# Infertility misperception and improper health-seeking behavior between urban and rural areas

## TL;DR

This study compares how urban and rural Indonesians perceive and respond to infertility, finding more misconceptions and delayed healthcare in rural areas.

## Contribution

The study reveals urban-rural differences in infertility perception and health-seeking behavior in Indonesia.

## Key findings

- Rural respondents have more misconceptions about infertility causes, such as believing stress is a leading risk factor.
- A higher percentage of rural individuals seek advice from midwives rather than general practitioners.
- Both urban and rural groups show a need for improved fertility education to address misconceptions and delay in seeking care.

## Abstract

The prevalence of infertility among reproductive-age couples in Indonesia is around 10-15%. Lack of understanding, misleading myths, and negative attitudes could result in improper behavior. This study aims to reveal the discrepancy between perception and behavior towards infertility in urban and rural areas in Indonesia.

A cross-sectional study using an internet-based questionnaire was given to 408 individuals, divided into two groups, Java and outside Java, representing urban and rural populations. The study included Indonesian citizens over 18 who were willing to participate, encompassing individuals of both genders, regardless of their fertility status. All participants completed the questionnaire from October 2020 to April 2021.

Half of the respondents from both groups consider infertility a disease. All respondents have excellent access to information. Although more than 80% of subjects from each group had been exposed to infertility information, a better understanding was observed in the urban community. Most subjects answered that smoking is the leading risk factor for infertility, followed by stress and advanced age. More respondents in rural areas have the wrong perception that stress causes infertility. Furthermore, they seek unwarranted advice, as 19.5% came to midwives and only 9.1% came to general practitioners. This study showed that 35.6% of subjects in the urban group and 41.6% in the rural group are considered late to seek healthcare assistance. Most respondents from both groups accept using Assisted Reproductive Technology and fertility-enhancing drugs as treatment options.

Infertility misconceptions are more prevalent in rural groups than in urban groups. Fertility education among both groups needs to be improved to optimize the chance of conceiving and having a healthy baby.