Men who go sterile for their women

The other day through an idle drive NyarSindo asked me my opinions about vasectomy. I told her my grandfathers would be shuddering if they would even hear her contemplate ending the long line of Manyala’s, risking the link onto the next generation.

Vasectomy is not popular in Kenya, with just about 557 Kenyan men who walked into the doctors last year and had the procedure, according to the Economic survey. The lower uptake is mainly blamed on misconceptions about whether it is reversible or not, and cultural significance of a man’s manhood.

After, I asserted how as a custodian of our culture, I would not be the first of my people to self-mutilate in the name of being politically correct and progressive. Only to learn later, when I went to dig up the data for this story ,that my people from Busia are among the three counties with the highest rate of vasectomy.

Lamu county has the largest proportion of men using vasectomy sterilization as a form of birth control according to the 2022 Kenya Demographic & Health Survey, at about 0.4 percent, with Busia and Bungoma having 0.3 percent of their men.

I have chosen to conveniently ignore this fact whenever she challenges my argument, but generally the data seems to suggest that the appeal of permanent family planning methods in Kenya are on a decline. The number of women undergoing Sterilization has come down to 4,107, more than half of the10,814 women who sterilized in 2018.

In fact, in our most fearful times, when our survival was not guaranteed during Covid-19, vasectomy in Kenya became even less popular. Declining from a high of 658 in 2019 to 334 during 2020 Covid-19 era, 334 in 2020 and 248 in 2021 according to KNBS data.

But while permanent sterilization is becoming unpopular, family planning is becoming ever more successful where the total fertility rate has declined by 3.3 children (from 6.7 to 3.4) between 1989 and 2022. Over the same period, the fertility rate among women in rural areas declined from 7.1 children to 3.9 children while among urban women, the fertility rate reduced from 4.5 children to 2.8 children.

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Data shows that the biggest form of family planning is the terror of having one child. The desire to have another child decreases sharply the more children a Kenyan woman has.

While 88 per cent of currently married women with no children want to have a child (66 percent soon and 22 percent within the next 2years) the percentage decreases to 33 percent among women with three children and to 16 percent among those with six or more children.

The second most significant contributor to planning families is education and working women. Education and employment has meant that fertility is low among adolescents (73 births per 1,000 women age 15–19), peaks at 179 births per 1,000 among women age 20–24, and then decreases thereafter.

Kenya’s official data shows that only a quarter of illiterate women use any form of contraception but the proportion jumps quickly to 64 percent on as little as primary educated women and up to 68 percent of those who go beyond secondary school.

Among currently married women, the most commonly used methods are injectables (20 percent), implants (19 percent), and contraceptive pills (8 percent).

While among sexually active unmarried women, male condoms are the most commonly used contraceptive method (20 percent), followed by injectables (16 percent) and implants (11 percent).

As education among women alters the time which women say they are ready to have children and the methods used, increasingly men will be called upon to play a role in birth control.

My only line of defense now is that in Kenya the men who are more likely to agree to vasectomy are those among the middle class and older men between the ages of 40 and 49, of which I am neither.

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