors gave their consent for the study findings to be
biaraabia” which means “the stranger” [16]. In an attempt to published.
protect the child from being insulted, the participants viewed
that the adoptive parents will constantly have problems with
other family or community members. Conflicts of Interest
In Northern Ghanaian society, property of a man is
traditionally inherited by the first born male who then shares The authors declare that there are no conflicts of interest.
with his male siblings. The study findings indicate that the
adopted child will not be allowed to inherit or share the Authors’ Contributions
property of the adoptive parents. The participants find this
denial of inheritance so humiliating that they will rather stay Gilbert Ti-enkawol Nachinab conceptualised the study and
away from adopting a child who will obviously suffer in the had series of discussions with Ernestina S. Donkor and
future. FlorenceNaabwhich resulted inwriting a proposal for ethical
clearance. Gilbert Ti-enkawolNachinab thenwent to the field
5. Conclusion for data collection. Gilbert Ti-enkawol Nachinab, Ernestina
S. Donkor, and Florence Naab analysed data. Gilbert Ti-
This study suggested a number of barriers to child adoption enkawolNachinab drafted themanuscript and itwas critically
but central among them is the high premium placed on reviewed by Ernestina S. Donkor and Florence Naab. All
biological parenting. The preference for a biological child authors read and approved the final manuscript.
8 BioMed Research International
Acknowledgments State , Nigeria,”African Journal of PrimaryHealth Care&Family
Medicine, pp. 1–8, 2011.
We are grateful to the authorities of the Mission hospital [15] O. Foluso and U. Chinomso, “A phenomenological study to
where the study was done. We also appreciate the two assess the opinions of infertile women regarding child adoption
nurses that helped us with the recruitment of participants. in south-western Nigeria,” IOSR Journal of Nursing and Health
This manuscript is drawn from a broader study on factors Science, vol. 3, no. 3, pp. 26–34, 2014.
influencing child adoption among women with infertility [16] C. T. Nwaoga, “Socio - religious implications of child adoption
which was an academic thesis presented to the University of in Igboland South Eastern Nigeria,” Mediterranean Journal of
Ghana. Social Sciences, vol. 4, no. 13, pp. 705–710, 2013.
[17] O. A. Ojelabi, P. E. Osamor, and B. E. Owumi, “Policies
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