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Low family planning unmet need? Have we tried vasectomy?

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Added 23rd November 2016 01:42 PM

Globally, women would both trust and welcome a more active role in family planning by their male spouses.

By Wasswa Joseph

So Friday 18th November 2016 was the World Vasectomy Day! (New Vision of 21st November 2016). Unfortunately, the day elapsed unnoticed.

It’s rather disturbing when some useless World days get a lot of media coverage yet days like these that would cause tremendous and significant positive change in the lives of many pass unnoticed to a larger extent!  I will begin by posing a question, would you accept vasectomy as your Family Planning method of choice? In my work experience with Mariestopes Uganda, I realized there was a very wide unnecessary discrepancy between vasectomy and other Family planning methods. Even to the many advocators and implementers of Family Planning/Reproductive Health services country wide, a lot of emphasis is surprisingly given to other methods more than Male Sterilization.

Globally, women would both trust and welcome a more active role in family planning by their male spouses. However, the narrow contraceptive methods available for men are some of reasons for men’s slow or no uptake of family planning, which has led to the unmet need for family planning to persistently stay high majorly in the African countries , yet studies have indicated that men’s participation can tremendously improve acceptance of family planning.

Men’s participation should not only be defined in terms of population control, but also in reducing the unfairness in contraceptive burden that is seen between men and women. Available information indicates that the alarmingly high; Maternal Mortality rates, Infant Mortality rates and Fertility rates witnessed in many parts of Africa, most especially in Sub Saharan Africa could enormously be brought down by continuous and consistent use of family planning alone. Programs targeting men in regard to family planning have and are still very little, making reflection on the desires and views of men in contraceptive services to be limited yet women still take a front seat when it comes to family planning issues as methods targeting women are given more interest while males take on the role of just providing support leading to the very low observed utilization of the male focused family planning methods.

Furthermore, as male sterilization/Vasectomy has been existent and being utilized in most of the developed countries, it has either been; nonexistent, under-utilized or worse still its incidence has steadily just been going down in the developing countries. Although, suggestions to implement policies intended to see men’s participation in reproductive health and studies focusing on their perceptions of family planning practices begun in 1994 in Cairo with the International conference on Population and Development, universally, even when some men may express some willingness to be equally involved in reproductive awareness-raising programs including family planning; the social structures that shape, compel, and enable greater reproductive health are almost entirely aimed at targeting women.

However, it is believed that participation of men in contraceptive issues demands both social and behavioral change which will not only interest extra men in concerns of family planning but as well will start giving support to their spouses in issues concerning reproductive health matters. Despite of all the above, studies have indicated that male focused methods-most particularly vasectomy is insignificantly utilized by populations hence further confirming contraception as a female responsibility.

It is not surprising that for a method which was first performed on humans in 1899, had to wait until On October 18, 2013 when Jonathan Stack and Doug Stein launched World Vasectomy Day with the hope to inform people about vasectomies and bring these services to those furthest afield and based on the overwhelming response, November 7 was declared as World Vasectomy Day!

Male sterilization or vasectomy is regarded as a simple, effective and safe family planning method for men. Even though new studies have indicated that the surgical technique used is very crucial in safeguarding safety and effectiveness of the procedure. There are two steps done when carrying out vasectomy; Isolating the vas deferens and occluding the vas deferens and it takes 20 minutes to complete the entire procedure although the client may leave the clinic after an hour and can start taking on heavy works after two days.

Presently, vasectomy is the main convenient and effective surgical family planning method for men, principally because of its uncomplicatedness, low intrusiveness, effectiveness, and comparatively low complication rates. Vasectomy is a procedure that can be practiced by any community with different resource settings. Although, it can be reversed in most men who want to restore their fertility, it is considered a permanent birth control method. Regardless of the fact that it is commonly done in outpatient minor theatres under local anesthesia, it is not 100% effective, though more effective when compared to tubal ligation and less costly.

Male sterilization holds a front position amongst the most effective family planning methods but regrettably it is also among the least sought after method though it is believed that it would unquestionably address the contentious subject of men’s participation in family planning issues. Researches all over the world have shown that male sterilization is the least used and known method compared to its counterpart female sterilization in developing countries while reverse methods are more popular in developed countries.

Uganda’s contraception history has a close connection with the Family Planning Association of Uganda (FPAU) established in 1957, which was later renamed Reproductive Health Uganda. It has been known that during that period majority of the Ugandans favored large families, so little did they believe in Family planning.

So it was Asians and African Mothers’ Union, a group of volunteers who later forged a simple association which started promoting for family planning. There is a window of opportunity in Uganda currently for advocating for improved uptake of vasectomy as a family planning method of choice and increase its popularity since its utilization at the moment is far below that of tubal ligation. This is further exacerbated by the frequent family planning programs that concentrate more to women and very little devotion to the role played by men in issues relating to this subject of family planning.

The writer is a public health advocate specializing in Population & Reproductive Health

Tel: +256-779/702-372 009


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