The Ghana vasectomy initiative: facilitating client-provider communication on no-scalpel vasectomy.
OBJECTIVE
In 2003-2004 and 2007-2008, an initiative was implemented to improve client and provider knowledge and acceptance of no-scalpel vasectomy (NSV) in Ghana.


METHODS
At eight facilities, physicians were trained in NSV and staff received training in the provision of "male-friendly" services. Health promotion activities provided NSV information to prospective clients. Client-provider communication was assessed via a mystery client study (n=6). Knowledge and acceptance of NSV among potential clients were assessed with baseline and follow-up surveys (each n=200) in 2003-2004 and three follow-up panel surveys in 2008 (each n=240).


RESULTS
Trained health staff exhibited improved attitudes and knowledge regarding NSV. Mystery clients reported receiving accurate, nonjudgmental NSV counseling. Awareness of NSV among panel respondents doubled from 31% to 59% in 2003-2004 and remained high (44%) in 2008. The proportion of men who would consider NSV increased from 10% to 19% in 2007-2008. NSV procedures increased three-fold from 2003 (n=26) to 2004 (n=83) and 2007 (n=18) to 2008 (n=53).


CONCLUSIONS
Provider training in client-centered services, coupled with targeted health promotion, improved client and provider knowledge and acceptance of NSV in an African context.


CONCLUSIONS
Complementary, sustained provider training and health promotion are needed to maintain NSV service quality and acceptance.
RESPOND Project, EngenderHealth, New York, NY 10001, USA. laura.sita@post.harvard.edu
Laura
L
Subramanian
Cindi
C
Cisek
Nicholas
N
Kanlisi
John M
JM
Pile
D003142:Communication; D005500:Follow-Up Studies; D005869:Ghana; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D010817:Physician-Patient Relations; D034121:Reproductive Health Services / Q000458:organization & administration; D014659:Vasectomy / Q000379:methods*