Pre-registration of hypotheses for the Ghana Infertility Stigma Scale (GISS): A mixed-methods psychometric study

This project develops and validates the Ghana Infertility Stigma Scale (GISS), a culturally specific instrument for measuring infertility-related stigma among women and men in Ghana. Infertility is both a medical condition and a psychosocial crisis, yet existing stigma scales are imported from Western contexts and fail to capture Ghanaian realities. The study uses a mixed-methods design: (1) systematic review of existing scales using COSMIN criteria, (2) qualitative exploration of lived experiences, (3) item generation and Delphi content validation, and (4–6) quantitative validation through exploratory and confirmatory factor analysis, discriminant validity, and reliability testing. Grounded in structural stigma theories (Hatzenbuehler, 2009; Pescosolido et al., 2008), Link and Phelan’s stigma processes, and Earnshaw and Chaudoir’s tripartite model, the study tests whether stigma mechanisms are universal or culturally specific. Expected outcomes include a validated scale that enables accurate prevalence estimates, identification of vulnerable subgroups, and examination of stigma’s impact on mental health. Clinically, the GISS will help practitioners identify stigma-related distress; at the policy level, it will provide evidence for advocacy and planning. Methodologically, it sets a precedent for pre-registered psychometric research in African contexts and offers a transferable framework for stigma measurement in domains such as HIV, mental health, and disability.