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  • Title: Barriers to service in Kenya: the other side of voluntarism.
    Author: Halpern J.
    Journal: AVSC News; 1987 Dec; 25(4):5-6. PubMed ID: 12281231.
    Abstract:
    Removing obstacles to access to contraceptive services is as important a problem in some parts of Africa as ensuring informed consent. The 1984 Kenya Contraceptive Prevalence Survey indicated that 32% of currently married, fecund women do not want any more children. 20% of these women reported that their last pregnancy was unwanted. Although sterilization would be a good contraceptive choice for many of these women, overcrowded hospitals are rarely able to provide this service, forcing women to use temporary methods. An important focus for the Association for Voluntary Surgical Contraception (AVSC) would be to reorient both clients and health professionals to minilaparotomy under local anesthesia. This procedure obviates the need for a sophisticated operating room or a lengthy postoperative stay. Moreover, experience in East Africa indicates that most potential sterilization patients find local anesthesia less frightening and more acceptable than general anesthesia. The AVSC is supporting training for over 40 African doctor-nurse teams a year in tubal ligation under local anesthesia. There are 25 AVSC supported sterilization service sites in Kenya. According to the AVSC, the typical sterilization client is a 34 year old woman of relatively high fertility who works at home on the land learned of voluntary sterilization through a clinic or community-based education system.
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