Navigating the social, ethical and legal challenges in the provision of in-vitro fertilisation care in Ghana: a qualitative study

In-vitro fertilization (IVF) presents complex ethical challenges, particularly in settings like Ghana, where cultural diversity and limited regulation exist. This study explored the lived experiences of healthcare professionals regarding the strategies they use to address the social, ethical and legal issues that arise in the provision of IVF services at the University of Ghana Medical Centre (UGMC). A qualitative phenomenological study was conducted. Ten (10) healthcare providers were purposively selected from UGMC’s Assisted Reproductive Technology (ART) unit using a maximum variation sampling strategy. In-depth interviews were conducted using an open-ended interview guide. Interviews lasted between 30 and 60 min. All interviews were audio-recorded, transcribed verbatim, and analysed thematically. The study revealed that healthcare providers primarily addressed ethical challenges in IVF service delivery through comprehensive counselling before, during, and after treatment. They also relied on collaborative decision-making, often involving multidisciplinary teams, to navigate complex dilemmas. Further, they adapted international guidelines to develop internal policies to guide their practice. Additionally, continuous professional development including ethics training, mentorship, and reflective practices was reported as essential for enhancing ethical competence and informed decision-making among IVF service providers. IVF service providers at UGMC employ multi-layered strategies to address the social, legal and ethical challenges that arise in the provision of IVF services. However, these efforts remain largely context-specific and might not be enforceable across facilities. To strengthen ethical practice in the delivery of IVF services beyond this study context, mandatory ethics education and collaborative policy and guidelines development are essential.