Shattuck Dominick, Wesson Jennifer, Nsengiyumva Theophile, Kagabo Leonard, Bristow Helen, Zan Trinity, Ngabo Fidele
FHI 360, Durham, NC, USA.
FHI 360, Kigali, Rwanda.
Contraception. 2014 Jun;89(6):564-71. doi: 10.1016/j.contraception.2014.02.003. Epub 2014 Feb 10.
Vasectomy is safe and highly effective; however, it remains an underused method of family planning (FP) in Africa. In view of this, three Rwandan physicians were trained in no-scalpel vasectomy with thermal cautery and fascial interposition on the prostatic end as vasectomy trainers in 2010, and this initiative has resulted in over 2900 vasectomy clients from February 2010 to December 2012.
This cross-sectional descriptive study describes vasectomy clients (n=316) and their wives (n=300) from 15 randomly selected hospitals in Rwanda.
The vasectomy clients were mainly over age 40, had young children (age <3) and were married and cohabiting. Limited financial resources, satisfaction with existing family size and avoiding side effects from hormonal methods (wives') were key motivators for vasectomy uptake. High rates of previous FP use and high degree of interspousal communication are known correlates of higher FP use.
Future and current Rwandan FP programs and other interested parties will benefit from understanding which couples elect vasectomy, their motivations for doing so and their service utilization experiences. Better integration of vasectomy counseling and postvasectomy procedures will benefit the program.
Until this project, vasectomy projects in sub-Saharan Africa were viewed as unrealistic. This study confirms factors influencing vasectomy uptake identified in earlier research, but does so within a robust sample of vasectomy users and their wives and provides a strong understanding of who likely vasectomy users are in this context. Promotion of vasectomy services should be considered as an essential element of a healthy contraceptive method mix.
输精管结扎术安全且高效；然而，在非洲它仍是一种未得到充分利用的计划生育方法。鉴于此，2010年，三名卢旺达医生接受了无手术刀输精管结扎术培训，采用热烧灼和前列腺端筋膜置入术作为输精管结扎术培训师，这一举措在2010年2月至2012年12月期间带来了超过2900名输精管结扎术客户。
这项横断面描述性研究描述了来自卢旺达15家随机选择医院的输精管结扎术客户（n = 316）及其妻子（n = 300）。
输精管结扎术客户主要年龄在40岁以上，有年幼子女（年龄<3岁），已婚且同居。有限的经济资源、对现有家庭规模的满意度以及避免激素方法的副作用（妻子方面）是接受输精管结扎术的关键动机。以前较高的计划生育使用率和较高程度的配偶间沟通是已知的与较高计划生育使用率相关的因素。
卢旺达未来和当前的计划生育项目以及其他相关方将受益于了解哪些夫妇选择输精管结扎术、他们这样做的动机以及他们的服务利用体验。更好地整合输精管结扎术咨询和输精管结扎术后程序将使该项目受益。
在这个项目之前，撒哈拉以南非洲的输精管结扎术项目被认为是不现实的。这项研究证实了早期研究中确定的影响输精管结扎术接受率的因素，但这是在输精管结扎术使用者及其妻子的一个强大样本中进行的，并对在这种背景下可能的输精管结扎术使用者有了深入了解。应将推广输精管结扎术服务视为健康避孕方法组合的一个基本要素。
