Despite the increase in contraceptive use in Malawi, a lot of men are still shunning vasectomy due to existing cultural bias and myths associated with family planning.
Vasectomy, a surgical procedure for permanent male sterilization, is seen as a crucial method needed to fight against the rapid population growth in Malawi where culturally men have the final say on childbearing in relationships. According to statistics from the 2011 world contraceptive use data sheet, contraceptive usage in Malawi made a sharp rise to 42 percent. This is almost double from the 24 percent record over a decade, which is unprecedented for the tiny southern Africa country with the estimated population of 17 million. However, only 0.8 percent of the contraceptive users opted for a vasectomy.
Raphael Mwase, a community health worker and family planning advocate in Lunzu said since he started work as a health worker and contraceptives promoter eight years ago, no one has ever asked for vasectomy despite the huge efforts put into creating awareness about all the methods available to clients.
“We teach people about all available family planning methods including vasectomy so that they are able to choose, but up to date, no one has ever chosen vasectomy,” Mwase said.
He went on to explain that among the contraceptives available, injectables, pills, and implants are the most used at his health center. These account for 85 percent of the contraception uptake. He said people prefer short-term contraceptives, which they can easily stop using, to long-term ones.
In a random interview conducted with men in Malawi, most of the respondents shared different reasons for shying away from vasectomy. Some of them include the unreliability of marriage partners and fear of death.
Kondwani Silungwe, 35, of the northern city of Mzuzu said most men don’t want to choose vasectomy as a form of contraception because of the myths they hear about it. He explained that people believe that once a man undergoes a vasectomy procedure, they will lose the ability to satisfy their partners sexually.
“I can’t go for such a contraception method. I would prefer my wife to go and have an injectable method,” he said.
According to statistics from the Family Planning Association of Malawi (FPAM), an NGO working in the sexual and reproductive health in Malawi, injectables that have a high rate of discontinuation due to side effects, represents over 40 percent of the contraceptives used by most people.
The fear of being left without options after a spouse’s demise also prevents some men from considering vasectomy as a family planning method.
“We are living in the world where death is part of life, so if I decide to undergo vasectomy today and my wife dies, I will likely remarry, therefore a need to reproduce,” said Alex Mitswati.
“If I would undergo the procedure and fail to [have children] with my new partner, some people will laugh at me for being infertile, ” the 49-years old father of five explained.
To Emmanuel Banda of Dowa district in central Malawi, a vasectomy would make him less manly and its lack of popularity makes him suspicious of the procedure.
“There are several contraception methods out there and almost all of them are in use by many people, but I wonder why vasectomy is still not popular, so I cannot go for such method because I deem it risky to my health,” Banda said.
A medical practitioner, Kondwani Sulani, who works with Malawi government as a clinician said all the negative things said about vasectomy have not been scientifically proven, therefore they are just myths. He goes on to say when a man undergoes vasectomy procedure which is fast, painless and requires little recovery time, what happens is that their sperm is just made infertile while maintaining their sexual performance.
“Unlike other contraceptives, there are no side effects with vasectomy and it does not interfere with sexual function or pleasure, so people especially men should not be worried about the consequences coming as a result of using the method,” Sulani explained.