Guatemala: On-site training and outreach increases demand for and provision of vasectomy

About one-third of Guatemalan women use modern contraceptives and half of these use female sterilization. Despite the strong demand for permanent methods, vasectomy is used by less than 1 percent of all couples. An ineffective service introduction model contributes to the low use of vasectomy. In the traditional model, doctors are sent to a hospital (often abroad) where a relatively high number of vasectomies are performed, and the trainee performs at least five supervised vasectomies. In their home practice, however, trained doctors frequently find a low demand and, unable to routinely perform vasectomies, soon lose their enthusiasm and surgical skills. In 2005, FRONTIERS tested a new model for introducing sustainable no-scalpel vasectomy services in hospitals in Guatemala City. The model involved vasectomy training for the entire health team, counseling and information for potential clients, and on-site training of surgeons with clients identified by the health teams. The goal was to establish four vasectomy service centers, one of which could become a training center. As noted in this brief, this facility-based approach using team orientation, on-site training, and counseling for potential clients significantly enhanced demand for vasectomy services.