Increasing the availability of vasectomy in public-sector clinics
Haws, J.M.; McKenzie, M.; Mehta, M.; Pollack, A.E.
Family Planning Perspectives 29(4): 185-186; 190
1997
ISSN/ISBN: 0014-7354 PMID: 9258652 Document Number: 268247
The low utilization of vasectomy in the US by low-income, minority men reflects, in part, the lack of availability of this contraceptive method through the public sector. Nationally, only 23% of family planning agencies offer this option. To improve the availability and quality of vasectomy services for low-income men, physicians at 43 public-sector clinics in 17 states were trained in the no-scalpel vasectomy technique during 1993-95. 37% of the physicians trained had never performed a vasectomy before. Among the 38 clinics that responded to a follow-up survey, the number providing vasectomy services increased from 23 before the training to 32 in 1996. At the time of the follow-up survey, these 32 clinics were providing 1650 vasectomies annually. Thus, the training program increased the number of clinics performing vasectomies by 37% and the number of men obtaining them by 18%. In-depth interviews with physicians from 7 clinics that reported sharp increases in their vasectomy caseloads after the training and 7 clinics that experienced sharp decreases identified 3 key components of a successful vasectomy service: 1) a sufficient number of providers committed to serving men and providing a quality service, 2) marketing activities to raise awareness among women and men about the availability of vasectomy services, and 3) the commitment of funds to subsidize vasectomies for men who cannot afford them. Midlevel clinic staff (e.g., nurse practitioners and physician assistants) could be trained to perform no-scalpel vasectomy, thereby easing the burden on physicians, reducing costs, and increasing access.