More people Embrace permanent forms of family planning
Tubal ligation (TL) and vasectomy are surgical family planning procedures which render women and men permanently incapable of giving birth or making someone pregnant. But what would make someone decide never to get pregnant or impregnate someone again?
For 31-year-old Hasfah Logose, a resident of Jinja municipality, it is the number of children and her inability to care for them.
“I have six children, with the eldest being 13 and the youngest now four months old. They are all girls but even though I don’t have any boy, I don’t want to give birth to any other child,” Logose said as she awaited her turn to be taken to the theatre for her tubes to be cut.
She adds that her children have three fathers but her current partner and the father to her last born has seven wives and is never around. However, even though she has come to be worked upon today, she wanted to stop giving birth about four years ago.
“I wanted to stop giving birth four years ago but my friends discouraged me saying that it is too painful and that after the surgery, the tubes reconnect and one can get pregnant again. Others instead encouraged me to use herbal methods all in vain,” Logose continues.
Logose is one of the women who are now able to get the service after Marie Stopes - Uganda, a non-governmental organisation which provides contraception and safe abortion services, trained clinical officers to carry out the minor surgery in the absence of doctors.
According to Faith Nassozi Kyateka, a communications manager, the number and availability of clinical officers in different health centres is higher than medical doctors who are mandated to carry out the minor surgery.
“The study started in 2014 and enrolled 20 clinicians; they were trained to carry out minor surgery for tubal ligation and vasectomy. Preliminary results showed that clinicians can carry out TL and vasectomy just as well as doctors as a way of increasing family planning use,” Kyateka explained.
She added that whereas their focus is not the permanent forms of family planning, many women and men are now embracing the method with at least three people every month seeking the service at the Jinja-based centre.
Change of mind
One of the clinicians, Arafat Mugaba, added that before he got the training, he was a counsellor and most of the times he was left stuck with who would carry out the surgery.
“If they say they want to cut the tubes and cannot wait, but then there is no doctor, they easily get discouraged and change their mind,” he explained.
Unlike Logose who came without the knowledge of her current partner, 35-year-old Tom Nadiope wanted to support his wife who had refused to undertake any form of family planning. With four children, Nadiope says he tried telling his wife to go for tubal ligation but she refused, thinking he would cheat on her and have other children.
“I decided to carry out the procedure on my own to prove to my wife that I loved her but that I never want to have more children. I want to see my children go to good schools and graduate from university so that they can have a good life,” Nadiope, a resident of Kamuli District, explained.
Tubal ligation and vasectomy are some of the many methods of family planning which are given to both women and men depending on their desire. Some of the common methods of family planning in Uganda are IUDs, injectable, emergency pills and condoms.
According to World Health Organisation, there is an estimated 225 million women in developing countries who would like to delay or stop childbearing but are not using any method of contraception.
In Uganda, the unmet need stands at 34 per cent. Busoga region is known to have the highest fertility rate with every woman estimated to have at least six children.
Healing time
Dr Arafat Mugaba says the surgery takes between 15 to 20 minutes to be carried out. In case of tubal ligation, the wound should be sealed off so that it does not get in contact with water for three days. After the three days, it should be massaged with hot water and the woman should resist from sexual activity for at least 10 days to allow proper healing.
He continues that for vasectomy, it becomes effective after three months. After cutting the tubes, he says the sperms which remain in the tubes can make a woman pregnant and cautions men to use condoms during the first three months until the sperm duct is cleared of all sperms. For TL, the procedure is effective immediately.
