INCREASING THE AVAILABILITY OF VASECTOMY IN PUBLIC-SECTOR CLINICS

A program designed to improve the availability of vasectomy in public- sector clinics trained physicians at 43 facilities in no-scalpel vasec tomy between 1993 and 1995. Among the 38 clinics that responded to a f ollow-up survey in 1996, the number of clinics providing vasectomies r ose from 23 to 32, an increase of almost 40%, while the number of vase ctomies performed rose by 18%. Seventeen of the 32 clinics performed m ore vasectomies after the training; 10 of the 17 had not previously pr ovided the procedure. In-depth interviews with staff from seven sites that experienced large caseload increases and from seven that experien ced decreases identified three elements for the successful establishme nt or expansion of vasectomy services-sufficient numbers of trained pr oviders, funds to subsidize vasectomies for men who cannot afford them and activities to raise awareness about the availability of low-cost or free vasectomy.