Assessing the Acceptability of Vasectomy as a Family Planning Option: A Qualitative Study with Men in the Kingdom of Eswatini

Abstract

The uptake of vasectomy in many countries in sub-Saharan Africa is low. In Eswatini, a kingdom with strong patriarchal norms, the use of vasectomy is at 0.3%. This is despite great efforts to introduce vasectomy and involve men in reproductive health. This study explored the views of men about the acceptability of vasectomy and their willingness to adopt vasectomy as a family planning option. Focus group discussions were conducted with adult men recruited from health facilities located in rural, semi urban, and urban areas in two of the regions of Eswatini. A thematic approach was used to analyze the data. The acceptability of and intention to use vasectomy as a family planning option was very low. Cultural beliefs, societal norms, lack of knowledge about the procedure for vasectomy, and misconceptions influenced the acceptability of vasectomy greatly. The participants could not grasp the concept of a family planning method that is as permanent as vasectomy. However, the decisions to accept or reject vasectomy were influenced by their misconceptions and fears about vasectomy and were not based on facts. To address the need to involve men in reproductive health and improve the acceptability and adoption of vasectomy, planning should be conducted with them and informed by their understanding of their needs.

Intention to use vasectomy and its associated factors among married men in Debre Tabor Town, North West Ethiopia, 2019

“…The result of this study also showed that there was a positive relationship between knowledge of vasectomy and its acceptance by married men; it revealed that participants who had good knowledge about vasectomy had a higher intention to use it. The finding was also in line with a study conducted in Nigeria and the Kingdom of Eswatini [34] and [11] respectively. This might imply that knowledge plays an important role in the intention of vasectomy by increasing the awareness of individuals, having good knowledge about vasectomy used to helps men to know the importance of it from other methods avoids different misconceptions, changes the behavior and positively affects the attitude of men towards vasectomy.…”

“…International health organizations in recent years have suggested that the involvement of men on the utilization and promotion of contraceptive methods is very crucial to provide couples with more male-oriented contraceptive choices, such as vasectomy. Even though its procedure is simple and easy with a high success rate (>99%) and minimal complications, it is underutilized around the world, especially in developing countries including Ethiopia [10][11][12] Couples who complete their family or no want more children, vasectomy is the option than tubal ligation, due to it poses fewer surgical risks. Although it's a higher effective, simple process and fewer complications, currently vasectomy users in the United States only 8% [13].…”

“…Different reviewed literature reports showed that the intention to use vasectomy was associated with different variables [11,15,17,18]. Age, educational status, occupation, religion, Cultural beliefs, societal norms, lack of knowledge about the procedure for a vasectomy, and misconceptions were found to be predictors of intention to use vasectomy.…”

Factors affect the vasectomy uptake of married couples in Bangka Belitung Islands, Indonesia

“…In a situation where access to correct information is lacking, community members are compelled to rely on misinformation, which is always bothering myths [32,33]. A study conducted in the Kingdom of Eswatini found that lack of knowledge about the procedure for a vasectomy, societal norms, cultural beliefs, and misconceptions influenced the acceptability of vasectomy [34].…”

Knowledge of Vasectomy and its Associated Factors Among Married Men in Debre Tabor Town, Northwest Ethiopia: A community Based Cross-sectional Study.

“…International health organizations in recent years have suggested that involvement of men on the utilization and promotion of contraceptive methods is very crucial to provide couples with more maleoriented contraceptive choices, such as vasectomy. Even though its procedure is simple and easy with a high success rate (> 99%) and minimal complications, it is underutilized around the world, especially in developing countries including Ethiopia [11][12][13].Studies in African countries showed that knowledge of vasectomy is low [14][15][16].…”