THERE is widespread ignorance about male sterilisation or vasectomy as an alternative method of contraception among the male folk in Zambia.
While most men still cling to the perception that family planning is largely a responsibility of women, a Consultant Obstetrician Gynecologist at the University Teaching Hospital (UTH), Samson Chisele says vasectomy is an effective contraceptive method for men.
With Zambia’s maternal mortality rate at 398 per 1000 live births, and of which 30 per cent of women deaths being caused by unsafe abortions due to unwanted pregnancy, vasectomy is one of the options that if largely embraced by men, could abate unintended pregnancy.
Currently, vasectomy and male condoms are the only known family planning options for men to prevent unwanted pregnancy.
However, Dr Chisele observes that there is very little acceptance of the vasectomy option among men in Zambia.
Vasectomy is defined as a surgical procedure that involves the cutting, closing, or blocking of the tube that carry sperm from the testicle to the urethra.
Dr Chisele says, “After a vasectomy is performed, there are no sperm in the semen but the testicles still continue to produce sperms which are absorbed by the body. This procedure is very quick and can be done in less than an hour with little or no risks of complications.”
According to the 2013 world statistics on contraceptives, just 2.2 per cent of the men around the globe had undergone the vasectomy procedure in comparison with 18.9 per cent of women that sought female sterilisation in the same year.
In Africa, only 0.1 per cent of men underwent vasectomies in that year, a huge contrast with the United Kingdom that posted 21 per cent of men of reproductive age.
How well do Zambian men know about vasectomy?
This author carried out a random survey among men on the Copperbelt province to determine their knowledge about vasectomy, its benefits, and implications, as well as how and where the sterilisation procedure can be performed.
Though most of the responses gathered are similar from respondents aged roughly between the ages of 25 and 35 years old, here are some that spell out the fears men have on vasectomy.
“The only option of contraception for men that I know of is a barrier method using condoms. I don’t know anything about that other method (vasectomy) you are mentioning. If it’s anything to do with (surgical) operation on my manhood, I can’t do it,” says one of the respondents, James Mwango of Ndola.
Another respondent Kabangasheshe gave an interesting view. He said vasectomy is a form of castration that results in loss of sex drive and sexual satisfaction among men.
“I wouldn’t want to lose my relevance in marriage. Taking up vasectomy is as good as confirming divorce with my wife, and I don’t want to be a man who fails to satisfy a woman in bed. I feel, it’s not a bad idea for my wife to be taking contraceptives because she has a wide range of choice.”
“All I need to do as a man is support the women and encourage them to take up contraceptives of their choice. As long as there is consensus on family planning between couples and men take a leading role, we will definitely get somewhere,” he says.
Sipho Mwanza is married and has two children. He says once his target of having four kids is attained; he would be keen to choose a permanent method but has little knowledge about vasectomy.
“My wife and I have agreed to have a maximum of four children. Thereafter, anyone of us will have to undergo permanent contractive. I have heard about vasectomy but I don’t have much information about it… I wouldn’t mind having it done on me because I want my children to have the best of education and just life itself,” he says.
The survey further reveals some myths and misconceptions that men strongly hold on vasectomy, hence the low uptake.
It is widely perceived among men that vasectomy leads to being overweight and developing of obesity owing to the high amount of protein in the body while others are of the view that it causes painful sex.
From the responses provided above, it is clear that there is a serious knowledge gap that needs s to be addressed by various stakeholders promoting sexual and reproductive health in Zambia.
Dr Chisele now dispels the fake notions surrounding vasectomy in the country.
“After undergoing a vasectomy procedure, a man can still have erections and orgasms. He can ejaculate about the same amount of semen though it doesn’t contain sperm and the sex drive, and ability to have sex does not change.”
“The sperm cannot leave the testes and cannot reach the egg. It takes about three months for the procedure to be fully effective and during that time, a backup method of contraception is used until tests confirm that there is no sperm in the semen,” he says.
Dr Chisele explains that the only change is that a man cannot father a child and warns that men considering a vasectomy must carefully analyse their choice to avoid regret.
It is important for key stakeholders to come up with effective programmes to enhance the male folk’s knowledge of vasectomy as well as break the barriers to personal use of, and counselling for vasectomy.
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