Down But Not Out: Vasectomy Is Faring Poorly Almost Everywhere-We Can Do Better To Make It A True Method Option.

Area of Science:

• Global Health
• Reproductive Health
• Contraception

Background:

• Vasectomy, a male contraceptive method, faces low demand due to widespread myths, misconceptions, and provider bias.
• Limited programmatic attention and sporadic donor funding have hindered vasectomy services.

Purpose of the Study:

• To analyze global vasectomy use trends in low-, middle-, and high-income countries.
• To identify challenges and disparities in vasectomy service provision.

Main Methods:

• Analysis of vasectomy use data from 95 countries (84 LMICs and 11 high-income countries).
• Inclusion of UN survey data, population estimates, and gender inequality rankings.
• Review of recent literature on vasectomy challenges.

Main Results:

• Vasectomy use has decreased by 61% over two decades, with 17 million women relying on it globally.
• Tubectomy use has increased, with 219 million women using it.
• Female-to-male permanent method use disparity widened globally from 5:1 to 13:1.
• Vasectomy prevalence is below 2% in most LMICs, with significant regional disparities.

Conclusions:

• Vasectomy use is declining globally, particularly in LMICs, due to low demand and program prioritization.
• Holistic program efforts, including addressing demand and service provision, are crucial for accessibility.
• Mass media campaigns and provider training are vital to normalize vasectomy and increase its uptake.