More men opt for vasectomy for family planning

Vincent Karangwa, 40, is a father of five. The resident of Bwisyhura Sector, Karongi District in Western Province realised 10 years ago that he was risking bringing into the world children he may not be able to support. So, after consulting his wife, she was put on contraception pills, with advice from a health centre, to prevent any more unwanted pregnancies. “However adhering to this method became extremely challenging; the tablets gave her extreme nausea, unnecessary weight gain, and sometimes missed her menstruation periods. Some days she forgot to swallow the pills, risking an unwanted pregnancy,” he said. Karangwa notes that his wife had to live with the inconvenience and uncertainty of using pills until four years ago when he heard over a local radio station, a medical worker explaining how vasectomy works to prevent unwanted pregnancies. Vasectomy is a permanent contraception method for men, where, a surgical procedure is performed, cutting and sealing tubes that carry sperm from the testicles to the seminal vesicles—making it impossible for a man to impregnate a woman. He shared the message with his wife and a few days later, they visited the district hospital and had the less-than-30 minutes operation performed for free. “Now we can plan for the future of our children without fear of having extra accidental ones,” Karangwa said. Anastase Kanyamahanga, 50, the president of Turuhure Abagore Bacu, an association of vasectomy beneficiaries based in Rulindo District, Northern Province, said myths people have often told about vasectomy are diminishing because of sensitization. This has resulted in many men opting for the procedure. “About a year ago, we had about 50 members, but this has now grown to 158,” he said. Vasectomy, a relatively uncommon family planning method in Rwanda, was piloted in Muhanga, Rulindo, Nyabihu and Gicumbi Districts in 2010 by the Ministry of Health. It has now been rolled out to more public health facilities country-wide. Dr Rushanika Christopher, a vasectomy specialist working with Byumba Hospital, Gicumbi District in Northern Province, dispels fears that the operation causes erectile failure. “Of all the 3,000 plus men who have undergone vasectomy country-wide, I have not heard of any complaining of side effects,” he said. According to the Ministry of Health, the number of vasectomy beneficiaries had risen from just 2,500 in 2012 to 3,200 as of May 2013. The same report shows that the ratio of men to women who had acquired some form of permanent contraception was 1:3. As of may last year, Nyabihu, Gicumbi and Rulindo districts were the leading countrywide as far as vasectomy subscription is concerned. A 2013 study conducted by FHI 360, a US non-government organisation working in the area of human development, estimated that every 1,000 vasectomies would avert 12 maternal deaths and 125 infant deaths in Rwanda. The 2010 Rwanda Demographic Health Survey (DHS) indicates that maternal mortality stands at 4.87 deaths per 1,000 live births and infant mortality (before the age of 1) at 50 per 1,000 live births. “Married men with a mean age of 45 years had a mean number of 5.5 children and 59 percent of them had children under three years old,” the report says. In Rwanda, national guidelines require each vasectomy client to be more than 30 years old and to have a signed consent from his wife. A total of 64 doctors and 103 nurses from 42 hospitals in all 30 districts in Rwanda had been trained in the technique as of last year. The national census of 2012 in Rwanda showed that contraceptive prevalence increased from 10 per cent in 1990 to 45 per cent in 2012. The census result showed that women in rural areas have 4.8 children on average, compared with 3.4 children on average per woman in urban areas. According to information from the United Nations Population Fund (UNFPA) Rwanda, 19% of women in the country would want to have fewer children than they have now but they don’t because of limited access to contraceptives. The rise in the rate of married or cohabiting women using a modern method of contraception; from just 4% in 2000 to 44% in 2010.

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More men opt for vasectomy for family planning