The Ghana vasectomy initiative: Facilitating client–provider communication on no-scalpel vasectomy

Abstract Objective In 2003–2004 and 2007–2008, an initiative was implemented to improve client and provider knowledge and acceptance of no-scalpel vasectomy (NSV) in Ghana. Methods At eight facilities, physicians were trained in NSV and staff received training in the provision of “male-friendly” ser...

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Bibliographic Details
Published in:Patient education and counseling 2010-12, Vol.81 (3), p.374-380
Main Authors: Subramanian, Laura, Cisek, Cindi, Kanlisi, Nicholas, Pile, John M
Format: Article
Language:English
Subjects:
Acceptance
Biological and medical sciences
Client–provider communication
Communication
Doctors
Family planning
Follow-Up Studies
Ghana
Health Care Surveys
Health Knowledge, Attitudes, Practice
Health Personnel - education
Health promotion
Humans
Internal Medicine
Male
Medical sciences
Miscellaneous
Nursing
Patient Acceptance of Health Care
Physician-Patient Relations
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality of service
Reproductive health
Reproductive Health Services - organization & administration
Vasectomy
Vasectomy - methods
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Summary:Abstract Objective In 2003–2004 and 2007–2008, an initiative was implemented to improve client and provider knowledge and acceptance of no-scalpel vasectomy (NSV) in Ghana. Methods At eight facilities, physicians were trained in NSV and staff received training in the provision of “male-friendly” services. Health promotion activities provided NSV information to prospective clients. Client–provider communication was assessed via a mystery client study ( n = 6). Knowledge and acceptance of NSV among potential clients were assessed with baseline and follow-up surveys (each n = 200) in 2003–2004 and three follow-up panel surveys in 2008 (each n = 240). Results Trained health staff exhibited improved attitudes and knowledge regarding NSV. Mystery clients reported receiving accurate, nonjudgmental NSV counseling. Awareness of NSV among panel respondents doubled from 31% to 59% in 2003–2004 and remained high (44%) in 2008. The proportion of men who would consider NSV increased from 10% to 19% in 2007–2008. NSV procedures increased three-fold from 2003 ( n = 26) to 2004 ( n = 83) and 2007 ( n = 18) to 2008 ( n = 53). Conclusion Provider training in client-centered services, coupled with targeted health promotion, improved client and provider knowledge and acceptance of NSV in an African context. Practice implications Complementary, sustained provider training and health promotion are needed to maintain NSV service quality and acceptance.
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2010.05.008