OBJECTIVES: The literature shows female sterilization is safer (has less complications) and at least as effective, if not more, in preventing unwanted pregnancies. The objective of this study was to analyze female-to-male sterilization rates by region in Colombia, as an indicator of a health-related gender gap, using data from SISPRO, the official database, which registers 500 million patient contacts per year, almost 3 million of which are classified as surgical procedures.

METHODS: We searched the Colombian Ministry of Health database for surgical sterilization procedures performed during the five-year period 2017 to 2021. For the analysis, Colombia was divided in 5 geographical regions (Amazon, Andes, Caribbean, Orinoco, and Pacific), and rates, based on 2019 population, as ascertained by DANE, the official statistics agency, were estimated for every 1000 females/males in each region. Costs, from a third-party payer perspective (the Colombian healthcare system) were converted into US dollars (USD) at the official exchange rate for 2019: 1 USD = 3,208 COP.

RESULTS: During the five-year period, a total of 279,486 tubal sterilization procedures and 68,384 vasectomies were performed in Colombia, for an average female/male (F/M) ratio of 4.1. F/M ratios for each region varied notably, and were Amazon 7.7, Andes 3.0, Caribbean 26.0, Orinoco 3.9, and Pacific 5.9. Rates per 1000 males were more than 10 times higher in the Andes (4.04) than the Caribbean (0.36). Average cost , as reimbursed by the healthcare system to each health provider, was USD $95.16 for the male procedure, and USD $146.70 for females.

CONCLUSIONS: From an economic perspective, male surgical sterilization would be the dominant intervention: safer, less costly and at least as effective, as compared with the female counterpart. Incentives should be implemented to increase its acceptance, particularly in the Colombian Caribbean region.