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Table of Contents
ORIGINAL ARTICLE
Year : 2023  |  Volume : 28  |  Issue : 1  |  Page : 50-53

Determinants of female health workers’ attitude toward spouses’ use of vasectomy for family planning


1 Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Enugu, Nigeria
2 Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology, Enugu, Nigeria

Date of Submission29-Jun-2022
Date of Decision01-Aug-2022
Date of Acceptance05-Oct-2022
Date of Web Publication13-Dec-2022

Correspondence Address:
Eric E Asimadu
Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmh.IJMH_54_22

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  Abstract 

Background: Vasectomy is an effective and safe surgical method of male contraception. It is simpler than female tubal ligation and has fewer complications. Objective: The aim of this study was to determine the effect of selected demographic characteristics on female health workers’ attitudes to spouses’ use of vasectomy for birth controlMaterials and Methods: This was a cross-sectional study of female health workers in two tertiary health institutions in Enugu, Southeast Nigeria. Data were collected using a pretested structured self-administered questionnaire. Data were collected on sociodemographic characteristics and attitudes toward vasectomy. Results: Two hundred and ninety female health workers completed the questionnaire. The mean age of participants was 32.26 ± 9.39 years. Approximately 66.6% of the women were less than 35 years and 53.1% were married. Only 21.0% of the respondents would encourage their spouses or partners to undergo vasectomy after they have had their desired number of children. Half of the women (50.0%) would prefer to have their tubes tied (tubal ligation) and 63.1% had never discussed vasectomy with their spouses or partners. Younger women (<35 years) were significantly more likely to encourage their spouses/partners to have a vasectomy (odds ratio [OR] 2.1289; P = 0.0231). However, ever-married women (OR 0.1296; P = 0.0000) and women who have had children (OR 0.1767; P = 0.0000) were significantly less likely to do the same. Nurses were more likely to encourage their spouses to undertake vasectomy compared to doctors (OR 2.4750; P = 0.0041). Conclusion: Vasectomy is not widely accepted among our female health workers; only a fifth of them would encourage their spouses/partners to have a vasectomy.

Keywords: Attitude, family planning, female, health workers, vasectomy


How to cite this article:
Menuba IE, Asimadu EE, Nweze SO. Determinants of female health workers’ attitude toward spouses’ use of vasectomy for family planning. Int J Med Health Dev 2023;28:50-3

How to cite this URL:
Menuba IE, Asimadu EE, Nweze SO. Determinants of female health workers’ attitude toward spouses’ use of vasectomy for family planning. Int J Med Health Dev [serial online] 2023 [cited 2023 Feb 8];28:50-3. Available from: https://www.ijmhdev.com/text.asp?2023/28/1/50/363255




  Introduction Top


Vasectomy is a safe, effective, and permanent method of contraception for men who do not want any more children. It is a simple surgical operation to divide the two vas deferens in the testes. It is a simpler procedure than bilateral tubal ligation (BTL), requires less recovery time and has less risk of complications, and is more cost-effective.[1] This operation prevents spermatozoa from leaving the testis into semen. It has a failure rate of less than 1%.[2]

Nigeria is the most populous African nation with its population estimated to be over 211.4 million people, an average annual population growth rate of 2.6%, a contraceptive prevalence rate of 17%, and a total fertility rate of 5.2 children per woman.[3] Vasectomy accounts for 5.4% of contraceptive use in developed countries as compared with 1.9% in developing countries, with the rate in West Africa and Nigeria at 0.0%.[4] Nigeria also has one of the highest maternal mortality rates in the world with a maternal mortality ratio of 917 maternal deaths per 100,000 live births estimated in 2017.[3] There is a low level of knowledge of vasectomy as a family planning method in poor developing countries[5] and its uptake is hampered by myths and misconceptions such as it being a form of castration.[6] Thus, uptake of vasectomy has remained low in Nigeria, despite its proven safety and effectiveness as a family planning method.

The majority of the family planning methods target the female population. However, within traditional African families, reproductive health decisions have to be approved by husbands. Thus, programs that target men will help address this imbalance. The increased use of vasectomy will also increase male involvement in family planning. Female health workers have good knowledge of different forms of contraception,[7],[8] and their support of their spouse’s use of vasectomy for birth control may increase its uptake.

