Organizing a Public‐sector Vasectomy Program in Brazil

Abstract

Although models of high-quality family planning services for men exist in Latin America, few if any have been organized within the complex and resource-constrained national public health systems. This study provides evidence from the Santa Barbara project in southern Brazil showing how vasectomy was introduced into the municipal health system. It demonstrates that once the necessary operational and quality-of-care improvements were in place, and sufficient political and technical support existed to proceed, it was possible to establish low-cost, well-used, and sustainable vasectomy services free of charge. The findings show that careful attention to the development of strong technical competence and an informed choice process resulted in high user satisfaction. Focus-group discussions with men who underwent vasectomy indicate that they had no objection to being served in the context of a women's health center and that they act as opinion leaders who draw an increasing clientele to the service.

Vasectomy within the public health services in Campinas, São Paulo, Brazil

“…The profile of the men who had undergone vasectomy in the public health‐care network of the municipality of Campinas since the introduction of the regulations at the end of 1997 coincides in general with that reported in studies carried out previously in Brazil (Berquó & Cavenaghi 2003; Penteado et al. 2001; Vieira et al.…”

‘I’m committed to her and the family’: positive accounts of vasectomy among New Zealand men

“…In contrast to much of the earlier research, Amor et al (2008) found that the operation was supported by masculine cultures within the workplace or between friends. Whether this is a feature of the majority of men's experiences of the operation is still to be determined Much of the recent social scientific research concerning vasectomy has occurred within developing/newly industrialised contexts such as Brazil (e.g., Kincaid et al, 2002;Manhoso & Hoga, 2005;Marchi, de Alvarenga, Osis, & Bahamondes, 2008;Penteado et al, 2001), Mexico (Gutmann, 2005;Gutmann, 2007), Bangladesh (e.g., Khandaker, Vereecken, & Nijs, 2001). This work tends to take a much more critical approach than the earlier US and UK based literature, and has offered some useful insights into countries with lower uptake of vasectomy.…”

Vasectomy Disparities among Foreign-Born Latinos Living in the United States: A Preliminary Study

“…However, academic research in four Latin American countries has documented an increase in the number of vasectomies performed and theorized the factors that influence Latino men to undergo the procedure. The studies suggest that vasectomies challenge social constructs of hegemonic masculinity in Latinos by allowing men to care for their families and be more engaged with contraceptive responsibility (Penteado et al, 2001;Pomales, 2013;Vernon, 1996). As stated by Pomales (2013), vasectomies facilitate the development of emergent masculinities as men embody new characteristics that oppose some of the characteristics of the hegemonic "macho".…”

“…To complement the findings of the CDC's 2012 contraceptive use report, this study draws on research conducted in Latin American countries where there has been an increase in vasectomy utilization. The studies in Latin America have not only focused on the promotion of the procedure through public health interventions, but also on the possible relation between changes in masculinity traits and acceptance of vasectomy procedures (Penteado et al, 2001;Pomales, 2013). Considering the commonalities between Latinos in their home countries and the U.S., it is hypothesized that a combination of factors-such as affordability/accessibility and changes in masculine identities-may have influenced immigrant foreign-born Latinos in the U.S. to have more acceptance of the procedure and consider a vasectomy as an option of permanent sterilization.…”

“…In the United States, the recent increased number of vasectomized foreign-born Latinos suggests that the financial and cultural context may play a role in men's decision to undergo the procedure. In order to understand the increase of vasectomized Latinos, it is important to note that some Latin American countries such as Costa Rica, Colombia, Mexico, and Brazil have also reported an increase in the number of vasectomies after the implementation of public health campaigns advocating the procedure (Penteado, 2001, Pomales, 2013, Vernon, 1995. Studies in these Latin American countries indicate that expansion of coverage for the procedure, changes in people's notions of masculinity, and proper public health interventions are some of the factors that are responsible for the increase in the procedure.…”