Vasectomy in Tanzania

Study examines acceptability among men and women.

Family Health Research: 2008, Vol. 2, Issue 1

Research by FHI, the ACQUIRE Project (managed by EngenderHealth), and the nongovernmental organization Healthscope in Tanzania's Kigoma Region identified a number of reasons why men and their partners might choose vasectomy. The findings also highlight barriers to the acceptance of vasectomy and suggest ways to increase the adoption of the method, both within and outside the region.

Rates of vasectomy use are slightly higher in Kigoma Region than they are in other parts of Tanzania. But in general, less than one percent of the couples who use contraception in Tanzania or other sub-Saharan countries rely on vasectomy.

What men say: "I had been expecting to be more educated about it, because I have no idea what is being done during the procedure. How do they start? I don't know. I need to get a whole picture about vasectomy before I decide to do it." — Potential vasectomy client, Kigoma Region

For this study, 10 vasectomy clients were interviewed during July and August 2004 about their decisions to have a vasectomy. An additional 28 clients and 22 of their wives, 29 potential clients, and 33 women who had undergone tubal sterilization were also involved in group discussions about contraceptive decision-making.

Read or download the full study, published in International Family Planning Perspectives.

Results Economic hardship due to the expense of raising children was the most common reason participants gave for finding vasectomy acceptable.  Wives played an important role in the decision to undergo a vasectomy. While most wives accepted the procedure, four potential vasectomy clients said their wives did not want them to be sterilized.  Several men decided not to have a vasectomy for religious reasons, but an equal number of participants had been sterilized despite the disapproval of their churches. More than one-quarter of vasectomy clients said that they had to postpone the procedure because a provider was not available to perform it. Several mentioned that vasectomy clients often have no one to turn to if they experience problems after the procedure. Some men and women feared that they might want more children later, or that their spouses would be unfaithful after the procedure. A general lack of knowledge was the most common reason why potential clients had not undergone the procedure. Both men and women cited specific rumors and misconceptions about vasectomy. Implications for Service Delivery To improve access and service delivery: Establish vasectomy outreach services and referral systems Improve counseling by providers Ensure that clients understand the need to use alternative contraception for 12 weeks following the procedure To increase demand for vasectomy: Orient family planning services toward men Design communication strategies to improve public knowledge about vasectomy Target spouses as well as potential clients with promotional messages Photo Credit: Jim Daniels Vasectomy acceptibility was linked to economic hardship in the study, particularly among men.