Determinants and Predictors of Fertility Awareness Among Women Attending Gynaecology and General Outpatient Clinics in Calabar, Nigeria: A Cross-Sectional Study

Background: Understanding reproductive physiology, the fertile window, and factors affecting conception, known as fertility awareness, is fundamental to promoting reproductive health. However, data from sub-Saharan Africa indicate that many women have poor fertility knowledge, which can negatively impact reproductive decisions and outcomes. This study sought to evaluate the extent of fertility awareness and determine its associated factors and predictors among women attending gynaecology and general outpatient clinics at a tertiary hospital in Calabar, Nigeria. Methods: We carried out a cross-sectional descriptive study involving 300 women aged 18–49 years, selected via systematic random sampling. Information was gathered using a pretested, structured, interviewer-administered questionnaire that covered sociodemographic data, reproductive history, and fertility awareness across several domains. Analysis was done with SPSS v26.0 using descriptive statistics, chi-square tests, and binary logistic regression. A p-value <0.05 was considered statistically significant. Results: Respondents had a mean age of 31.4 ± 7.8 years. Overall, 50.7% (152/300) had good fertility awareness. Knowledge was greatest for menstrual cycle regularity (74.7%) and least for basal body temperature charting (32.7%). Multivariate analysis showed that tertiary education (OR = 4.62; 95% CI: 2.78–7.68; p < 0.001), prior family planning counselling (OR = 3.44; 95% CI: 2.08–5.70; p < 0.001), being a civil servant (OR = 2.98; 95% CI: 1.76–5.04; p < 0.001), previous infertility assessment (OR = 2.76; 95% CI: 1.60–4.76; p < 0.001), and monthly income >₦100,000 (OR = 2.36; 95% CI: 1.44–3.86; p = 0.001) were independent predictors of good fertility awareness. Conclusion: About half of women had adequate fertility awareness, with education, occupation, income, and exposure to reproductive health services as main predictors. There is an urgent need for targeted health education, especially for women with lower education and income, to enhance fertility awareness and improve reproductive health outcomes in Nigeria.