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Open Access Research article

“If you do vasectomy and come back here weak, I will divorce you”: a qualitative study of community perceptions about vasectomy in Southern Ghana

Philip Baba Adongo1*, Placide Tapsoba2, James F Phillips3, Philip Teg-Nefaah Tabong1, Allison Stone3, Emmanuel Kuffour2, Selina F Esantsi2 and Patricia Akweongo4

Author Affiliations

1 Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, P. O. Box LG 13, Accra, Ghana

2 Population Council, 14B Ridge Road, Roman Ridge, Accra, Ghana

3 Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, B-2, New York, NY 10032, USA

4 Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, P. O. Box LG 13, Accra, Ghana

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BMC International Health and Human Rights 2014, 14:16  doi:10.1186/1472-698X-14-16

Published: 8 May 2014

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.

Keywords:
Vasectomy; Pregnancy; Family Planning; Male involvement; Southern Ghana