This study explored knowledge, attitudes, and practices around vasectomy in Nairobi County, Kenya. Key findings include that knowledge of vasectomy is fairly good, but negative attitudes are common due to religious and traditional beliefs. Some women felt vasectomy could lead to promiscuity in men or regret. The study used focus groups and interviews with men who had vasectomies, their wives, and community health workers. It found uptake of vasectomy is generally low and decisions are often made by men. Recommendations include providing accurate information, identifying vasectomy champions, and working with women to reach their spouses.

1. Vasectomy knowledge, attitudes and practices in Nairobi County, Kenya: An exploratory study
Authors: Ofware Raphael, Olivia Nuccio, Vitalis Akora, Jeremiah Ochieng, Edward Kubai, Julie Taft, and Cristin Gordon-Maclean
Background
• High unmet need for family planning in Kenya
• Marie Stopes Kenya provides a comprehensive method
mix of FP through a range of service delivery channels
and settings
• Vasectomy uptake remains very low
Key findings: Knowledge and attitudes
• Knowledge of vasectomy is fairly good; however, negative
attitudes are common
• Religious and traditional beliefs contributed to negative
attitudes
• Some women felt that vasectomy could lead to sexual
promiscuity among vasectomised men, as they would no
longer have to worry about an unintended pregnancy
• Some thought that men would regret the decision to have
a vasectomy
• However, there were several benefits of vasectomy
among acceptors: “I am an outspoken and determined
champion of [vasectomy] use as a family planning method
and I believe that if more men chose vasectomy, it could
dramatically improve the lives of Kenyan families.” - IDI
participant
Methods
• 8 focus group discussions
• 12 in-depth interviews
• Participants included men who had and had not
received a vasectomy; their wives; and community
health workers
• Purposive and snowball sampling techniques used
Common misconception
Vasectomy interferes with testosterone production, which is
the hormone that makes a man ‘a man’
Key findings: Practices
• Uptake for vasectomy was generally low
• “Such decisions [on child bearing] in many households
in this community are either strongly influenced or are
made solely by men” married female FGD participant,
Kibera Sub-County
Recommended messages
• Reach men with accurate information and promote male
involvement in family planning
• Work with women to reach their spouses
• Identify role models who have received vasectomy
Factors affecting the uptake of vasectomy
Vasectomy
uptakePolitical factors
Religious
beliefs
Myths and
misconceptions Traditional beliefs
Education
levels
Provider attitude
Set up
‘Well Man’
clinics
Create
public
awareness
Work with
women to reach
out to their
spouses
Better policies to
address
vasectomy uptake
Evidence to Action
RATIONALE
Marie Stopes Kenya is grateful to the U.S. Agency for International Development (USAID) for funding the study implementation and for overall sustained financial and technical support through the Support for International Family planning Organization (SIFPO) Project.
Rationale
Determine the
levels of
knowledge,
attitudes and
practice towards
vasectomy
Assess community
perceptions on
availability and
quality of
vasectomy
services
Identify major and
trusted sources of
vasectomy
messaging and
modes for
communication