The Male Role as “King of the Family”: Barriers to Vasectomy Uptake


  • Agnes Cyril Msoka Aga Khan University
  • Eunice S Pallangyo Aga Khan University
  • Sharon Mary Brownie University of Oxford
  • Eleanor Holroyd Aga Khan University



vasectomy, barriers, beliefs, Tanzania, men


Vasectomy is a long-acting male-centred family planning method that is accepted globally as a safe, low-cost procedure. However, the vasectomy uptake remains low in Africa and birth rates remain high, particularly in rural areas. In Tanzania, family planning education and service delivery are currently women-centred. Vasectomies to date have not been positively perceived in African societies including urban Tanzania, owing to the adherence to strong patriarchal belief systems and the social role of men. This study aimed to explore rural men’s perceptions and beliefs regarding barriers to vasectomy uptake. Significant barriers to vasectomy uptake were the lack of knowledge, expectations around men’s gendered role, religious beliefs, and social stigma. The participants were 51 purposively selected married men aged 35 to 61 years. Four focus group discussions and 20 in-depth interviews were conducted. Five main themes were extracted, namely men as the kings of their families; multiple sources of knowledge causing confusion; gender roles in family planning; cultural and religious beliefs; and stigma related to failure to produce children after vasectomy. Overall, men expressed the view that vasectomy was a challenge to their role as “king of their family”. Engaging in targeted media releases, using community billboards, and providing grassroots-based health education delivered by male “elimisha rika” (peer educators) at community level are recommended as awareness raising strategies in communities.


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Author Biographies

Agnes Cyril Msoka, Aga Khan University

Adjunct Lecturer

School of Nursing & Midwifery

Aga Khan University


Eunice S Pallangyo, Aga Khan University

Senior Lecturer

School of Nursing & Midwifery

Aga Khan University

Sharon Mary Brownie, University of Oxford

Research Associate 

Green Templeton College

University of Oxford

United Kingdom

Professor of Health Workforce Development

School of Medicine

Griffith University


Eleanor Holroyd, Aga Khan University

Professor Research Capacity Development

School of Nursing and Midwifery

Aga Khan University



How to Cite

Msoka, Agnes Cyril, Eunice S Pallangyo, Sharon Mary Brownie, and Eleanor Holroyd. 2019. “The Male Role As ‘King of the Family’: Barriers to Vasectomy Uptake”. Africa Journal of Nursing and Midwifery 21 (2):18 pages.