Attitudes and acceptance of Nigerians towards vasectomy--A comparison of married men and women in Lagos.

Abstract

Background : Nigeria with a growth rate of 28%, accounts for over two thirds of the West African population. It also has one of the highest maternal mortality rates in the world with contraceptive prevalence among married couples less than 10%. Despite its safety and efficacy vasectomy appears to be unpopular in our environment. Objective : To assess the perception and acceptance of married men and women towards vasectomy and the influence of the spouse on the man’s decision to accept or reject vasectomy. Design : A cross sectional questionnaire based study. Setting : With an estimated population of 20 million, Lagos is the most cosmopolitan and urbanised city in Nigeria and accounts for 65% of all commercial activities in the country. Virtually all the tribes in Nigeria are represented in the city. Subjects : Literate pregnant women recruited from the antenatal clinics and literate new fathers. All subjects were recruited from three health facilities in the Lagos metropolis. Results : Twenty seven point five and twenty one percent of the men and women respectively had a good Knowledge of vasectomy while 49.1% and 19% of all men and women respectively with good knowledge would accept vasectomy (or agree for their spouses to have the procedure). Overall acceptance rates for men and women were 26 and 13.5% respectively while 92% of men who can opt for vasectomy will only do so if their spouses agree. Knowledge about vasectomy was the strongest single factor  influencing the acceptance of vasectomy (p= 0.013) with stronger  correlation among men than women (p=0.005 vrs p=.0.023). Conclusion : Knowledge and acceptance of vasectomy is significantly better in males than female Nigerians living in Lagos.