A Survey of Clients and Ethical Perspectives of Voluntary Tubal Ligations in the South-Western Nigeria

Abstract

Background: Acceptance of voluntary tubal ligation is gradually gaining wide acceptability in the developing countries. Aim: This study described the sociodemographic characteristics of acceptors of voluntary female surgical sterilizations (VSS) and assessed clients’ perception of compliance of health care providers with ethical, statutory, and policy requirements in family planning (FP) practices. Subjects and Methods: Retrospective, analytical study of VSS within the period January 2012 and June 2013, followed by a descriptive cross-sectional study of 96 sterilized clients from randomly selected health facilities in the South-Western Nigeria. The resultant data collected using interviewer-administered questionnaires were analyzed using SPSS software version17.0 (Chicago, IL, USA). Results: Seventy-two (75.0%) had the VSS procedure carried out during the cesarean operations. All clients were counseled by the surgeon/gynecologists on benefits of the procedure, though only 13.6% (13/96) received additional counseling from the FP care providers. All were counseled on benefits of the procedure while 75.0% (72/96) were counseled on the risk associated with the procedure and 67.7% (65/96) were offered alternatives to the procedure. No respondent was offered incentives for accepting tubal ligation. There was a statistically significant association between having a voluntary sterilization done on clients and having counseled client on benefits of the procedure (P - 0.01), having sterilization done based on both client and her husband’s decision (P - 0.05), and clients voluntarily accepting sterilization (P - 0.02). Conclusion: Statutory and ethical requirements being followed in VSS were performed and reviewed in this study. Clinical specialist working in the areas of tubal ligations should always endeavor to send their clients to FP clinics for a more thorough secondary counseling on their chosen method.

KEY WORDS: Compliance, statutory and policy requirements, sterilization, tubal ligation