Assisted Reproductive Techniques: Awareness, Knowledge and Attitudes in The Gambia; A cross- sectional study

Background: Infertility is a significant public health issue worldwide, carrying profound emotional and social impli- cations, particularly in sub-Saharan Africa. Assisted Reproductive Technologies (ART) offer solutions, yet their utili- zation remains limited in low-resource settings like The Gambia. This study sought to evaluate the awareness, knowledge, attitudes, and perceived barriers to ART among gynecology patients in The Gambia. Methods: A cross-sectional descriptive study was conducted involving patients attending outpatient gynecology clin- ics at the Edward Francis Small Teaching Hospital (EFSTH). Using a stratified random sampling technique, data were collected via a structured interviewer-administered questionnaire. Data analysis was performed using SPSS ver- sion 26, utilizing descriptive statistics, Chi-square tests for associations, and binary logistic regression to identify pre- dictors of awareness and willingness to use ART. Results: Four hundred responders were assessed and the findings revealed that only 28.8% of respondents were aware of ART, with in-vitro fertilization (IVF) being the most recognized method (17.8%). Tertiary education was a strong predictor of awareness (aOR = 19.32, p < 0.001). While a majority (64.8%) supported the promotion of ART in The Gambia, fewer (43%) were willing to use or recommend it, particularly for unmarried individuals. Cultural and religious beliefs were significant predictors of unwillingness to use ART (aOR = 3.14, p < 0.001). Conclusion: Awareness and understanding of ART among gynecology patients in The Gambia are notably low, heavily influenced by educational attainment, marital status, and entrenched cultural and religious values. There is a critical need for enhanced public education, supportive policies, and culturally sensitive interventions to foster greater acceptance and improve access to ART services in The Gambia.