Knowledge and attitude towards vasectomy among men in a selected district of the Eastern province, Rwanda

Abstract

Background: Vasectomy is a permanent method of contraception supporting men in family planning. Perry et. al. (2016) found the worldwide use of vasectomy was lower (2.4%) than tubal ligation (19.2%). Vasectomy is a safe surgical procedure using local anesthesia versus tubal ligation and general anesthesia. Rwanda Ministry of Health (MOH) (2012) strategic plan highlighted the underutilization of vasectomy. Barriers to vasectomy include negative attitudes in males in Sub-Saharan Africa. Pupose/Aim: Determine Knowledge and attitudes towards vasectomy among men in a selected District of the Eastern Province of Rwanda Methods: A cross-sectional, quantitative descriptive design was used. A total number of 390 participants from a selected Administrative District were selected using a systematic sampling strategy. A validated questionnaire in African countries (olayinka et.al.2013) was used. Data were analyzed using SPSS, Version 20. Univariate, bivariate correlational and multivariate analyses were performed. Results : Most participants were ranging from 31-39 years old (43,1%), catholic by religion(58.7%),farmers(54.6%) and respondents with primary education(42.3%).The study findings identified barriers such as lack of evidence based knowledge, religious factors, and low educational status as primary barriers influencing increased negative attitudes and rumors limiting the utilization of vasectomy. Participants (56.9%) viewed vasectomy as castration,while the odds of accepting vasectomy correlated with religion (Catholic Odds Ratio =0.451, 95% CI=0.02- 0.854, P. value< 0.040).Approving that men should be primarily responsible for decision making on family planning method to utilize increases with academic attainment and vice versa(secondary OR=2.937, 95%CI=1.647-6.286 ,P.value < 0.011), (university level OR=3.456, 95%CI=2.242-8.445,P.value=0.014.). Conclusion: Vasectomy is misconceived and underutilized, thus is associated with negative attitudes and rumors limiting its usage among men. Therefore there is a need for a community-based educational program development. It is recommended to specifically include vasectomy in existing family planning educational programs. Furthermore, Vasectomy services need to be decentralized to primary health care facilities.