A baseline audit of post-vasectomy follow-up at three Cape Town district health facilities.

Abstract

Background:  Our study focuses on vasectomies, an underutilised contraception method worldwide. Little is known about post-vasectomy semen analysis (PVSA) adherence in our setting, which is an essential step in confirming the procedure's success. We aimed to describe patient adherence to post-vasectomy follow-up and the success of procedures performed by different surgeon categories at three Cape Town district health facilities.

Methods:  We conducted a retrospective descriptive audit. We extracted sociodemographic and procedural information from theatre records and patient folders. The PVSA results were retrieved from Groote Schuur Hospital's Reproductive Medicine Unit.

Results:  The records of 270 patients who underwent vasectomies in local district-level facilities from September 2016 to July 2021 were included. Only 122 (45.2%) semen analysis results were retrievable, of which 115 (94.2%) showed that the procedure was successful. Incomplete patient records significantly impacted the study. A data-collection instrument and implementing standardised stationery were developed, which some sites already use. These measures are designed to ensure more comprehensive datasets for future audits.

Conclusion:  The study's findings have identified flaws in record-keeping practices at the three study sites, a crucial step towards improving post-vasectomy care. Tracking procedural success and patient adherence to post-vasectomy semen analyses using the implemented stationery may assist future research and help drive quality improvement projects.Contribution: This audit strengthens our understanding of improving this underutilised family planning option in the district health services. In partnership with the local teams, a revised clinical care pathway was developed to inform the delivery of an evidence-informed vasectomy service.