Determinants Affecting the Adoption of Vasectomy as a Family Planning Method among Married Men in Kiziranfumbi Sub-County, Kikuube District

Abstract

Despite its reliability, vasectomy remains an underutilized family planning choice among men, being prevalent in only a handful of countries. Globally, its use stands at 2%, with sub-Saharan Africa reporting less than 100,000 cases by 2019 and a mere 0.4% utilization in Uganda. To investigate this, a cross-sectional community-based study was conducted to scrutinize the factors influencing the acceptance of vasectomy among married men in Kiziranfumbi sub-county, Kikuube district. Three parishes—Bulimya, Munteme, and Kidoma—were chosen, and 384 married men residing in the area for over six months were selected through systematic random sampling. The majority fell within the 21-30 age range (30.2%), with the Banyoro tribe comprising 66.4%, Catholics at 53.9%, primary education level at 70.6%, and 82.6% engaged in peasant farming. Monogamous marriages (69%) were prevalent, lasting between 5-25 years (69%), and with less than five children (50.8%). While 85.9% were aware of vasectomy, sources of information varied—32.6% from health workers and 25.3% from family and friends. Misconceptions persisted, with 52.1% uncertain about its impact on sexual function and 19.3% mistaking it for castration. Cultural influences loomed large, with 45.8% citing cultural beliefs as influencing their decision, 35.7% considering it culturally unacceptable, and 38.8% labeling it taboo. Furthermore, 42.2% believed vasectomy diminished men’s societal role. The study revealed a generally low level of knowledge (mean 2.1189, SD 0.38994), a high prevalence of negative attitudes (mean 3.1289, SD 0.30335), and strong cultural beliefs (mean 2.8620, SD 0.58887) against vasectomy. However, despite these barriers, 46.6% expressed an intention to opt for vasectomy, influenced significantly by knowledge (P 0.011) and cultural beliefs (P 0.000), contributing to 51.5% of the observed intention to uptake vasectomy. Addressing these hurdles will require widespread vasectomy awareness campaigns through health education, with a focus on male involvement in family planning to enhance the acceptance and uptake of vasectomy as a viable choice. Keywords: associated factors, vasectomy, family planning