ACCEPTABILITY, PERCEPTIONS, AND BARRIERS TO VASECTOMY ACCESS IN LATIN AMERICA: A SYSTEMATIC REVIEW INFORMING POLICY AND HEALTH SYSTEM ACTION
Author(s)
Jazmin Figueroa, MD MSc1, Guillermo Reynoso, MD MSc2;
1Universidad Nacional Mayor de San Marcos, Lima, Peru, 2Universidad de San Martin de Porres, Lima, Peru
1Universidad Nacional Mayor de San Marcos, Lima, Peru, 2Universidad de San Martin de Porres, Lima, Peru
OBJECTIVES: The objetive of this review was to synthesize evidence on acceptability, perceptions, barriers, and facilitators influencing vasectomy uptake among men in Latin America, and identify policy-relevant determinants for improving equitable access.
METHODS: A systematic qualitative evidence synthesis was conducted following PRISMA 2020. Searches were performed in PubMed/MEDLINE, LILACS and SciELO, for studies published between 2015-2025. Eligible studies included qualitative, quantitative, and mixed-methods research addressing perceptions, acceptability, and access to vasectomy in Latin America. Two reviewers independently screened studies and extracted data using a standardized framework. Analysis was guided by access and equity frameworks (Levesque, PROGRESS-Plus), the Theoretical Framework of Acceptability, and gender theory. A thematic synthesis identified barriers, facilitators, and policy-relevant determinants
RESULTS: A total og 14 studies were identified. Evidence indicates a persistent gap between awareness and uptake of vasectomy. While knowledge and willingness are relatively high among medical trainees and some urban populations, actual utilization remains constrained by sociocultural norms, misinformation, and service delivery barriers. Religious affiliation, gender norms, and regional inequities shape perceptions, while provider-related factors—such as limited training and inconsistent counseling—further restrict access. Facilitators include couple-based decision-making, clear and trusted information, and exposure to trained providers. Evidence from public programs demonstrates that integrating no-scalpel vasectomy into primary care and standardizing counseling can improve access and acceptability.
CONCLUSIONS: Underuse of vasectomy in Latin America reflects systemic and sociocultural barriers rather than lack of demand. Policy responses should prioritize male-inclusive counseling, integration of vasectomy into primary care, and equity-oriented service delivery standards. Framing vasectomy as a routine, rights-based component of reproductive health may strengthen efficiency, equity, and sustainability of public health systems.
METHODS: A systematic qualitative evidence synthesis was conducted following PRISMA 2020. Searches were performed in PubMed/MEDLINE, LILACS and SciELO, for studies published between 2015-2025. Eligible studies included qualitative, quantitative, and mixed-methods research addressing perceptions, acceptability, and access to vasectomy in Latin America. Two reviewers independently screened studies and extracted data using a standardized framework. Analysis was guided by access and equity frameworks (Levesque, PROGRESS-Plus), the Theoretical Framework of Acceptability, and gender theory. A thematic synthesis identified barriers, facilitators, and policy-relevant determinants
RESULTS: A total og 14 studies were identified. Evidence indicates a persistent gap between awareness and uptake of vasectomy. While knowledge and willingness are relatively high among medical trainees and some urban populations, actual utilization remains constrained by sociocultural norms, misinformation, and service delivery barriers. Religious affiliation, gender norms, and regional inequities shape perceptions, while provider-related factors—such as limited training and inconsistent counseling—further restrict access. Facilitators include couple-based decision-making, clear and trusted information, and exposure to trained providers. Evidence from public programs demonstrates that integrating no-scalpel vasectomy into primary care and standardizing counseling can improve access and acceptability.
CONCLUSIONS: Underuse of vasectomy in Latin America reflects systemic and sociocultural barriers rather than lack of demand. Policy responses should prioritize male-inclusive counseling, integration of vasectomy into primary care, and equity-oriented service delivery standards. Framing vasectomy as a routine, rights-based component of reproductive health may strengthen efficiency, equity, and sustainability of public health systems.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR193
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives, Patient Engagement
Disease
SDC: Reproductive & Sexual Health, STA: Surgery