Abstract
Background
Vasectomy is safe and highly effective; however, it remains an underused method of
family planning (FP) in Africa. In view of this, three Rwandan physicians were trained
in no-scalpel vasectomy with thermal cautery and fascial interposition on the prostatic
end as vasectomy trainers in 2010, and this initiative has resulted in over 2900 vasectomy
clients from February 2010 to December 2012.
Study design
This cross-sectional descriptive study describes vasectomy clients (n=316) and their wives (n=300) from 15 randomly selected hospitals in Rwanda.
Results
The vasectomy clients were mainly over age 40, had young children (age <3) and were married and cohabiting. Limited financial resources, satisfaction with
existing family size and avoiding side effects from hormonal methods (wives′) were
key motivators for vasectomy uptake. High rates of previous FP use and high degree
of interspousal communication are known correlates of higher FP use.
Conclusions
Future and current Rwandan FP programs and other interested parties will benefit from
understanding which couples elect vasectomy, their motivations for doing so and their
service utilization experiences. Better integration of vasectomy counseling and postvasectomy
procedures will benefit the program.
Implications
Until this project, vasectomy projects in sub-Saharan Africa were viewed as unrealistic.
This study confirms factors influencing vasectomy uptake identified in earlier research,
but does so within a robust sample of vasectomy users and their wives and provides
a strong understanding of who likely vasectomy users are in this context. Promotion
of vasectomy services should be considered as an essential element of a healthy contraceptive
method mix.
Keywords
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Article info
Publication history
Published online: February 12, 2014
Accepted:
February 3,
2014
Received in revised form:
January 28,
2014
Received:
March 12,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
