Making the connection between vasectomy, family planning goals and development

Dominick ShattuckWorld Vasectomy Day offers an opportunity to consider how vasectomy can contribute to development. This underused contraceptive method is particularly important as countries work toward achieving the Family Planning 2020 goals, which include providing an additional 120 million women and girls in the world’s 69 poorest countries with access to voluntary family planning information, services and supplies by 2020.

The number 120 million is a lot of women and girls to reach, and it raises an important question: What role do men play in achieving this target?

Robust family planning initiatives protect women’s and children’s health, help fight HIV infection, reduce abortion and give women control over when they become pregnant.1 When experts and leaders from 150 countries gathered for the 2012 London Summit on Family Planning, they recognized that providing comprehensive access to contraceptives is both beneficial and achievable. They identified metrics to measure their success.

Vasectomy programs can make a strong contribution to fulfilling the Family Planning 2020 goals while allowing men to more fully participate in family planning. Vasectomy is safe, effective and one of the least expensive contraceptive methods.2 Vasectomies are provided more quickly — and are safer— than female sterilization.3

Vasectomy is being “reintroduced” in some African countries, but the method continues to face challenges, including a lack of strong infrastructure and staffing, limited marketing, a lack of general health services for men and plain old machismo.4

One country that is making big gains in contraceptive uptake is Ethiopia, the second most populous country in Africa. According to the most recent Demographic and Health Survey report, Ethiopia seeks to increase its contraceptive prevalence rate (CPR) to 66 percent by 2015 from a current rate of 28.6 percent among married women. If Ethiopia achieves this increase, while maintaining its current contraceptive method mix, the total number of married women using contraceptives will increase from approximately 1.3 million to almost 2.9 million.5 In terms of couple years of protection (CYP), which provides a contraceptive protection value for each contraceptive method being used, this translates to a total of 2.17 million CYP, from the current rate of 947,000 CYP.

If Ethiopia were to provide 28,869 vasectomies, the country’s total CYP would increase approximately 300,000 to about 2.5 million. This change could also prevent an additional 298 maternal and 4,258 infant deaths.6 The country could achieve the same impact by using its current contraceptive method mix, but this would require significantly higher numbers of medical visits by women, more client interactions for staff, a higher risk of discontinuation and greater costs. Female sterilization could yield a similar impact as vasectomy, but the method is significantly more dangerous and costly. In this case, adding vasectomy to the contraceptive mix would make an important difference.7

There is no better time to recognize the potential impact of vasectomy. Men’s role in the family, including family planning, continues to evolve, and vasectomy can contribute to this process for the better while increasing contraceptive choices and supporting global development.

1 U.S. Agency for International Development.
2 Tumlinson K, Steiner MJ, Rademacher KH, Olawo A, Solomon M, Bratt J. The promise of affordable implants: Is cost recovery possible in Kenya? Contraception. 2011;83(1):88-93.
3 American Urological Association.
4 Jacobstein R, Pile JM. Vasectomy: The unfinished agenda [working paper]. New York: EngenderHealth, ACQUIRE Project; 2007.
5 American Urological Association.
6 Central Statistical Agency [Ethiopia], ICF International. Ethiopia demographic and health survey 2011. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ICF International; 2012.
7 American Urological Association.

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