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

Vasectomy use has historically been very low in Bolivia, constituting just 0.1% of the method mix in 2021. MSI Reproductive Choices Bolivia (MSI Bolivia), one of the major reproductive health organizations in the country, sought to increase the affordability, availability, and quality of vasectomy services in their nationwide clinics and mobile units by training in-house providers to replace contracting external providers with high fees. We describe the MSI Bolivia vasectomy program in 2021 and its results over the following two years.

The program included components of the Engender Health Supply-Enabling-Environment-Demand (SEED) Programing Model™ for evidence-based vasectomy programming. First, MSI Bolivia offered free vasectomies through a social media campaign during November 2021. Second, two international No-Scalpel Vasectomy (NSV) experts trained four MSI Bolivia physicians during a week-long teaching program in La Paz, Bolivia. Third, MSI Bolivia formed partnerships and held a dissemination event to publicize the campaign. MSI Bolivia continued conducting training and marketing campaigns in 2022 and 2023.

During the 2021 six-week promotional campaign, 884 men signed up and over 600 were scheduled for the procedure. During the training week, the trainees performed 127 supervised vasectomies. Over the following weeks, the four trained physicians performed over 300 additional unsupervised vasectomies. Two of the newly trained physicians taught NSV to seven other colleagues in 2022 and 2023. MSI Bolivia reduced the fees for a vasectomy from Bs. 1500 (USD 215) to Bs. 850 (USD 122). The number of vasectomies performed by MSI Bolivia increased from 77 in 2019 to 643, 918, and 1,135 in 2021, 2022, and 2023, respectively.

By training their own physicians to perform NSV, reducing costs, and advertising through social media, MSI Bolivia was able to increase the availability, quality, and acceptability of vasectomy in Bolivia.