Vasectomy messaging in africa: Findings from the Rwanda vasectomy scale-up project

Purpose: From March 2010 to December 2012, Rwandan physicians performed almost 2600 vasectomies. This five-fold increase in vasectomies before 2010 resulted from increased availability and outreach activities. We asked randomly selected vasectomy clients and their wives to list barriers to vasectomy uptake that they encountered, ways to overcome the barriers and community messaging necessary to facilitate greater increases in vasectomy uptake.

Study Design: This cross-sectional descriptive study describes a sub-set of data from structured interviews of vasectomy clients (n = 316) and their wives (n = 300). All participants were randomly selected from vasectomy records at 15 randomly selected hospitals in Rwanda.

Results: Clients and wives described people in their community as uninformed about vasectomy. Although they reported limited discussion of vasectomy with friends, their decision to have a vasectomy was a private matter. Sex change (men becoming women) and lack of sexual satisfaction and drive were frequently reported rumors associated with vasectomy. Participants reported that radio; community meetings and health workers were the best communication channels for dispelling myths and increasing knowledge of vasectomy.

Conclusions: The 2010 Rwanda DHS reports that 71% of married women and 82% of married men are aware of male sterilization (vasectomy) as a family planning method. Despite high levels of awareness clients believe that vasectomy is misunderstood as a family planning method and subject to myths and, therefore, negatively perceived in their communities. Effective vasectomy messaging should dispel myths surrounding the method and strive to increase awareness of its low-risk and permanent benefits.