Attitudes toward voluntary surgical contraception in four districts of Kenya

A series of 32 focus groups were held among men and women in the catchment areas of four active voluntary surgical contraception (VSC) programs in Kenya. Women who had had tubal ligation and their husbands were uniformly favorable to this method. The majority of couples using reversible methods saw tubal ligation as a logical future choice. Participants were frank about economic motives, and many were willing to endure criticism of the older generation in accepting tubal ligation. By contrast, attitudes toward vasectomy were uniformly negative. These findings dispel the idea that tubal ligation is culturally unacceptable in the sub-Saharan African context. Rather, favorable attitudes appear to have emerged due to readily accessible, low-cost VSC services in the areas studied.