Unraveling Factors Shaping the Acceptance and Non-acceptance of Non-scalpel Vasectomy in Rural Central India: A Cross-Sectional Study

Abstract

BackgroundIndia, with a population exceeding 1.43 billion, faces significant demographic challenges, necessitating effective family planning measures. Non-scalpel vasectomy (NSV) is a less complex and cost-effective male contraceptive, yet its acceptance remains low, especially compared to female sterilization. Understanding the determinants of NSV acceptance is crucial for informed decisions on family planning methods. MethodsThis cross-sectional study investigated NSV acceptance among males who underwent non-scalpel vasectomy (acceptors of NSV) and spouses of women who underwent tubectomy (non-acceptors of NSV). The study was conducted among 116 NSV acceptors and 116 non-acceptors from rural Central India. Data were collected over six months, employing a pre-designed questionnaire covering socio-demographic details, reasons for acceptance/non-acceptance, and information sources for the same. Statistical analysis was done utilizing Epi Info 7.2.6 (Centers for Disease Control and Prevention [CDC], Atlanta, GA), employing descriptive statistics and tests of association. ResultsSignificant associations were found between NSV acceptance (p<0.05) and the age and education of study subjects, age of wife, duration since marriage, and total number of children. Incentives also played a significant role (p=0.014). Opposition to NSV, mainly from wives, was a key factor for non-acceptance (38%). Reasons for acceptance included a previous cesarean section (40.52%), the simplicity of the NSV procedure (26.72%), and the wife's illness (23.28%). Non-acceptance reasons comprised family/friend opposition (38%), lack of awareness/ignorance (25.00%), and fear of surgery (23.28%). Study subjects perceived community reluctance to NSV as mainly due to misbeliefs (30.17%), fear of surgery (27.58%), and illiteracy (26.29%). ConclusionThe study highlights socio-demographic factors influencing NSV acceptance and identifies key reasons for acceptance/non-acceptance. Community-based interventions, increased advertisement, and health provider counseling were suggested for enhancing acceptance. Despite challenges, participant satisfaction with NSV was high. These findings contribute to understanding the complex dynamics surrounding NSV acceptance in rural Central India, informing future family planning strategies.