Transcript TUAB019 – Factors Affecting Acceptance And Use Of Vasectomy In

Factors Affecting Acceptance and Use of
Vasectomy in Kigoma and Dar es Salaam
Tanzania Regions, Tanzania
Authors: Emmanuel philipo1, Festo mboya1, Mengi Ntinginya1, Mwemezi
Ngemera1, Olivia Nuccio2
AMREF International Conference Nairobi Kenya
25th November,2014
Presenter: Mengi Ntinginya
Marie Stopes Tanzania
SLIDE 1
Background

Vasectomy is a simple, safe,
effective
and
permanent
method
of
contraception
available for men.

Despite being a highly effective,
vasectomy
is
relatively
underutilized throughout the
world, compared to tubal
ligation.

This is particularly true in
Tanzania, where less than 1%
of the population undergo
vasectomy.
SLIDE 2
Study Objectives

Purpose
–

To explore motivations and barriers to uptake of vasectomy
services in the Kigoma and Dar es Salaam regions of Tanzania in
order to design behaviour change communication strategies, to
expand access to vasectomy services in Tanzania.
Objectives
–
To identify how the community perceives men who have
undergone vasectomy
–
To identify how the community perceives the wives of vasectomy
clients
SLIDE 3
Methodology
Study design
Study population
• Explorative: qualitative data collection
• Focus group discussions
• In-depth interviews
• Adults men and women
• Married and unmarried 25 years
and above
Coverage
Sample:
• Temeke and Ilala district, Dar es
Salaam region
• Kasulu district and Kigoma urban,
Kigoma region
• 16 Individual community groups(Total
respondents 196)
• 43 in-depth interviews
• 13Vasectomized men
• 10 wife of the vasectomized men
• 20 non-vasectomized men
All data were transcribed and coded for thematic analysis
SLIDE 4
Demographic Characteristics
of Study Population

More male(129) than female(110)
participated in this study

The average respondent was over
40 years, married, had a primary
level of education, and worked in
agriculture.
SLIDE 5
Why men accept Vasectomy?

Desired family size
‘’....I am the second born in my
family; I know what I have gone
through caring for my younger
sisters and brothers. I promised
myself that I would have only two
children at an interval of five years.
My wife used implants until we got
our second child. Then I said now it
is my right time …… I undergone
vasectomy…’’
(Vasectomized men, IDI- Ilala)

Economic hardship
‘’…that is what motivated me,
after the birth of our fifth child
things were not going well and
caring for those children was a
challenge, so I decided to go for
vasectomy so that I can have
additional income to take care of
my children …’’
(Vasectomized men, IDI- Kigoma)
SLIDE 6
Why men accept Vasectomy?

Maintained sexual drive

“… I didn’t see any
change after vasectomy
I am having sex as usual
and I can see my sex
drive has improved, I am
45 now but it seems like
I have gone back to
adolescence”(Vasectomi
zed men, IDI-Ilala)
“.... since undergone vasectomy, I
have been able to motivate other
men and three of them
undergone vasectomy”
(Vasectomised Men, IDI- Ilala)

“…… my husband had vasectomy four years ago and
up to this time he is doing fine, I can say he trusts me
more now than ever since I have not gotten pregnant
and this has improved our relationship and trust”
(Wife of Vasectomized men, IDI- Kasulu)
Evidence from the satisfied clients
Male concern about partner’s health
“….because she has high blood
pressure and diabetic … so I
decided to undergo vasectomy “
(Vasectomized men, IDI-Kasulu)
SLIDE 7
Why do men not choose
Vasectomy?

Lack of knowledge about
vasectomy

Fear of the procedure and
its side effects
‘’…. this information about male
sterilization is new, what we know is
women sterilization but for us men… it
is a new lesson”(Male FGD Ilala)
‘’…..men think
that the
procedure is complicated and
dangerous ”(Female FGD)
SLIDE 8
Why do men not choose
Vasectomy?

Partner’s disapproval of vasectomy
• Desire for more children
• Concerns about the loss of sexual
performance

Religion
‘’….based on Gods’ principles,
religion does not agree with any
harmful act concerning child birth
when it can be avoided”
(Male FGD Ilala)
SLIDE 9
Community Perceptions of
Vasectomized Men
Teased
Man without
power
Laughed at
‘’In our community
when you tell a man to
undergo vasectomy is
like you have insulted
him. He can even
inform your parents
and this will bring
conflicit ”
(FGD, female Ilala)
Useless
Castrated
SLIDE 10
Vasectomy Services Data
From 2012 to September 2014, a total of 392 male clients accessed
vasectomy services at Marie Stopes.
.
SLIDE 11
Implications for programming

A BCC campaign should address fears and misconceptions
by providing facts about vasectomy.
–
Use a variety of communication channels and platforms

Strengthen FP information and education by including FP
messages targeting men.

Engage satisfied clients to share their vasectomy
experiences

Encouraging spousal communications among partners about
all FP methods, including vasectomy, will increase knowledge
and acceptance.
SLIDE 12
Implications for programming

Train more service providers to perform vasectomy,
so that supply-side issues do not create a barrier.

Improve pre and post vasectomy counselling, to
improve knowledge and attitudes.
SLIDE 13
Thank You!
SLIDE 14