Acceptance and Prevalence of Vasectomy in Developing Countries

The author concludes that the growing popularity of female sterilization proves the existence of a market for a permanent method and that acceptance of vasectomy is responsive to "provider determinants"--program actions are tied clearly to annual changes in the numbers of men choosing vasectomy.

Abstract

The paper presents an overview of acceptance and prevalence information for sterilization. The use of vasectomy in developing countries shows much variation. China India and Bangladesh have relied heaviliy on it while other large developing countries have made little use of it. Sterilizaiton in general has been increasing rapidly in many countries but female sterilization has usually been the leading alternative. There is evidence that as tubal ligation has become simpler safer and more popular vasectomy has declined in some countries. Widely fluctuating numbers of vasectomies within regions and over time suggest that acceptance is highly sensitive to the way in which vasectomy is provided. Lack of emphasis and limited availability have meant that relatively few countries have adequately tested the true interest in vasectomy. Tables provide sterilization prevalence for selected developing countries in % of couples using this method trends in male and female sterilization acceptance in national programs and acceptors of government supported sterilization services by method and year of acceptance for 20 countries. The trend is for acceptors to be younger and have fewer children. However men choosing vasectomy appear to have smaller families than women choosing sterilization in the same country and time period. The author concludes that the growing popularity of female sterilization proves the existence of a market for a permanent method and that acceptance of vasectomy is responsive to provider determinants--program actions are tied clearly to annual changes in the numbers of men choosing vasectomy. (authors modified)