Knowledge, Attitude and Acceptability of Vasectomy Among Married Men: A Cross-Sectional Survey of Lira City, Northern Uganda

Abstract

Background: Vasectomy is a highly effective method of male contraception; however, its uptake remains low in many sub-Saharan African contexts, including Uganda. This study assessed the levels of knowledge, attitudes, and acceptability of vasectomy among married men in Lira City and identified factors influencing its acceptability. Methods: A community-based cross-sectional survey was conducted among 421 married men in Lira City using a cluster multistage sampling technique. Data was collected through face-to- face interviews with a structured, pretested questionnaire. Data entry and analysis were performed in STATA version 17. Descriptive statistics, bivariable, and multivariable logistic regression analyses were conducted, with adjusted odds ratios (AORs), 95% confidence intervals (CIs), and a significance level of p < 0.05 used to identify predictors of acceptability. Results: Overall, 83.4% of respondents had ever heard of vasectomy, mainly through the media, and 85% demonstrated adequate knowledge. About half (51%) expressed positive attitudes toward vasectomy, yet only 28% reported willingness to undergo the procedure. Predictors of acceptability included age 40–49 years (AOR = 1.411; 95% CI: 1.221–4.761), tertiary education (AOR = 0.406; 95% CI: 0.170–0.966), a desired family size of two to four children (AOR = 2.354; 95% CI: 1.363–4.067), and a positive attitude (AOR = 2.336; 95% CI: 1.459–3.741). Conclusion: Despite high awareness and knowledge, vasectomy acceptability among married men in Lira City remains low due to cultural beliefs and misconceptions. Recommendations: Targeted community-based education, male role model engagement, and integration of vasectomy counselling into routine family planning services are essential to enhance acceptability. Keywords: Knowledge, Attitude, Acceptability, Vasectomy, Married Men, Cross-Sectional Survey, Lira City, and Northern Uganda