Study of the effects of the vasectomy promotion project on knowledge, attitudes, and behaviour among men in Dar Es Salaam

Type Working Paper
Title Study of the effects of the vasectomy promotion project on knowledge, attitudes, and behaviour among men in Dar Es Salaam
Publication (Day/Month/Year) 1997
Vasectomy is unique among the array of modern methods of contraception as it enables the
male partner to take primary responsibility for fertility control. Its availability broadens the
choice of methods for family planning users and contributes to promoting male involvement
in family planning. Furthermore, vasectomy is highly effective in preventing pregnancy
independent of subsequent behavior modification by the vasectomized man and the nonscalpel
vasectomy procedure is convenient and safe for the client and simple to perform.
While sterilization is the most widely used family planning method worldwide, in most
settings the number of women sterilized for contraceptive purposes far exceeds the number of
men. The lowest rates of sterilization in the world are found in Africa where fewer than
three percent of married women of reproductive age rely on sterilization to avoid pregnancy
and male sterilization is negligible (Ross and Frankenberg, 1993).
Male attitudes are often blamed for the underutilization of this method. Frequently cite
examples of attitudes which discourage the use of vasectomy include men s lack of interest
in or responsibility for avoiding pregnancy, the association of vasectomy with castration, and
fear of the procedure. However, some advocates of vasectomy believe more than negative
attitudes among potential male adopters underlie the low levels of use. A recent review of
male involvement in family planning concluded that modern male methods (condoms and
vasectomy) are underutilized, particularly in Africa, not because men oppose family planning,
but because providers are unwilling or unable to provide men information and services to
meet men s needs (Danforth and Jezowski, OJO date?). Policy-makers and providers lack of
attention to the method, and sometimes even prejudices against it, are often the biggest
obstacles to vasectomy services. Experience indicates that the promotion of vasectomy by the
media and service providers and high-quality services draw clients and increase adoption
rates (Liskin, Benoit, and Blackburn, 1992; Kincaid et al., 1996; Wilkinson et al., 1996).

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