This study aimed to determine the effect of selected demographic characteristics on female health workers’ attitudes to spouses’ use of vasectomy for birth control


  Materials and Methods Top


This was a cross-sectional study at the University of Nigeria Teaching Hospital and Enugu State University of Science and Technology Teaching Hospital, Enugu, Nigeria. Study participants were female health workers comprising female medical doctors, dentists, nurses, medical laboratory scientists, pharmacists, optometrists, and physiotherapists. Written informed consent was obtained from each participant before recruitment into the study, and ethical approval was obtained from the Ethics Committee of UNTH, Ituku-Ozalla, Enugu (UNTH/CSA/329/OL.5: NHREC/05/01/2008B-FWA00002458-1RB00002323). All the guidelines outlined in the Declaration of Helsinki.

Data were collected using a pretested structured self-administered questionnaire. Data were collected on sociodemographic characteristics, knowledge, and attitudes toward vasectomy.

It was coded and analyzed using Epi Info software. Descriptive and inferential statistics were calculated, and the P value was set at P < 0.05.


  Results Top


Two hundred and ninety female health workers completed the questionnaire. The mean age of the study participants was 32.26 ± 9.39 years.

[Table 1] shows the sociodemographic characteristics of the respondents. Approximately 66.6% of the women were less than 35 years and 53.1% were married. [Table 2] shows the women’s attitude toward vasectomy. Fifty percent of the respondents would prefer to have their tubes tied (tubal ligation) and 63.1% had never discussed vasectomy with their spouses or partners. [Table 3] shows the association of various sociodemographic characteristics of the women and their attitude toward vasectomy. Age less than 35 years (odds ratio [OR] 2.1289, 95% confidence interval [CI] 1.0995–4.1222, P = 0.0231), Pentecostal Christian women (OR 4.2, 95% CI 2.0068–8.7903, P = 0.0001), and nurses (OR 2.4750, 95% CI 1.3196–4.6420, P = 0.0041) were significantly more likely to encourage their spouses/partners to have a vasectomy. However, ever-married (married, separated, or divorced) respondents (OR 0.1296, 95% CI 0.0681–0.2461, P = 0.0000) and those who have had children (OR 0.1767, 95% CI 0.0932–0.3351, P = 0.0000) were significantly less likely to encourage their spouse/partners to have a vasectomy.
Table 1: Sociodemographic characteristics of the respondents

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Table 2: Attitude of respondents to vasectomy

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Table 3: Determinants of respondents’ attitude to vasectomy after completion of family size

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  Discussion Top


This population of female health workers studied were mostly nurses and doctors, 37.9% and 45.5%, respectively (total of 83.4%). Twenty percent would encourage their spouses to have a vasectomy after completion of their family size. Approximately 8.6% of the women would prefer to have a BTL, and only 17.9% had ever discussed vasectomy with their partner or spouse. In a study on barriers and facilitators of vasectomy among couples in Iran, 10.08% and 21.16% would agree or extremely agree to have a tubal ligation rather than a vasectomy.[9]

Women less than 35 years of Pentecostal Christian faith nurses were significantly more likely to encourage their spouses/partners to have a vasectomy after they have completed their desired family size. However, women who were “ever married” and had children were significantly less likely to encourage their spouses or partners to have a vasectomy after the completion of their desired family size. Thus, even among female health workers, the majority of the women would not encourage their spouses or partners to have a vasectomy. In a study among married men and women in Lagos, Nigeria, 92% of the men who were willing to have a vasectomy would only go with the procedure if their spouses supported them to do so.[10] The study did not find age, religion, or number of children to significantly affect the attitude of their female study participants to vasectomy. Among medical students in a private Malaysian medical school with a mean age of 22 years, 69.1% of the respondents agreed that vasectomy was a good choice for family planning among couples with their desired number of children.[8]

