A Successful Multi-Component Program for Expanding Vasectomy Services by MSI Reproductive Choices Bolivia.

Area of Science:

• Reproductive Health
• Surgical Procedures
• Public Health Initiatives

Background:

• Vasectomy utilization in Bolivia was historically low, representing only 0.1% of contraceptive methods in 2021.
• MSI Reproductive Choices Bolivia aimed to enhance vasectomy services' affordability, accessibility, and quality nationwide.
• The strategy involved training in-house providers to perform vasectomies, reducing reliance on expensive external specialists.

Purpose of the Study:

• To describe the implementation and outcomes of the MSI Bolivia vasectomy program initiated in 2021.
• To evaluate the impact of training, cost reduction, and marketing on vasectomy service delivery.
• To assess the increase in vasectomy procedures over a two-year period following program implementation.

Main Methods:

• The program incorporated elements of the Engender Health Supply-Enabling-Environment-Demand (SEED) Model.
• A social media campaign offered free vasectomies in November 2021, alongside a week-long No-Scalpel Vasectomy (NSV) training for four physicians by international experts.
• Partnerships and a dissemination event were organized, with ongoing training and marketing in subsequent years.

Main Results:

• During the 2021 campaign, 884 men registered, and over 600 were scheduled; 127 supervised vasectomies were performed during training, followed by over 300 unsupervised procedures.
• The cost of vasectomy was reduced from Bs. 1500 (USD 215) to Bs. 850 (USD 122).
• The number of vasectomies performed annually by MSI Bolivia surged from 77 in 2019 to 643 (2021), 918 (2022), and 1,135 (2023).

Conclusions:

• MSI Bolivia enhanced vasectomy availability, quality, and acceptability through in-house physician training in NSV.
• Cost reduction and targeted social media advertising were key factors in increasing service uptake.
• The program demonstrated a successful model for expanding access to vasectomy services in low-uptake settings.