Female sterilization in camp settings in Nepal: an early follow-up study
Panday, K.R.; Manandhar, V.; Mackenzie, P.; Chhettri, M.; Pradhan, A.; Trouton, K.
Jnma; Journal of the Nepal Medical Association 31(106): 215-221
1993
ISSN/ISBN: 0028-2715 PMID: 12154937 Document Number: 333821
Sterilization is the most widely used method of fertility control in Nepal. Since 1979, the number of female sterilizations has exceeded that of male sterilizations such that more than 500,000 sterilizations had been conducted in the country up to 1992. Debate, however, has surfaced in recent years over the safety of sterilization procedures in voluntary surgical contraception (VSC) camps under less than ideal field conditions. This study was therefore undertaken to give some insight into the safety of female sterilization in such camps, focusing primarily upon complications on the day of surgery and during the early post-operative period. 200 minilap clients and 200 laparoscopy clients from VSC camps in four districts in 1992 were interviewed on the day of surgery and two weeks later. Respondent characteristics were similar to those reported nationally. There were neither deaths nor hospital admissions among the sample. Three uterine perforations in one minilap camp was the main complication on the day of surgery. Each case was followed until recovery. The surgeon was also unable to ligate both tubes in three minilap and three laparoscopy cases. No serious complications were identified among the 96% of clients followed over a two-week post-surgery period, although mild to moderate morbidity occurred in 38% of laparoscopy clients and 28% of minilap cases. Minor wound infections and local skin reactions were common in three camps despite the prophylactic use of antibiotics. The authors recommend that quality assurance for VSC services in camp settings be improved, as well as in preoperative client screening, aseptic technique, and minilap training.