title: Who chooses vasectomy in Rwanda? Survey data from couples who chose vasectomy, 2010-2012.
abstract: BACKGROUND
  Vasectomy is safe and highly effective; however, it remains an underused method of family planning (FP) in Africa. In view of this, three Rwandan physicians were trained in no-scalpel vasectomy with thermal cautery and fascial interposition on the prostatic end as vasectomy trainers in 2010, and this initiative has resulted in over 2900 vasectomy clients from February 2010 to December 2012.
  
  
  METHODS
  This cross-sectional descriptive study describes vasectomy clients (n=316) and their wives (n=300) from 15 randomly selected hospitals in Rwanda.
  
  
  RESULTS
  The vasectomy clients were mainly over age 40, had young children (age <3) and were married and cohabiting. Limited financial resources, satisfaction with existing family size and avoiding side effects from hormonal methods (wives') were key motivators for vasectomy uptake. High rates of previous FP use and high degree of interspousal communication are known correlates of higher FP use.
  
  
  CONCLUSIONS
  Future and current Rwandan FP programs and other interested parties will benefit from understanding which couples elect vasectomy, their motivations for doing so and their service utilization experiences. Better integration of vasectomy counseling and postvasectomy procedures will benefit the program.
  
  
  CONCLUSIONS
  Until this project, vasectomy projects in sub-Saharan Africa were viewed as unrealistic. This study confirms factors influencing vasectomy uptake identified in earlier research, but does so within a robust sample of vasectomy users and their wives and provides a strong understanding of who likely vasectomy users are in this context. Promotion of vasectomy services should be considered as an essential element of a healthy contraceptive method mix.
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Dominick
authors.initials: D
authors.lastname: Shattuck
authors.affiliation: FHI 360, Kigali, Rwanda.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wesson
authors.affiliation: FHI 360, Kigali, Rwanda.
authors.forename: Theophile
authors.initials: T
authors.lastname: Nsengiyumva
authors.affiliation: Rwanda Ministry of Health, Kigali, Rwanda.
authors.forename: Leonard
authors.initials: L
authors.lastname: Kagabo
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Helen
authors.initials: H
authors.lastname: Bristow
authors.affiliation: FHI 360, Durham, NC, USA.
authors.forename: Trinity
authors.initials: T
authors.lastname: Zan
authors.affiliation: Rwanda Ministry of Health, Kigali, Rwanda.
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
mesh_terms: D000328:Adult; D003151:Community Health Centers; D003268:Contraception Behavior / Q000208:ethnology; D003430:Cross-Sectional Studies; D019049:Developed Countries; D005193:Family Planning Services; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology; D006297:Health Services Accessibility; D006767:Hospitals, District; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009679:Nuclear Family / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D017060:Patient Satisfaction / Q000208:ethnology; D012432:Rwanda; D062211:Spatio-Temporal Analysis; D014659:Vasectomy / Q000009:adverse effects; D055815:Young Adult
keywords: Africa; Male involvement; Rwanda; Surgical sterilization; Vasectomy