How about a va­sec­tomy?

Uganda wants more men to say yes

Sentinel-Review (Woodstock) - - LIFE - RODNEY MUHUMUZA

KAMPALA, Uganda — When Martin Owor, a fa­ther of six, told his wife he was con­sid­er­ing a va­sec­tomy, she told him it was out of the ques­tion. How would they live as hus­band and wife af­ter his sur­gi­cal ster­il­iza­tion?

But af­ter a long con­ver­sa­tion about grow­ing up poor, the Ugan­dan man went ahead with a pro­ce­dure that re­mains widely un­pop­u­lar in sub-Sa­ha­ran Africa, where mis­un­der­stand­ings are high.

To spur de­vel­op­ment, this East African coun­try that has been a re­gional leader in tack­ling health chal­lenges such as AIDS now hopes to lower pop­u­la­tion growth. The is­sue is wide­spread in Africa, which faces a pop­u­la­tion boom even as other parts of the world see drop­ping birthrates. Over half of the global pop­u­la­tion growth be­tween now and 2050 will take place in Africa, the UN says.

Sub-Sa­ha­ran Africa, with some of the world’s most im­pov­er­ished na­tions, will con­tinue to be plagued by poverty un­less gov­ern­ments re­duce high fer­til­ity rates, de­vel­op­ment ex­perts say. Uganda has started re­cruit­ing “cham­pion men” to speak pub­licly on tele­vi­sion and else­where about va­sec­tomies as a method of fam­ily plan­ning. It has proven dif­fi­cult. Many men fear it leads to im­po­tence. Some worry about be­ing stig­ma­tized. Oth­ers ask what might hap­pen if, af­ter a va­sec­tomy, they lose all their chil­dren in some catas­tro­phe.

“Many peo­ple think that when a man goes for a va­sec­tomy, he is not go­ing to con­tinue be­ing a nor­mal man,” said Owor. “But there is no prob­lem. My wife is very happy.”

Owor said he was com­pelled to have a va­sec­tomy be­cause he didn’t want his chil­dren to grow up hope­lessly poor.

“My fa­ther had 12 chil­dren, so we never had a chance of hav­ing a qual­ity ed­u­ca­tion,” Owor said. “I needed a num­ber that I would try to man­age.”

Uganda’s pop­u­la­tion has bal­looned to more than 41 mil­lion in 2016 from 17 mil­lion in 1990.

Only 35 per cent of mar­ried women in Uganda use mod­ern meth­ods of con­tra­cep­tion, ac­cord­ing to gov­ern­ment statis­tics. Abor­tion is il­le­gal in Uganda, ex­cept to save the mother’s life.

Al­though Uganda’s fer­til­ity rate dropped to 5.4 to­day from 6.9 births per woman in 2001, of­fi­cials say a de­sir­able rate is four births per woman. As “cham­pion men” speak out, the gov­ern­ment is work­ing to in­crease male in­volve­ment in fam­ily plan­ning to meet that goal.

“We can’t co­erce them, be­cause fam­ily plan­ning is vol­un­tary and is sup­posed to be based on hu­man rights, and we want to keep on en­gag­ing them,” said Placid Mi­hayo, an as­sis­tant gov­ern­ment com­mis­sioner in charge of sex­ual and re­pro­duc­tive health.

Uganda re­mains one of the world’s poor­est coun­tries, with a per-capita in­come of $780, ac­cord­ing to World Bank data. The sit­u­a­tion is dire in ru­ral ar­eas, where health fa­cil­i­ties of­ten lack ba­sic medicines and many chil­dren drop out of school.

Some warn that the coun­try won’t come close to meet­ing its am­bi­tious de­vel­op­ment tar­gets — achiev­ing lower-mid­dle-in­come sta­tus by 2040 — with­out wider use of birth con­trol.

“If you pro­duce 100 chil­dren and cre­ate only two jobs in that pe­riod, so where are the other 98 go­ing to get jobs?” asked Sam Mwan­dara, project co-or­di­na­tor for Re­pro­duc­tive Health Uganda, a UN-sup­ported group. “The pop­u­la­tion is ex­pand­ing so fast in re­la­tion to land, jobs, ed­u­ca­tion and health. So it’s alarm­ing.”

Va­sec­tomies are still a small part of Uganda’s ef­fort. Each month, two or three of the pro­ce­dures are per­formed at a clinic run by Re­pro­duc­tive Health Uganda in Kampala, said Dr. Ken­neth Buy­inza. The va­sec­tomy costs about $13, which Buy­inza said is af­ford­able to most Ugan­dans. The price is $50 or more at some pri­vate fa­cil­i­ties.


Health worker Sylvia Maret­tah Ka­tende dis­plays re­pro­duc­tive health prod­ucts and in­for­ma­tion at a fam­ily plan­ning ex­hi­bi­tion in Kampala, Uganda. More than half of the world’s pop­u­la­tion growth be­tween now and 2050 will take place in Africa and Uganda, a leader in tak­ing on global health is­sues such as AIDS, is turn­ing to “cham­pion men” to pro­mote va­sec­tomies in fam­ily plan­ning.

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