In Malawi, infertility is still widely perceived as a woman’s problem, often leaving women to carry the blame, stigma and emotional pain when couples fail to conceive.
But emerging evidence tells a different story.
Researchers estimate that 12 percent of men in Malawi are infertile, while male factors contribute significantly to infertility among couples. Yet misconceptions persist — including the belief that a man who ejaculates is automatically fertile.
This exclusive feature by Robert Loka takes readers inside the hidden burden of infertility through the experiences of women who were blamed for failing to conceive, only to later become pregnant with other partners. Their stories expose the painful consequences of assigning infertility to women without testing both partners.
The feature also examines the experiences of men struggling to establish their fertility status, including the limited availability and affordability of male fertility testing in Malawi.
From broken marriages and family pressure to stigma and calls for better reproductive health services, the story challenges deeply rooted assumptions about infertility and asks a fundamental question:
Before a woman is blamed for childlessness, have both partners been tested?
The feature calls for a shift from blame to diagnosis, stigma to understanding, and assumptions to evidence — because infertility is not simply a woman’s burden.
One hundred and sixty-one kilometres from Lilongwe, Malawi’s capital, lives Nankhoma, in Ntcheu, a district in the Central Region bordering Mozambique.
But for Nankhoma, home is often a painful reminder of a marriage that ended in heartbreak and tears.
Chased away from her matrimonial home in Blantyre, Malawi’s commercial capital, she left with only a small share of her hard-earned possessions, while her husband’s relatives took the lion’s share.
Her alleged crime?
She could not have a child.
In a sorrowful tone, she recalls how her husband’s relatives came to force her out of the house.
“The family members of my husband came and forced me out of the house. They said I was worthless because I had never given their son a child. In their words, they said, ‘You’re wasting our time. We need a child.’”
But two years into another relationship, fate appeared to take an unexpected turn.
Nankhoma missed her menstrual period for the first time in more than two decades.
What followed was a shock — and, for her, a revelation.
She was pregnant.
“It was in August 2023 when I realised that I was pregnant. I couldn’t believe it was possible, but it happened,” she said.
For years, Nankhoma had lived under the accusation that she was infertile.
Yet another question continued to trouble her: not one of her former husband’s brothers had children in their respective families.
“Two of his siblings had no child. But then, in our case, I was the one blamed for the childlessness,” she said.
Nankhoma is not alone.
Forty-year-old Jane Mkandawire, from Blantyre, also spent years believing that she was responsible for her inability to conceive.
After 17 years of marriage without a child, Jane blamed herself — until 2024, when her story changed.
She says her husband took a traditional concoction, after which she unexpectedly became pregnant.
“I was in total disbelief when the doctor told me that I was three months pregnant. I openly told him, ‘That is not possible. I cannot be pregnant.’”
But the doctor repeated the news.
She was three months pregnant.
When blame falls on women
The experiences of Nankhoma and Jane are not isolated.
Their stories reflect the experiences of women who have endured years of blame, stigma and emotional suffering over childlessness.
It is a story of women labelled infertile when, in reality, the causes of infertility may be far more complex.
It is also a story of a society where the burden of infertility has traditionally been placed largely on women.
But science tells a different story.
Professor Fanuel Lampiao, a physiologist at the Kamuzu University of Health Sciences, says studies estimate that 12 percent of Malawian men are infertile and that male factors contribute to about 30 percent of infertility cases.
Women contribute another 30 percent, while the remaining 40 percent is attributed to causes that are not well explained.
“If they’re not having a child, they would think that it’s a woman. But according to studies, infertility is not just in women. There’s also a male factor in infertility, such that it’s 30% a man contributes, 30% the female contributes. And the other 40% is due to idiopathic causes, causes that are not well explained,” he said.
Ejaculation does not mean fertility
One of the biggest obstacles to diagnosing male infertility, Professor Lampiao says, is the widespread belief that producing semen automatically means a man is fertile.
But ejaculation and fertility are not the same thing.
“A man may have an erection, ejaculate and produce what appears to be normal semen, yet have no sperm in the sample or have sperm of very poor quality,” he said.
He also points to lifestyle factors such as smoking and excessive alcohol consumption as possible contributors to infertility in men.
Lampiao says wearing very tight underwear may also affect sperm production, explaining that the testes require a temperature lower than the body’s core temperature for normal sperm production.
Yet while women can access some infertility services, male fertility testing remains a challenge in Malawi’s public health system.
A man searching for answers
Childless and married for six years, 38-year-old Mwayi Banda wants to know his fertility status.
But his search for answers has exposed another problem.
“After two years of our marriage without a child, people started to ask questions. At first, we thought it was normal and it would happen with time.”
“But after four years, we decided to go to Ntcheu District Hospital to seek fertility testing. But we only got advice because the facility does not offer fertility tests,” he said.
The pressure has not only come from the community.
“My own family puts pressure on me to try with another woman to prove I am okay,” he said.
For Mwayi, the absence of accessible testing leaves him trapped between uncertainty and social expectations.
The cost of testing
Dr Owen Chinkhwaza, director of reproductive health in the Ministry of Health and Sanitation, attributes the limited availability of male fertility testing to financial constraints.
“These services are expensive. I’m not going to run an advocacy for men to come and have them analyzed. It’s not necessary,” he said.
But health rights activist Dorothy Ngoma argues that the absence of accessible male fertility testing helps perpetuate the belief that infertility is primarily a woman’s problem.
She calls for deliberate efforts to mobilize resources for fertility-testing infrastructure for men.
“We need to offer such services without belittling their problem, because these families really suffer psychologically.”
“They suffer a lot of stress, and even, you know, marriages break, people commit suicide. I mean, I have seen it, read it, and it is bad,” Ngoma said.
Changing the mindset
So, what needs to change?
Memory Ngosi, a gender rights activist, believes the answer begins with awareness and changing mindsets around infertility.
She says cultural norms in Malawi continue to fuel stigma against women.
“We need mindset change when it comes to issues of infertility. We really need to talk about infertility issues at all levels in our communities. We should reach a point of understanding that infertility affects both men and women,” Ngosi said.
At the continental level, the African Union has recognized infertility as not only a medical condition but also an issue with gender, social justice and human rights dimensions.
Malawi is also among African countries that have committed to international frameworks, including the Maputo Protocol, which advocates for sexual and reproductive health and rights.
These frameworks highlight concerns around structural inequalities, cultural biases and gaps that can leave women facing disproportionate discrimination and social stigma.
Beyond blame
For Nankhoma, the woman once made to believe that she could not conceive, and Jane, whose husband took traditional medicine before she became pregnant, the message is simple: childbearing is an issue that concerns both partners.
“It’s my wish that infertility should be understood and addressed as an issue that can affect both partners, not just the woman.
“When we recognize that both men and women can experience infertility, we can reduce blame and stigma placed on women,” Nankhoma said.
Jane agrees.
“When the community sees a family without children, it shouldn’t be quick to point fingers at the woman or blame her for the situation,” she said.
For years, women like Nankhoma have carried the weight of accusations they did not deserve.
Their experiences raise a simple but important question about how Malawi approaches infertility.
Perhaps it is time to replace blame with testing, ridicule with understanding, and silence with accessible reproductive health services.
Because infertility is not simply a woman’s burden.
And before a woman is blamed, shamed, divorced or stripped of her dignity, perhaps the first question should be much simpler:
Have both partners been tested?