IOSR Journal of Nursing and Health Science (IOSR-JNHS) e-ISSN: 2320–1959.p- ISSN: 2320–1940 Volume 3, Issue 6 Ver. IV (Nov.-Dec. 2014), PP 70-76 www.iosrjournals.org www.iosrjournals.org 70 | Page Vasectomy in Pakistan: Changing culture of sharing responsibility towards better family health 1 Sumaida Anwar 2 Majid Shahzad 1 (Principal, Regional Training Institute Sahiwal, Population Welfare Department, Government of Punjab) 2 (PhD Fellow, Department of Anthropology, Quaid-I-Azam University Islamabad, Pakistan) Abstract: The model study aims to improve the health of women’s reproductive age by finding out the socio- economic factors, which contribute towards vasectomy decision making and associated experiences of married couples in two districts of Southern Punjab Pakistan. For quantitative part 140 vasectomize males were interviewed. The mean age of sample was 38.7 years, 93.6% respondents were satisfied with their decision and 92.9% had religious satisfaction on their choice of permanent contraception. In-depth interviews from couples for qualitative part revealed eight overarching reasons contributed towards vasectomy decision making and post vasectomy experiences depended on five factors i.e. attitude of service providers, post-operative recovery, sexual relationship, and effect on the health of husband and wife, and overall effect on family. Keywords: Family Planning, Gender, Health Promotion, Responsiveness, Vasectomy I. Introduction Sterilization is the most pervasive and widely used contraceptive method in the world. According to ACQUIRE project report and as Pile envisions [1, 2], it will remain the same for the next two decade. But it is the female sterilization which is fixed upon and preferred to vasectomy (i.e. permanent male contraceptive surgical method) without concurring that vasectomy is a boon. Its advantages are numerous it is quicker, much cheaper, suits to more settings and there is fast recovery according to John Hopkins Bloomberg School of Public Health [3]. As far as mortality is concerned, till now there is no documented mortality correlated to vasectomy while 10 to15 women die each year in America due to tubal ligation and the associated complications. Failure rate of vasectomy is around 1% and female sterilization is 2% according to Kathrine [4]. In developing countries like Pakistan, the chasm between vasectomy and tubal ligation is too wide to bridge as the prevalence of vasectomy is 0.1% and female sterilization is 8.2%- reported by Population Reference Bureau [5]. Throughout the world female is the main target group for family planning activities as discussed by Jagannadha [6]. Even if male contraceptive choices are available, health care providers devote little or no consideration to these procedures including vasectomy. This attitude no longer seems acceptable. Realization of this manager level ignorance towards issue resulted in male oriented activities to enhance the male involvement in reproductive health and family planning. Evidence from literature also indicates that men play prime role in family planning decision making and in determining the family size-a couple should have [7]. International agencies are investing mammoth amount in family planning programs. Developing countries family planning program predominantly depends on donor assistance but as donor assistance is expected to decline so main expenditure of services is likely to pass on to consumers [1]. In case of withdrawing of assistance, there is a need to promote cost effective methods of family planning. Vasectomy is safe, effective and cheaper, so the need is to make research and consider the factors which motivated these vasectomized males to opt vasectomy in family planning services. There is limited study on vasectomy in Pakistan. The identification and understanding of underlying factors leading to decision in favor of vasectomy and post- vasectomy experiences are vital for future strategic planning to enhance male involvement in reproductive health and family planning and to create attitudinal shift from tubal-ligation to vasectomy. II. Methods A descriptive cross-sectional study carried out in Southern Punjab, Pakistan. It was a mixed model study having two elements i.e. quantitative and qualitative part. Sample: 140 vasectomized males were selected through simple convenient sampling for quantitative part. The vasectomized males included those who had vasectomy during 2005 to 2009 in Government sector settings i.e. in FHCs (Family Health Clinics) & extension camps through FHC in marginalized, outreach rural areas of two districts of southern Punjab. For qualitative part, in-depth interviews were conducted from vasectomized couples, till saturation was secured. Drug addicts and those vasectomize males who had some chronic illness were excluded from study.