A STUDY ON THE KNOWLEDGE AND ACCEPTANCE OF MEN TOWARDS VASECTOMY AS A METHOD OF CONTRACEPTIVE AMONG MALE STAFF

1.1 Introduction

Vasectomy is a permanent method of family planning involving a surgical process where the service provider cuts the vasa differentia, through which sperm travel from the testicles to combine with semen making the semen sperm free. Vasectomy is also an effective contraceptive method that has been approved worldwide and proven to be an effective method of contraception among males in the perspective of controlling a population. Vasectomy is effective, safe and cheap to perform and has few side effects (Kols and Lande, 2008). Vasectomy or male sterilization is a method of contraceptive that involves incision, occlusion or excision of a portion of the vas deferens. It is perceived to be a form of castration, which can make men weak and incapable, thereby unable to satisfy their wives sexually, leading to marital conflicts.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

Vasectomy is a simple effective and safe surgical procedure for permanent male fertility control. The procedure which simply interrupts the delivery of sperm has no effect on either the production of male sex hormones (mainly testosterone) or their secretion into the bloodstream (Wright et al., 2005). According to the Population Reference Bureau (PRB) family planning worldwide report (Dassow et al., 2006); vasectomy made up only 7% of all modern contraceptive use worldwide. Furthermore, studies have shown high acceptance rates of vasectomy in developed countries like the USA and Australia (FPWDS, 2002; Barone et al., 2004); while vasectomy prevalence is low in most developing countries especially in Asia and Africa, where it rarely exceeds 0.1% (Holden et al., 2005). For instance a study conducted in India among rural men shows that 82.7% of the study population had heard about vasectomy. But, only about 22% were ready to accept vasectomy as a contraceptive method. In addition, of the total married men in the study, only one man had undergone vasectomy procedure. Of the men who were married and not undergone any permanent method of contraception, only few men were willing to accept vasectomy as a method in future (Bunce et al., 2007).

In Nigeria, family planning services including the permanent methods have been almost directed at women exclusively with little attention paid to men which has resulted in negative attitudes to permanent family planning methods among men. For instance, a Nigerian study found that only a small percentage of men reported even considering undergoing vasectomy (Suwarna et al., 2015). Furthermore, according to the Nigerian Demographic Health Survey 2013, 26.90% of all men interviewed in Nigeria have knowledge of male sterilization as a type of family planning and 30.40% of currently married men have knowledge of male sterilisation as a type of family planning. This is also similar to a report in Ethiopia which reported low knowledge on permanent contraceptive methods, particularly vasectomy (Akpamu et al., 2010). In the same vein, the perception of men towards vasectomy in some African countries has been found to be low (Alem et al., 2014).

Similarly, while family planning services have mainly targeted women over the past decades, thus there is a growing recognition that reproductive health is the joint responsibility of men and women and as such both should be adequately involved and targeted in its services; given that men often have significant influences on the choice of a couple’s contraceptive use (Kabagenyi et al., (2014).

The patronization of contraceptives has increased in many parts of the world with the intension of controlling the population growth rate (World Health Organization, 2015). Worldwide, great effort has been made towards reducing the fertility rate through family planning. Family planning plays a significant role in the reduction of infant, child, maternal mortality and morbidity (Onasoga, Edoni&Ekanem, 2013).

Contraception or family planning comes with different types of methods ranging from short term, long term, permanent and emergency methods (WHO, 2016). Complications of vasectomy include hematoma formation, infection, sterilization failure, sperm granulomas, short-term postoperative pain (nodal pain, scrotal pain, and ejaculation pain), and chronic pain syndrome (Pant et al., 2007). The long-term safety of vasectomy is mainly threatened by cardiovascular disease, testicular or prostate cancer, long-term loss of sexual function after the operation, and the formation of antisperm antibodies (AsAbs) (Labrecque et al., 2002).

Therefore, in Central Hospital, Agbor where the research was carried out, the activities that was conducted is to know the Knowledge and Acceptance of Men towards Vasectomy.

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1.3 Statement of Problems

Investigation revealed that the fact that the use and effectiveness of vasectomy has not been effectively evaluated and documented, leading to lack of information on vasectomy as an effective family planning method in Nigeria, has lead to a general reluctance by men to adopt vasectomy as a family planning method. Developing a framework whereby fertility behaviour is seen not only as the outcome of effects of well known intermediate and proximate determinants of fertility, but also as a result of the combined roles of the knowledge, attitude, and influence of attitude e.g media exposure, spousal communication and social-cultural environment of the people, on uptake of vasectomy. These determinants indeed constitute the subsurface forces to which lot more attention needs to be considered (Kols and Lande, 2008).

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1.4 Aim and Objectives of Study

The aim of the study is to examine the Knowledge and Acceptance of Men towards Vasectomy as a Method of Contraceptive among Male Staff at Central Hospital, Agbor. In achieving this aim, the following specific objectives were laid out as follows:

1. To investigates the level of knowledge and acceptance of vasectomy among married men in the area under study.
2. To explore men’s knowledge on vasectomy as a family planning option.
3. To explore the influence of attitude on the choice of vasectomy as a family planning method.
4. To determine the attitude of men towards Vasectomy as a method of family planning in the area under study.

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• Does attitude influence the choice of vasectomy as a family planning method?
• What is the knowledge of men on vasectomy as a method of family planning?
• What attitude do men have regarding vasectomy as a family planning method?
• What is the level of knowledge and acceptance of vasectomy among married men in the area under study?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There is no significant factor inhibiting the acceptance of vasectomy as a family planning option among Men in Central Hospital, Agbor
• H1: There is a significant factor inhibiting the acceptance of vasectomy as a family planning option among Men in Central Hospital, Agbor

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1.7 Significance of Study

The relevance of this research will prompt more pro-active inclusion of vasectomy as a family planning method in Nigeria, training more service providers and availing better facilities. The study focused on qualitative data- that is try to get the men and women tell us in their own words why they may /may not adopt vasectomy as a method of family control. It aid at understanding the true determinants of male attitude towards choice of vasectomy. The findings of this study will also serve as a theoretical contribution to the debates surrounding vasectomy, which much is not documented on, in Central Hospital, Agbor.

This study will be of immense benefit to other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.

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1.8 Scope of Study

The scope of the research is focused on the Knowledge and Acceptance of Men towards Vasectomy as a Method of Contraceptive among Male Staff at Central Hospital, Agbor.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Research material: availability of research material is a major setback to the scope of the study.
3. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
4. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Definition of Terms

Vasectomy: Vasectomy is a permanent method of family planning involving a surgical process where the service provider cuts the vasa differentia, through which sperm travel from the testicles to combine with semen making the semen sperm free.