Cultural, social and religious beliefs, perceptions and concerns shaping assisted reproductive technology uptake in Africa: a scoping review with evidence concentrated in Anglophone West Africa

Infertility affects approximately 15% of couples globally, yet assisted reproductive technology (ART) uptake remains low across sub-Saharan Africa. Beyond financial and access constraints, cultural, social, and religious beliefs are widely reported as barriers. This scoping review synthesised perceptions, beliefs, and socio-cultural and socio-religious concerns surrounding ART in African contexts to guide culturally responsive interventions. Using Arksey and O’Malley’s scoping review framework and the PRISMA-ScR guidelines, we searched four databases (January 2000–May 2025), supplemented by Google Scholar and African Journals Online. Records were screened independently in duplicate, and data were charted and synthesised using deductive qualitative content analysis. We screened 3,190 records, reviewed 87 full texts, and included 29 studies from 10 African countries, with the evidence base concentrated in Nigeria and Ghana. Nine recurring, conceptually interlinked themes were identified: ART as a luxury; ART babies seen as “unnatural”; stigma and gendered blame; lineage and kinship concerns; traditional gender roles; taboos about bodily practices; ART as “playing God”; spiritual concerns about gamete donation; and beliefs that ART children are spiritually inferior. These beliefs persist alongside secrecy, limited success narratives, and weak regulation. Because the evidence is concentrated in a few Anglophone countries, findings should not be generalised to all African contexts. Approaches proposed in the literature to address these beliefs include context-specific education, faith leader engagement, subsidised services, and culturally competent counselling; because none has been formally evaluated in these settings, each would require context-specific piloting and evaluation.