Permanent contraception: Learn about effectiveness

Haruna Kasango,46, a resident of Mafubira and father of nine, anticipated that his children would in the future fail to get the basic needs such as Education in case he lost a job or his salary did not increase.

He fumbled for a solution but failed until one day he sought advice from a friend who assured him that a permanent family planning method would be effective.

Kasango, a special hire driver did not ponder. He immediately bought the idea and he talked to his two wives about vasectomy, a permanent family planning method for men.

"I had pressure, Ulcers and was Asthmatic but the big family was also becoming an issue. Buying clothes and taking these children to good schools was becoming expensive. Adding a child to those I already had would worsen the situation I thought," explains Kasango.

It is against this background that Kasango underwent a vasectomy operation at the Marie Stopes Clinic in Jinja. His nine children are now studying in some of the best performing schools and he wants to maintain the standard.

Rosemary Nalyazi,42, a resident of Kavule in Bwaise a Kampala suburb is another person who opted for family planning . Nalyazi a mother 0f 10, was a housewife in 2006 when he took on tuba ligation, a permanent family planning method for women. She took on the method after a team from Marie Stopes Clinic in Kavule visited her home.

She says that by then her late husband was a casual worker and taking care of the children was soon to be out of their control. Taking on the Tuba ligation the team assured her was a solution.
 
"I reached an extent of covering five children with one blanket, we sometimes had to forego meals to save for the next day. Though my husband passed on, I can at least afford beddings for my children," Nalyazi notes.
 
Sarah Nakyambadde, 43, a mother of five in Sebina Zone in Makerere also took on Tuba ligation as she found it more reliable.
 
"As a Village health team member I had to live by example by giving birth to those I can care for. Compared to other methods I found this one not sceptical, I then discussed with my husband and took on this method," Nakyambadde assures.
 
Deciding to take on a permanent family planning method is a once in a lifetime decision, according to Dr. Latif Kaweesi a General Duties Doctor at Marie Stopes says.
 
According to Dr.Kaweesi, a General Doctor at Marie Stopes Clinic in Jinja, Tubal ligation for women and vasectomy for the male are permanent family planning methods.
 
He explains that Tubal ligation involves two main sterilisation procedures one where the clips are put on the fallopian tubes, and tubal occlusion, where a tiny, flexible device called a micro-insert is put into each tube.
 
"When a woman ovulates, an egg is released from the ovary, it moves down the fallopian tube. If it meets a sperm, conception happens. Sterilisation blocks the route of the sperm through the tube,"
 
Eggs are still released by the ovaries, but are broken down and safely absorbed by the body.
 
The ovaries are broken down and absorbed by the body and are not affected by sterilisation, expect periods because the ovaries will continuing to release the same hormones," he notes
 
 He adds that it does not cause menopause or affect a woman's sex drive.
 
Vasectomy for the male according to Kaweesi, involves the cutting of the tubes through which a man's sperm move, in order to stop his partner from getting pregnant.
 
Kaweesi emphasizes that when men undergo vasectomy, their sperm can no longer reach the semen, as a result, the semen that is ejaculated during sex does not contain sperm, which is needed to fertilize a woman's egg.
 
What you have to look out for before getting a permanent family planning method
 
Kaweesi outlines the following as what one should be cautious about before taking on a permanent family planning method.
 
The person deciding to take on the family planning method must have information and knowledge about it. This enables in the final decision making on the method.
 
It is proper to tell your partner or partners about the permanent family method as this enables a harmonious relationship in the future.
 
To avoid mistakes coming on board, consult a certified trained medical practitioner to explain and do the surgery.
 
Take the doctor's advice after the operation seriously; the time given to you before you resume normal duties is a concern that should not be taken for granted.
 
Even after the operation, keep in touch with the doctor who operated you for monitoring and success of the method.
 
Other family planning methods
 
There are natural methods such as abstinence, lactation, withdrawal, and safe period methods.
 
The other are Barrier methods which include Condoms with/without spermicide, diaphragm, cervical cap, sponge, vaginal spermicides.
 
And the Hormonal methods like the oral pills, injectable, implants and intrauterine devices among others.

Access to family planning (FP) services still remains a big challenge in Uganda. Recently Marie Stopes Uganda piloted task sharing of surgical contraception using clinical officers.

The ministry of health FP costed Implementation Plan (2015-2020) highlighted task sharing as a priority intervention towards improving Uganda's FP indicators and increasing access to FP.