Vasectomy Acceptability within Rwandan Family Planning Policy

Abstract

EXECUTIVE SUMMARY Vasectomy is a surgical procedure performed on males in which the vas deferens (tubes that carry sperm from the testicles to the seminal vesicles) are cut, tied, cauterized (burned or seared) or otherwise interrupted. The semen no longer contains sperm after the tubes are cut, so conception cannot occur. The testicles continue to produce sperm, but they die and are absorbed by the body. The purpose of this operation is to provide reliable contraception. International researches indicate that the level of vasectomy effectiveness is 99.6% which makes it the most reliable method of contraception. Contraception has many purposes which include overpopulation reduction, family planning with an overall objective of a sustainable economic development. In relation to family planning, contraception is proven to be the most efficient way for avoiding undesired pregnancy. It is therefore clear that in the case of an overpopulated nation, contraception should be encouraged to be used by sexually active female who do not desire to become pregnant or by teenagers who are not ready to become parents or parents who want to limit birth using various birth methods which include vasectomy, a most reliable male method. As confirmed by the 2014 Thematic Report on the 2012 Fourth Population and Housing Census, compared to neighbouring countries like Burundi (333), Uganda (173) or Kenya (73), Rwanda is the highest densely populated county in the region with 415 inhabitants per square kilometre (sq. km), whereas it was only 183 persons per sq. km in 1978, and 321 in 2002. Nevertheless the Rwandan overpopulation, the same report showed that the annual population growth for Rwanda has been slowing from 3.2% in 2002 to 2.6% in 2011, though it remains among the highest in Africa. The decline in the population growth rate indicates the success from the sustained campaign on responsible family planning, the increased uptake of contraceptive methods for both men and women, and improved living conditions including universal access to health and basic education. xiv Putting an emphasis to the family planning, in the Rwandan birth control history, it was observed that women have been the only involved in adhering to modern methods which are sometimes associated with a good number of side effects and therefore preventing them from actively participating in the development of their households and of the country. With the introduction of vasectomy as male birth control method, women found time to work and thus contribute to the same development. However, being strange in the Rwandan community and being exercised on men, rumours started circulating in the society that vasectomy is subject to various negative impacts not only on men’s physiological and biological status but also family relationship and socio-economic status, which might impact on the method acceptability by more men. Allying birth control to the development of the country, the researcher undertook a research on this vasectomy conception and acceptability in Rwanda. The research had as overall objective to assess the level of awareness and acceptability of vasectomy as a modern, irreversible and male focused birth control method meant to enable the socio-economic development. The research targeted the reproductive population of Rwanda and was sampled from the Kigali City, Gasabo District, which is a hybrid district (semi rural / semi urban) to represent attitudes, level of education and socio-economic life of the Rwandan reproductive population. Considering that the majority of the Rwandan population live in the rural part of the country, the research was also extended to Rulindo District, Bushoki Sector where Tare Health Centre has become a vasectomy centre of reference, so as to include views and attitudes of the rural population vis-à-vis male sterilization. The study sampled one hundred (100) key respondents who included thirty (30) sterilized men, their wives and thirty (30) other respondents from non sterilized families. In additional to these ninety (90) respondents, the researcher interviewed two (2) medical doctors and six (6) nurses, with expertise in vasectomy issues, who helped to harmonize information got from other respondents, interviews and observations. The research also got information from two (2) local administrative authorities who have social affairs in their daily attributions and xv who administratively contributed to the acceptability of vasectomy in their occupational territory. Findings showed that the Rwandan reproductive community is sufficiently aware of vasectomy and accept it as the most reliable and effective birth method meant to contribute to the socio-economic development of the Rwandan households and the community as a whole. However, the research found that there are still persisting problems hindering the wider acceptability of vasectomy which include myths that sterilization corresponds to castration, that there might be some vasectomy operational mistakes which can lead to reproduction and that vasectomy is against the will of God for people to multiply in the whole world and that those who accept it may face the sanctions of God. Therefore, the research recommended that vasectomy is a birth control method to opt for and even to be privileged over all other methods, especially for families which do not need more children in line with the national family size preferences and strategies. Most importantly, vasectomy would be selected because it assures a better life and smooth running of familial and social life, and more valuably, the economic development of households and of the country, as a whole.