Perceptions and Experiences Regarding Vasectomy Among Vasectomized Men at Larterbiokorshie.

BackgroundVasectomy is 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. Although safer, simpler, less expensive and equally as effective as female sterilization, throughout the world, it is one of the least used and least known methods of contraception. 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. The study aimed at determining perceptions and experiences regarding vasectomy among vasectomized men at Larterbiokorshie. MethodsThis study adopted a qualitative method utilizing Phenomenological research design. The sample consisted of 18 vasectomized men selected through purposive sampling method. Face-face interviews were conducted with participants using a semi-structured interview guide. ResultsThe study discovered that the vasectomized men have a positive perception about vasectomy in terms of promoting couples sexual Health. Nevertheless, public perception regarding vasectomy was found to be poor. Socio-cultural and religious factors were also found to influence vasectomy uptake. In addition, several reasons were cited for motivating men regarding their decision on vasectomy and finally, participants shared their experiences following their vasectomy. ConclusionConclusively, despite all the misconceptions and concerns raised about vasectomy, the study revealed a positive perception among the vasectomized men. The study recommends that the government should formulate policies which will improve the utilization of vasectomy through ongoing monitoring and evaluation of services.

The Swedish study on improved contraceptive counselling for immigrant women postpartum

Contraceptive choices postpartum have not previously been studied in Sweden. Being foreign born is a risk factor for induced abortion. Improving postpartum contraceptive counseling could potentially fulfill unmet needs for contraception. This is an organizational case study using a Quality Improvement Collaborative (QIC) within the regular healthcare setting at 3 maternal health clinics in Stockholm. The active phase of the study was Sep2018-Sep2019. Quantitative and qualitative methods were combined. Routine registration of choice of postpartum contraception was introduced at the clinics and analyzed focusing on Swedish born and foreign-born women. Midwives and researchers met continuously, and during the active phase every 2-3 months in learning seminars with around 20 participants. During the learning seminars PDSA-cycles were used and areas of improvements for continuous performance measures were chosen. The midwives decided on and tested multiple evidence-based changes in contraceptive counselling and services during action periods. Goals were set and competency building in areas chosen by the midwifes were held. In addition, both foreign- and Swedish born women gave their input to the improvement areas. Qualitative data was analyzed through content analysis from field notes and verbatim transcripts. Preliminary results show that the proportion of women choosing an effective contraceptive method (SARC or LARC) among immigrant women increased from 40% to 55% when comparing the start and the end of the project. The midwives reported how they had changed their approach when counselling women who were skeptical about contraception and tried to find a new way to meet women's needs. As much as the QIC showed positive results, it was a small-scale study in 3 clinics in one geographical area. A larger study to determine and explain the effectiveness of QIC on the proportion of immigrant women choosing an effective contraceptive method postpartum is planned for 2021-2024.

The progesterone-only pill

The progesterone-only pill is a popular and effective contraceptive method. It is particularly useful when either an oral method of contraception is preferred or there are contraindications to the combined pill. It is taken daily without a pill-free interval, and works mainly by increasing the cervical mucus. Desogestrel also inhibits ovulation. The progesterone-only pill is useful for those needing a reliable form of contraception within a short period, as it is effective after 48 hours when ‘quick started’. This article reviews current guidelines and answers some common clinical queries.

Dual Method Use among Postpartum HIV-Infected and HIV-Uninfected Malawian Women: A Prospective Cohort Study

Dual method use, use of condoms plus another effective contraceptive method, is important in settings with high rates of unintended pregnancy and HIV infection. We evaluated the association of HIV status with dual method use in a cohort of postpartum women. Women completed baseline surveys in the postpartum ward and telephone surveys about contraceptive use 3, 6, and 12 months later. Nonpregnant women who completed at least one follow-up survey were eligible for this secondary analysis. Prevalence ratios were calculated using generalized estimating equations. Of the 511 sexually active women who completed a follow-up survey, condom use increased from 17.6% to 27.7% and nonbarrier contraceptive use increased from 73.8% to 87.6% from 3 to 12 months after delivery. Dual method use increased from 1.0% to 18.9% at 3 to 12 months after delivery. Dual method use was negligible and comparable between HIV-infected and HIV-uninfected women at 3 months but significantly higher among HIV-infected women at 6 months (APR = 3.9, 95% CI 2.2, 7.1) and 12 months (APR = 2.7, 95% CI 1.7, 4.3). Dual method use was low but largely driven by condom use among HIV-infected women at 6 and 12 months after delivery.

Low Rates of Vasectomy Among Minorities: A Result of Differential Receipt of Counseling?

Male sterilization is a highly effective contraceptive method that is underused especially among minorities. This analysis examined the association between race/ethnicity and receipt of sterilization counseling. This study used data collected by the 2002 National Survey of Family Growth. The analysis included men 15 to 44 years old who had not undergone sterilization. The outcome was receipt of sterilization counseling in the 12 months prior to interview, and the primary predictor was race/ethnicity. Sociodemographic characteristics, history of fathering an unintended birth, intention for more children, and access to health care were examined as confounders. Sixty-one (1.7%) men reported receiving sterilization counseling. Although counseling was reported more commonly by Black and Hispanic men compared with White men, the rates were not significantly different (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 0.8-7.1 and OR = 1.9, 95% CI = 0.9-4.1, respectively). In this nationally representative sample of men aged 15 to 44 years, there were exceedingly low rates of sterilization counseling for all men regardless of race/ethnicity.