Attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students in a Malaysian private medical college

Knowledge, Attitude and Associated Factors Towards Vasectomy Among Married Men in Arba Minch Town, Southern Ethiopia, 2021; A Cross-Sectional Study

Background

Vasectomy is a safe and effective permanent contraceptive method. In Ethiopia, this method underutilized since the focus has been on contraceptive methods available for women rather than men. Few studies have examined this method in Ethiopia so far, so it is important to note that there is a lack of data about the method in the study area regarding married men's knowledge and attitudes toward vasectomy.

Methods

A community-based cross-sectional study conducted from May 2 to June 2, 2021, at Arba Minch town. A simple random sampling technique used to select 624 study participants. Data collected via the face-to-face interview technique using a semi-structured and pretested questionnaire. Data entered in EpiData 3.1, cleaned, and analyzed using SPSS for Windows version 25.0. Descriptive statistics and bivariable and multivariable logistic regression analyses were performed. An adjusted odds ratio (AOR) with 95% CI and a p-value < 0.05 estimated to identify statistically significant variables associated with knowledge and attitude towards vasectomy.

Results

From the total of 624 study subjects, 600 had completed the questionnaire, giving a response rate of 96.2%. From those who heard about vasectomy (36.8%), only 60.6% of men had good knowledge, and 48.4% had a positive attitude towards vasectomy. Men's knowledge of vasectomy was significantly associated with college or university attendance (AOR = 4.05, 95% CI: 1.720-9.521), age 31-40 years (AOR = 2.308, 95% CI: 1.081-4.929), and age ≥41 years (AOR = 2.671, 95% CI: 1.159-6.156). Age ≥41 years (AOR=4.735 95% CI 2.015-11.129), age of last child (AOR=3.868 CI 1.554-9.632) and discussing family planning with wife (AOR=2.821 95% CI 1.559-5.105) were significantly associated with attitude of men towards vasectomy.

Conclusion

In this study area, six out of ten and half of the married men had good knowledge and a positive attitude towards vasectomy, respectively.

Vasectomía: conocimientos, percepción y aceptación por parte de estudiantes de medicina en América Latina

Introducción. Los estudiantes de medicina desempeñan un rol importante en el logro de resultados en salud sexual y reproductiva, incluyendo una mayor participación de los hombres en la planificación familiar. Objetivo. Describir el nivel de conocimientos, la percepción y el nivel de aceptación de la vasectomía (i.e. si la recomendarían a sus pacientes y, en el caso de los hombres, si se la realizarían en algún momento de su vida) en una muestra de estudiantes de medicina latinoamericanos. Materiales y métodos. Estudio multicéntrico, transversal analítico realizado en noviembre de 2020 en 2676 estudiantes de medicina (1er-7mo año) de 8 países latinoamericanos. Los datos se recolectaron mediante un cuestionario validado en cada país y diligenciado mediante Google Forms. Se utilizó la prueba de chi-cuadrado de independencia para determinar las diferencias en las variables de estudio (nivel de conocimientos, percepción y nivel de aceptación) para cada subgrupo establecido, con un nivel de significancia de p<0.05. Resultados. El nivel de conocimientos fue alto y medio en 55.38% y 36.32% de los participantes. El país con mayor proporción de estudiantes con alto nivel de conocimientos fue México (77.31%) y el de menor proporción, Brasil (3.33%). Respecto a la percepción, 96.97% de los estudiantes consideró que la vasectomía no afecta la masculinidad y el 98.99% que la anticoncepción también es responsabilidad del hombre. En cuanto a la aceptación, el 94.02% recomendaría el procedimiento, pero solo el 69.82% de los varones (n= 759) se la realizaría. Conclusiones. La mayoría de participantes tiene un buen nivel de conocimientos, buena percepción y un buen nivel de aceptación del procedimiento. No obstante, es necesario implementar más estrategias de capacitación que les permitan promover el uso de la vasectomía como alternativa de planificación familiar en su vida profesional.  

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

BACKGROUND

Vasectomy is one of the most effective and permanent male contraceptive methods, and involves cutting and ligating the vas deferens to make the semen free of sperm during ejaculation. Although it is effective, simple, and safe, it is not well known and practiced in the majority of our community. This study assessed the intention to use vasectomy and its associated factors among married men in Debre Tabor Town, North West Ethiopia, 2019.

METHODS

A community- based cross-sectional study was conducted among 402 married men from March 05 to April 15, 2019. A simple random sampling technique was employed to select the study participants. Data was collected by face to face interview using a structured and pre-tested questionnaire. Questions concerned socio-demographic and reproductive variables and views on vasectomy. The association between variables was analyzed using a bivariable and multivariable logistic regression model.

RESULT

A total of 402 participants were included with a response rate of 98.75%. The mean participant age was 37.12(SD ± 6.553) years with the age range of 20-56 years. The prevalence of intention to use vasectomy was 19.6% with 95%CI (15.6%-23.4%). Multivariable logistic regression showed that age from 30-39 years (AOR = 3.2(95% CI: 1.19-8.86)), having more than three living children (AOR = 2.5(95% CI: 1.41-4.68)), good knowledge (AOR = 3.4(95%CI: 1.88-6.40)) and positive attitude (AOR = 4.8(95% CI: 2.61-8.80)) of married men were significantly associated with intention to use vasectomy.

CONCLUSION AND RECOMMENDATION

Intention to use vasectomy was comparable with findings in four regions of Ethiopia (Amhara, Oromia, SNNP, and Tigray). Age, the number of living children, knowledge, and attitude were significantly associated with the intention to use vasectomy. Improving the level of knowledge and attitude towards vasectomy is an essential strategy to scale up the intention of men to use vasectomy.

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

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.