Increasing demand for and supply of non-scalpel vasectomies by building provider capacity

Vasectomy is one of the most effective forms of contraception currently available, with a failure rate of 0.15 as compared to 9.0 for oral contraceptive pills. Clinically, it is the safest and quickest form of long-acting and permanent method of contraception. Unfortunately, men in developing countries have vasectomies at much lower rates than those worldwide; about 0.1% in Rwanda. Research has demonstrated, that to overturn low rates, successful programs must increase knowledge of vasectomy in men and their wives.

From 2012-2014, the USAID Rwanda Family Health Project (RFHP) worked with the Rwandan Ministry of Health to increase the use of vasectomy. Working in 14 of the 30 districts in Rwanda, RFHP and the ministry conducted assessments of facilities and providers to see what supplies and resources they would need to provide high-quality vasectomies. The project then provided community outreach and sensitization for community leaders and the general population to increase demand for vasectomy. In response to the needs assessment, the ministry and RFHP team trained 27 doctors and nurses in no-scalpel vasectomy, and 80 nurses in related necessary lab skills, such as semen analysis. In addition, the project supplied vasectomy kits and other necessary equipment and supplies to start and maintain the service. As a result, providers in supported districts completed a total of 380 non-scalpel vasectomies, resulting in 3,800 couple years of protection. Services in these districts are ongoing, and based on these results the ministry is scaling up vasectomy capacity building efforts to other districts.