Operations Research on Promoting Vasectomy in Three Latin American Countries

Abstract

Operations research findings are presented based on data collected from vasectomy programs in Brazil Colombia and Mexico. Operations research was conducted in the following contexts: a mass media vasectomy promotion in Sao Paulo Brazil in 1985; male-oriented clinics and promotion campaigns in medium-sized cities in Colombia; worksite talks and brochure distribution among clients of a Mexico City clinic in 1988-89; IEC videos and male promoters in clinics in Mexico City and two provincial cities in 1994; a follow-up of vasectomy acceptors in a Mexico City clinic in 1988; and vasectomy promotion at a Mexico City clinic in 1988. Vasectomy acceptors are characterized as averaging 32-35 years of age and with a high level of education small families and an urban residence. 56-98% of vasectomy clients or their wives were using contraception at the time the decision was made. 18-39% were using male methods. Decision making among respondents in the six projects followed four stages: awareness information-seeking evaluation and adoption. The awareness involved the realization that their desired number of children was reached or exceeded and that the present method of contraception was inadequate. Most vasectomy acceptors were informed about vasectomy through friends and relatives wives health personnel and mass media. The most common way of assessing promotion effectiveness is identified as the designation of the mass media as acceptors referral source. Ineffectiveness of interpersonal promotion strategies was attributed to poor audience segmentation and targeting. Men who were relatively young more educated and had fewer children were considered the most likely to have potential demand for vasectomy. It is concluded that potential clients were well-defined and informal interpersonal sources were very influential during the decision-making process. During the evaluation stage health personnel were the most consulted sources. Mass media was more effective in large cities with high quality services. Specific vasectomy messages are identified. Couples are expected to be open to vasectomy after family size is completed.