A study among resident doctors in Nigeria found that more than four-fifths of those interviewed did not believe that vasectomy was an acceptable mode of family planning for the Nigerian men, rather preferring tubal ligation as more acceptable in our sociocultural setting.[11] Of the studied population of resident doctors, approximately 43% said they would either use or encourage their spouses to use vasectomy, much higher than the 20% in our study population who would encourage their partners or spouses to have a vasectomy when they had had their desired number of children. In another study among married men and women in Lagos, Nigeria, only 19% would encourage their spouses to have a vasectomy,[8] similar to findings in this study. A study among women attending antennal clinics in Jos, north-central Nigeria found that 82.3% would not accept vasectomy.[12]

Only 17.9% of our respondents had ever discussed vasectomy with their spouses or partners. In a study among healthcare professionals and clinical medical students on their attitudes and practices of contraception in Cape Coast, Ghana, only approximately 48.8% had discussed contraceptive use with their partners.[13] This may indicate that discussion about contraceptive use of any kind is still not very common among partners.

The main limitation of this study is that it was a questionnaire-based study, and there could thus be recall bias.

In conclusion, only a fifth of our respondents would encourage their spouse or partners to undergo vasectomy after they have had their desired number of children and completed their family size. Four-fifths of the respondents would not encourage their partners/spouses to have a vasectomy. Thus, vasectomy still is not well accepted within our population, even among health workers.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Schwingl PJ, Guess HA Safety and effectiveness of vasectomy. Fertil Steril 2000;73:923-36.  Back to cited text no. 1
    
2.
Shih G, Turok DK, Parker WJ Vasectomy: The other (better) form of sterilization. Contraception 2011;83:310-5.  Back to cited text no. 2
    
3.
United Nations Population Fund-UNFPA. World population dashboard –Nigeria 2021. Available from: https://www.unfpa.org/data/world-population/NG. [Last accessed on 25 Oct 2021].  Back to cited text no. 3
    
4.
UN Department of Economic and Social Affairs-Population Division 2014. World contraceptive patterns wall chart; 2013. Available from: http://www.un.org/en/development/desa/population/publications/pdf/family/worldContraceptivePatternsWallChart2013.pdf. [Last accessed on 25 Oct 2021].  Back to cited text no. 4
    
5.
Jacobstein R The kindest cut: Global need to increase vasectomy availability. Lancet Glob Health 2015;3:e733-4.  Back to cited text no. 5
    
6.
Ezegwui HU, Enwereji JO Attitude of men in Nigeria to vasectomy. Int Health 2009;1:169-72.  Back to cited text no. 6
    
7.
Bhargava S, Hooja N, Nawal R, Kumawat B, Sharma A, Manish R Knowledge and behaviour regarding birth prevention of healthcare providers. J Obstet Gynaecol India 2017;67:282-5.  Back to cited text no. 7
    
8.
Ebeigbe PN, Igberase GO, Eigbefoh J Vasectomy: a survey of attitudes, counseling patterns and acceptance among Nigerian resident gynaecologists. Ghana Med J 2011;45:101-4.  Back to cited text no. 8
    
9.
Keramat A, Zarei A, Arabi M Barriers and facilitators affecting vasectomy acceptability (a multi stages study in a sample from North Eastern of Iran), 2005-2007. Asia Pac Fam Med 2011;10:5.  Back to cited text no. 9
    
10.
Ohn Mar S, Ali O, Sandheep S, Husayni Z, Zuhri M Attitudes towards vasectomy and its acceptance as a method of contraception among clinical-year medical students in a Malaysian private medical college. Singapore Med J 2019;60:97-103.  Back to cited text no. 10
    
11.
Tijani KH, Ojewola RW, Yahya GL, Oluwole AA, Odusanya B Attitudes and acceptance of Nigerians towards vasectomy: A comparison of married men and women in Lagos. East Afr Med J 2013;90:89-94.  Back to cited text no. 11
    
12.
Utoo BT, Mutihir TJ, Utoo PM Knowledge, attitude and practice of family planning methods among women attending antenatal clinic in Jos, North-Central Nigeria. Niger J Med 2010;19:214-8.  Back to cited text no. 12
    
13.
Agbeno EK, Osarfo J, Anane-Fenin B, Achampong EK, Neequaye NA, Opoku DA, et al. Attitudes and practices of healthcare professionals and clinical medical students on contraception: A cross-sectional study in cape coast, Ghana. Int J Reprod Med 2021;2021:6631790.  Back to cited text no. 13
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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