Men plus is a one-year project that started in February 2019 by Reach a Hand Uganda – RAHU in collaboration with Reproductive Health Uganda (RHU) which is aimed at increasing men’s involvement in Family Planning in Uganda through promoting access to and uptake of long-term and permanent Family Planning methods and services, through community outreaches, clinic-based interventions, group education sessions, online campaigns, and interpersonal communication between men in the different focus districts
By Amon Mulyowa
Social and Behavior Change Communication Consultant taking lead on the Men plus Campaign and Teal Lead Communication Consults Uganda
Overcoming Fear, Realizing the Dream
Increasing Men’s Uptake of Vasectomy as a Family Planning Method in Uganda
“My name is Daniel Nyamukaga (Uncle D as many people call me) from Kateraza Village, Rugando Sub-county, Rwampara County in Mbarara district in Southwestern Uganda. I always had people talk about Family Planning for men (Vasectomy) but felt it was not my thing. I always asked myself, why Family planning for men, do men get pregnant, is it our duty to plan for the family or the women’s? The un-answered question were too many for me.
Picture 1: Daniel Nyamukaga - a satisfied Vasectomy acceptor
My peers in the village talked about how one will not be able to function sexually, how society will look down upon you as castrate, how the testicles will rot after the procedure and I feared for my life.
But, one of our friends in village (Edson Mugume – a Male Champion) reached out to us during a men’s meeting in the village, explained to us what Vasectomy is, gave answers to many of the unanswered questions we had about Vasectomy and I was convinced what I knew about Vasectomy were all lies.
A number of my other peers at the meeting were equally convinced to take on Vasectomy as a Family Planning method we could use to Plan Smaller Families.
Edson (The Male Champion in Our Village) organized five (5) of my peers and I to go for service provision at one of the Reproductive Health service provision sites. During the journey though, I kept asking myself questions about my decision and the consequences that will come with it. At one time, I felt like opting out but the Male Champion was by my side and kept talking to me about the decision, the pros and cons and I moved on for the service.
On arrival at the Health facility in the Capital Kampala (approximately 300km from my village home), the Health service providers welcomed us very well, registered my presence in the service register, shared with me more about the service to ensure my informed consent before the procedure.
I dully signed consent forms and went on to receive the service.
One other interesting bit of my journey to get the service was the language the service providers used. They spoke in a language I understand and I ably asked all questions I had always had about Vasectomy.
Picture 2: Uncle D shares a moment with other acceptors at RHU Katego Clinic in Kampala
Frankly, the procedure was not as scary and painful as I had thought. I did not have any pain in my private parts, I went to the urinals and I was passing urine normally and all appreciations to the professionalism of the Service providers. The service providers cautioned me against engaging in unprotected sex before a ninety (90) days review period is over during which a sperm count will be conducted to establish if I cannot impregnate a woman and after that I will be “allowed” to go have unprotected sex with my spouse(s) without fear of making them pregnant.
Of course I was also reminded Vasectomy only prevents pregnancy NOT HIV/STIs (sexually transmitted infections).
I am very grateful to Reach a Hand Uganda, our Male Champion Edson Mugume, Reproductive Health Uganda staff for reducing on the child bearing and caring burden in my home. I am going back home satisfied at heart, in the mind and in the body.
I am one of the pioneers of this service for men in Uganda and in our Village and I pray it spreads to other parts of the country and have men realize we have a pivotal role to play in planning smaller families and Family Planning in our Families.
When I get back to our village, I will talk to my peers about Vasectomy, the procedure and give answers to many of the questions they still have.
Fortunately, the service providers have given me a service provision card as proof of service and if they need to see it, I will show them to prove I have taken on the service. I will also talk to them that the procedure is out of free will and one is not coerced into it.
I am very grateful indeed.”
Uncle D is one of the many men (over 800) that received Vasectomy as a Family planning method under our Men Plus Project of Reach a Hand Uganda.
Men plus is a one-year project that started in February 2019 by Reach a Hand Uganda – RAHU in collaboration with Reproductive Health Uganda (RHU) which is aimed at increasing men’s involvement in Family Planning in Uganda through promoting access to and uptake of long-term and permanent Family Planning methods and services, through community outreaches, clinic-based interventions, group education sessions, online campaigns, and interpersonal communication between men in the different focus districts.
The project is reaching out to men and engaging them to play a more active role in planning smaller families and in Family Planning. In doing this we are reaching to men as:
- Partners in Family Planning by helping out their spouse currently using or planning to take up a Family Planning method.
- Users of Family Planning by taking up one of the Family Planning methods for men especially Vasectomy.
- Champions of Family Planning by speaking to other men, addressing myths and misconceptions about Family Planning and encouraging them to use Family Planning.
This was against a background that in Uganda Fertility rate in 2016 reduced from 6.9% to 5.7%, more young people worldwide are considering not bearing children, many families and young people continue to have children that they’re unable to support financially, many interventions have been rolled out but concentrated on the contraception methods used by women and LARC (long-acting reversible contraception) with a very low uptake of Vasectomy among men.
As a result, men’s participation in contraception is largely limited to condom use due to myths and misconceptions about the procedure. For example, many men fear Vasectomy leads to impotence, some worry about being stigmatized since child bearing is attached to a man’s prestige in society and others ask what might happen if, after a vasectomy, they lose all their children in some catastrophe.
These however were overcome with our programming at Reach a Hand Uganda where over eight hundred (800) men received Vasectomy in eight (8) months. This has been attributed to use of satisfied users (Male Champions), establishing a support network where satisfied users keep checking on each other, share advice on how they need to manage relationships after Vasectomy, sensitizing health workers to provide a friendly atmosphere for men at the facilities, working in partnerships where we maximize strengths of each other (Reproductive Health Uganda – formerly Family Planning Association of Uganda and an affiliate of International Planned Parenthood Federation – IPPF with over 50 years of providing Family planning services in Uganda – and Reach a Hand Uganda – RAHU renowned for mobilization strategies in Uganda including use of social media to influence health seeking behavior).
Our plan is to increase access to more five (5) districts in Uganda from the current ten (10), work more with the central government facilities (these are widely spread in the country and one can easily access them for service and review), enlist Female Champions as we have realized women were pivotal in “stopping” many men from accessing service with a misconception of loss of sexual strength. We also plan to engage more on mass media as it creates awareness and gives the project legs.
Who knows, maybe, may be every man who has made a conscious decision to stop siring children, will access a Vas as it is medically known. All we need to do:
Address the fears, have men realize their dreams
About the Author:
Amon Mulyowa is a Social and Behavior Change Communication Consultant taking lead on the Men plus Campaign and Teal Lead Communication Consults Uganda.