"Is Surrogacy Acceptable in Nigeria?" Understanding Cultural and Social Influences through the Lens of the Theory of Planned Behavior

Background: Surrogacy, a form of assisted reproductive technology (ART), is increasingly adopted worldwide yet remains culturally sensitive and ethically controversial, particularly in Nigeria. The acceptance of surrogacy in Nigeria is influenced significantly by entrenched cultural, religious, and social beliefs, alongside personal experiences. Despite its potential benefits, limited empirical research exists on the determinants shaping surrogacy acceptance within this context. Informed by the theory of planned behavior (TPB), this study examines how cultural beliefs, sociodemographic factors, and personal or social exposure predict surrogacy acceptance among Nigerians.

Methods: This study utilized a cross-sectional survey design involving a diverse sample of Nigerian adults. Data was collected through a survey instrument adopted from the standardized attitude towards surrogacy scale (ATSS) developed by Lutkiewicz et al. (2023). Modifications were made to contextualize the instrument for Nigeria, ensuring relevance to the cultural, religious, and societal factors that may influence perceptions of surrogacy. Multiple regression analysis was employed to determine the predictors of surrogacy acceptance, operationalized using TPB constructs.

Findings: The regression analysis revealed that cultural belief (β=0.121, p =0.004), age (β =0.021, p =0.01), marital status (β =0.317, p <.001), and state of residence (β = -0.042, p =0.036) significantly predicted acceptance of surrogacy. Specifically, individuals with culturally supportive beliefs about surrogacy, older respondents, and married participants reported higher acceptance. Conversely, regional [state] differences negatively influenced acceptance levels.

Implications and Conclusion: These findings reinforce the theory of planned behavior (TPB) framework, underscoring the importance of subjective norms and perceived behavioral control as key determinants of surrogacy acceptance. Culturally embedded norms significantly influence reproductive intentions, indicating the necessity for culturally tailored educational and policy initiatives aimed at addressing misconceptions and normative resistance to ART. Additionally, regional [state] disparities highlight the importance of context-specific interventions. Future research should further explore qualitative dimensions of acceptance to provide deeper insights. In conclusion, this study emphasizes the importance of socio-cultural considerations in advancing discussions and policies regarding surrogacy practices in Nigeria.