title: "If you do vasectomy and come back here weak, I will divorce you": a qualitative study of community perceptions about vasectomy in Southern Ghana.
abstract: BACKGROUND
  Male involvement in contraceptive use is increasingly becoming a global reproductive health issue. Vasectomy is one of the two male modern contraceptive methods espoused by the National Family Planning Policy in Ghana. Despite these advocacies, there are reports of low patronage of this method in Ghana. This study adhering to RATS guidelines on qualitative research therefore explored the social and cultural factors that may be affecting the low vasectomy uptake in Southern Ghana.
  
  
  METHODS
  The study was conducted in Sefwi Bibiani-Ahwiaso Bekwai (SBAB) District and Komenda-Edina-Eguafo-Abrem (KEEA) Municipal area in the Western and Central regions of Ghana respectively. Twelve Focus Group Discussions were held with both male and female community members. In-depth interviews were also carried out with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and health managers at both the district and regional levels. The discussions and interviews were recorded, transcribed verbatim and analysed using Nvivo 10.
  
  
  RESULTS
  The study revealed that vasectomy was perceived as an act against God, which was punishable either by death or answerable on judgement day. Vasectomy was also 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. Women were more concerned about the negative effects of vasectomy on men. Cafalgin and panacin which are locally manufactured analgesics were perceived to have contraceptive abilities and therefore used by men as an alternative to modern contraceptive methods.
  
  
  CONCLUSIONS
  Stigma and the misconceptions in the community may be accounting for the low vasectomy uptake in Ghana despite several advocacy strategies. Women were highly influential in a man's decision on vasectomy. This calls for the need to increase health education to demystify the misconceptions about vasectomy. Vasectomy-related campaign messages should target both men and women.
authors.affiliation: Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, P, O, Box LG 13, Accra, Ghana. adongophilip@yahoo.com.
authors.forename: Philip Baba
authors.initials: PB
authors.lastname: Adongo
authors.forename: Placide
authors.initials: P
authors.lastname: Tapsoba
authors.forename: James F
authors.initials: JF
authors.lastname: Phillips
authors.forename: Philip Teg-Nefaah
authors.initials: PT
authors.lastname: Tabong
authors.forename: Allison
authors.initials: A
authors.lastname: Stone
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kuffour
authors.forename: Selina F
authors.initials: SF
authors.lastname: Esantsi
authors.forename: Patricia
authors.initials: P
authors.lastname: Akweongo
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception; D003268:Contraception Behavior; D003469:Culture; D004243:Divorce; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008571:Men; D008875:Middle Aged; D010465:Perception; D036301:Qualitative Research; D012111:Residence Characteristics; D014659:Vasectomy / Q000706:statistics & numerical data*; D014930:Women; D055815:Young Adult