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Assessment of Knowledge, Attitude and Practice (KAP) Prevailing in the Community for No-Scalpel Vasectomy (NSV) in District Bulandshahr (UP)

  • Arshid Nazir
  • Agency : No-Scalpel Vasectomy, Sterilization, NSV Acceptors, ASHAs’ Perspective, Family Planning
  • Objective : The objective of this study is to know the level of knowledge, attitude and practice of NSV prevailing in the community in the district Bulandshahr, (UP) with special focus on demographic and socio-economic profile of NSV acceptors, factors influencing acceptance of NSV and perception of ASHAs regarding factors affecting the acceptance of ‘No scalpel Vasectomy’.
  • Background : In order to promote male participation in family planning, the Union Ministry of Health and Family Welfare, launched the “No Scalpel Vasectomy Project” in 1998. Though as per NFHS-3 data, vasectomy accounts only 1%. In Uttar Pradesh, vasectomy accounts for 2.3% of the sterilization mix as per 2008-09 data available in the state. A lot of social and economical reasons have been attributed to and the most important was that the couples do not want to take the risk on the bread earner of the family.
  • Methodology : In order to assess the KAP for NSV prevailing in the community and the factors influencing the acceptance of vasectomy, a simple random sampling method was used and a 2-year reference period was used covering 40 NSV acceptors and 60 ASHAs residing in 4 different blocks of Bulandshahr, UP. Among others, the variables included demographic and socio-economic profile, knowledge and perceptions of NSV acceptors about NSV, reasons for choosing NSV, source of information, myths and misconceptions about NSV, etc.
  • Findings : The findings revealed that the mean age of accepting NSV is 38 years with almost majority of respondents literate. However, the rate of NSV acceptance falls with higher education. The study shows that NSV acceptance is more in men who are involved in doing heavy work and hard labour. This finding dispels the misconception that NSV is not for people who do heavy work. It was also found that economic status does not play any major role in accepting NSV. It was also found that the average number of children the NSV acceptors had is almost 3 with the average age of youngest child at the time of accepting NSV more than three years (3.37). No sexual weakness and relatively easier than tubectomy were the main reasons of motivation towards NSV. Some 77% NSV acceptor respondents expressed that they preferred NSV over tubectomy for the reasons that their wives were having one or other health problems. Mass media was reported as a major source of information followed by ASHAs/ANMs. Camps were seen as the preferred place for undergoing NSV as it linked with facilities provided and the kind of quality of services offered. From the discussion with ASHAs, issues that affect ASHAs efforts to mobilize NSV clients are lack of correct and complete knowledge related to NSV and skills required to communicate effectively, and lack of any support materials. Poor post-service delivery mechanism to handle complicated cases acts as a demotivator for ASHAs.
  • Recommendations : To improve accessibility and availability of NSV, medical officer’s upto PHC level should be trained in providing NSV services. Strong IEC material should be developed and activities to dispel myths/misconceptions should be taken up. Focus should be given to the effective interpersonal communication skills and counselling of clients. Regular reorientation of the health workers who are directly involved in the provision of services will help them to provide the service better. NSV acceptors to motivate his peers and developing them as NSV Champions should be involved. Holding regular camps in the peripheral facilities, needs focus.
study is to know the level of knowledge, attitude and practice of NSV prevailing in the community in the district Bulandshahr, (UP)