Male Contraception

Traditionally a preserve of women, men are slowly but surely embracing modern family planning methods. Reproductive health experts say an increasing number of professional men over the age of 35 are usurping the 'responsibilities' of their wives. Until recently, it was believed that contraception towards reducing the number of children was the role of the wife.

A recent United Nations Population Fund report says men usually decide on the number and variety of sexual relationships, timing and frequency of sexual activity. However, times are changing as more men are taking the lead role in containing unwanted pregnancies by undergoing vasectomy.

For starters, vasectomy is a minor surgical procedure, which stops sperms from being released when a man ejaculates.

According to Family Health International (FHI) reproductive health expert Dr Marsden Solomon,modern men are embracing vasectomy. "It is encouraging than men escort their wives to clinics and volunteer to undergo the minor surgical operations instead of their wives," Marsden says.

Marsden says education and informationavailable to men on modern contraception is making a difference. "Men seem to be demystifying the

belief that contraception is a preserve of women," Marsden says. On the fl ip side, Marsden says there are some wives who discourage

their men from undergoing vasectomy citing taboos, traditions and culture. Approximately 48.2 per cent of married men countrywide know

about vasectomy while 96 per cent are aware of condom use, according to the latest Kenya Demographic Health Survey (KDHS).

Surprisingly, the survey further shows that 80 per cent of married men were conversant with the emergency pill and 74 per cent with injectibles.

Statistics

But even as experts say vasectomy is safer, it remains a highly underutilised method of family p l a n n i n g w o r l d -wide.

Offi cial statistics show that the number of female sterilisations exceeds that of males in a ratio of five to one globally. The use of contraceptives

has become urgent as research shows that having sex without protection increases chances of pregnancy by 85 per cent. Doctors say contraception

i mproves maternal and infant health, reduces unintended pregnancy and, consequently, rates of unsafe abortions. Other benefi ts are prevention of

HIV and Aids transmission from mother to child reduces hunger and pressure on social amenities. Reproductive health experts say there are also men who walk into clinics for advice on vasectomy but keep postponing the surgery.

Take the case of Guaranti Group director Anthony Kibagendi who says he does not mind undergoing vasectomy after consultations with his spouse. "What I need would be a surety from the doctor that the minor surgery would not b a c k f i r e , " K i b a g e n d i says. Acco rd i n g to him,family planning is not the sole duty of the modern woman who balances between career, further education and family. "Society has changed and I believe spouses should make their decision after counselling," Kibagendi says.According to Pharm Access Africa regulatory affairs manager Jyoti Dhiman, men who take the lead role in family planning deserve a pat on the back.

"Men should take up the initiative…African culture demanded that women must get consent from their husbands to even start a business," Jyoti

says. For businessman Michael Mburu, 40, vasectomy is no longer a nightmare after undergoing counselling with his 28-year-old wife .

Last Child

"My wife is in a demanding profession and already has two children. I will not mind vasectomy after our third child," Michael says.For Merab, 36, a marketer, talking her husband into a family planning method apart from condoms is a nightmare. "I regretted why I ever introduced the topic of vasectomy to him…I have never seen him that disgusted," Merab says. Figures from the latest KDHS show 36 per cent of women discontinue use of contraceptives in their fi rst year of marriage. According to Mercy Gitau Mulehi, a social scientist, men seem to shy away from vasectomy over traditional

beliefs.

"They think it is the responsibility of the woman which, is not right as spouses should embrace family planning," Mercy says.According to the Ministry of Public Health and Sanitation reproductive health division head Dr Shiprah Kuria, traditional beliefs affect vasectomy. "An increasing number of spouses

are coming for advice on family planning, but husbands cite culture on vasectomy," Shiprah says.

She says majority of married men claim the minor surgery may affect their erection negatively. Public Health and Sanitation director

Dr Shanaaz Sharif says vasectomy is better than the withdrawal method, which most men believe in.

"The withdrawal method is risky as it needs a lot of discipline, which most men lack," Sharif says. He says pre-ejaculated liquids during

intercourse could have semen with sperms that may lead to an unwanted pregnancy.

"Men should embrace vasectomy as the safer, simpler, less expensive and equally effective as female sterilisation," Sharif says.

Shiprah says vasectomy does not affect erection and ejaculation…semen will be released but will not produce babies.

According to her, some men undertake the operation after assurance that their sexual desire will not vanish. FHI country director Peter

Mwarogo concurs with Shiprah. "More men should be encouraged to embrace vasectomy," Mwarogo says. Ministry of Public Health and Sanitation

division of reproductive health senior programme offi cer David Nyaberi According to him, the programmes German Foundation for World

Poverty Line

"More than half of our population She says maternal health of mothers "Bringing men on board family planning has advantages that outweigh

disadvantages. Three quarters of married women either want to delay having another child or stop child birth…husbands should understand,"

Caroline says. As reproductive health experts root for men to undergo vasectomy, not many medics can perform the minor operation. According to Marsden, few medical surgeons in the country are trained to perform vasectomy.

"However, the Government and private hospitals should start training medics on the minor surgery as men are slowly but surely boarding the

family planning ship," he concludes.