Current and future role of voluntary surgical contraception in increasing access to and utilization of family planning services in Africa.
BACKGROUND
Voluntary surgical contraception is the most widely utilized method of contraception in the world. High effectiveness, low complication rates and reduced cost in the long term make them the ideal contraceptive choice to diverse group of clients including clients from low resource settings.


OBJECTIVE
To assess the current status of utilization and effectiveness of voluntary surgical contraception in Africa and suggest possible future roles in contraceptive method choice.


METHODS
A review of available literature on voluntary surgical contraception and synthesis of information under relevant headings.


RESULTS
Despite very high total fertility rates in most countries of Africa, surgical contraceptives still contribute to a very small proportion ofcontraceptive method choice in the continent. Client profile and acceptability studies indicate a large unmet need for permanent contraception in the continent. Lack of information, misconceptions and weak health systems (particularly surgical care) are the major impediments to increasing availability of surgical contraception. Lack of knowledge and low levels of motivation among health care providers may also be significant barriers to access.


CONCLUSIONS
Ihcreasing availability of information on the safety and effectiveness of these methods to both health care providers and the general population can increase demand and acceptability. Delegating service provision to appropriately trained non-physician providers at primary care settings can assist in increasing accessibility of these important family planning methods.
UNICEF Ethiopia, P.O.Box 20106-1000, Addis Ababa, Ethiopia. ashebergaym@gmail.com
Asheber
A
Gaym
D000349:Africa; D005193:Family Planning Services / Q000706:statistics & numerical data*; D006266:Health Education; D006297:Health Services Accessibility; D006801:Humans; D013246:Sterilization, Tubal / Q000009:adverse effects / Q000706:statistics & numerical data*; D014659:Vasectomy / Q000009:adverse effects / Q000706:statistics & numerical data*