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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">JCARM</journal-id>
      <journal-title-group>
        <journal-title>Journal of Contemporary Academic Research and Methodologies</journal-title>
        <abbrev-journal-title>JCARM</abbrev-journal-title>
      </journal-title-group>
            <issn pub-type="epub">3139-7247</issn>
            <publisher>
        <publisher-name>Ivory and Finch Publishers</publisher-name>
      </publisher>
    </journal-meta>

    <article-meta>
      <article-id pub-id-type="doi">10.5281/zenodo.21859983</article-id>
      <article-id pub-id-type="publisher-id">JCARM_JUL_26_124</article-id>

      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Original Research Article</subject>
        </subj-group>
      </article-categories>

      <title-group>
        <article-title>Male Factor Infertility: Knowledge, Attitude, and Health-Seeking Behavior of Men in a Cosmopolitan Setting — A Cross-Sectional Study in Calabar, Cross River State, Nigeria</article-title>
      </title-group>

      <contrib-group>
        <contrib contrib-type="author">
          <name>
                        <surname>Ezukwa Omoronyia</surname>
            <given-names>Ezukwa</given-names>
          </name>
                    <aff>Department of Obstetrics &amp; Gynecology, University of Calabar, Nigeria</aff>
          <email>ezukwa2@gmail.com</email>
        </contrib>
                                          <contrib contrib-type="author">
              <name>
                                <surname>Eyong</surname>
                <given-names>Edu</given-names>
              </name>
                                          <aff>Department of Obstetrics &amp; Gynecology, University of Calabar, Nigeria</aff>
                          </contrib>
                                              <contrib contrib-type="author">
              <name>
                                <surname>Odusolu</surname>
                <given-names>Patience</given-names>
              </name>
                                          <aff>Department of Obstetrics &amp; Gynecology, University of Calabar, Nigeria</aff>
                          </contrib>
                                              <contrib contrib-type="author">
              <name>
                                <surname>Abeshi</surname>
                <given-names>Sylvester</given-names>
              </name>
                                          <aff>Department of Obstetrics &amp; Gynecology, University of Calabar, Nigeria</aff>
                          </contrib>
                                    </contrib-group>

            <pub-date pub-type="epub">
        <day>10</day>
        <month>08</month>
        <year>2026</year>
      </pub-date>
      <volume>1</volume>
      <issue>6</issue>
      
      
            <self-uri xlink:href="https://doi.org/10.5281/zenodo.21859983"/>
      
      <abstract>
        <p>Background: Male factor infertility contributes to nearly half of all cases of couple infertility globally, yet men&#039;s knowledge, attitude, and health-seeking behavior towards it remain understudied in Sub-Saharan Africa, where socio-cultural norms often place the burden of infertility on women. This study assessed the knowledge, attitude, and health-seeking behavior of men towards male factor infertility in Calabar, a cosmopolitan capital city in Cross River State, Nigeria.
Methods: A descriptive cross-sectional study was conducted among 384 adult men aged 18–60 years, selected by multistage sampling across the two urban local government areas of Calabar metropolis. Data were collected using a semi-structured, interviewer-administered questionnaire covering sociodemographic characteristics, knowledge of male infertility, attitude towards it, and health-seeking behavior. Data were analyzed using SPSS version 26, with descriptive statistics and chi-square tests of association at a 5% significance level. Andersen&#039;s Behavioral Model of Health Services Use guided the analysis of predisposing, enabling, and need-based determinants of health-seeking behavior.
Results: Overall, 24.0% of respondents demonstrated good knowledge, 41.8% fair knowledge, and 34.2% poor knowledge of male factor infertility. While 61.7% agreed that men should have semen analysis when a couple fails to conceive, 46.9% still viewed male infertility as a source of shame, and 38.3% believed traditional or spiritual remedies could cure it. Among men who had ever had fertility-related concerns, only 31.5% first sought care at a hospital or fertility clinic, while the remainder consulted traditional healers (24.8%), religious/spiritual centres (19.6%), patent medicine vendors (15.2%), or sought no care at all (8.9%). Educational attainment and knowledge level were significantly associated with orthodox health-seeking behavior (p &lt; 0.05).
Conclusion: Despite residing in a cosmopolitan urban setting with access to modern health facilities, men in Calabar demonstrate suboptimal knowledge and predominantly non-orthodox health-seeking behavior regarding male factor infertility, driven by persistent stigma and socio-cultural beliefs. Targeted male-focused reproductive health education and integration of male infertility services into routine primary and andrology care are recommended.</p>
      </abstract>

            <kwd-group kwd-group-type="author-keywords">
                <kwd>Male infertility</kwd>
                <kwd>Knowledge</kwd>
                <kwd>attitude and practice; Health-seeking behavior</kwd>
                <kwd>Cosmopolitan setting</kwd>
                <kwd>Calabar</kwd>
                <kwd>Nigeria</kwd>
              </kwd-group>
      
      <history>
        <date date-type="received">
          <day>29</day>
          <month>07</month>
          <year>2026</year>
        </date>
                <date date-type="accepted">
          <day>02</day>
          <month>08</month>
          <year>2026</year>
        </date>
              </history>

      <permissions>
        <copyright-statement>Copyright &copy; 2026 by the authors</copyright-statement>
        <license license-type="open-access">
          <license-p>This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.</license-p>
        </license>
      </permissions>

    </article-meta>
  </front>

    <back>
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