Air Date: Week of September 2, 1994

Contraception and family planning has historically been seen as the woman’s responsibility, especially in traditional societies. That’s slowly beginning to change. Host Steve Curwood talks with Cyprian Awiti, director of a family-planning clinic in Nairobi that’s offering vasectomy services to Kenyan men.

Transcript

Population numbers continue to soar around the world, but birth rates are coming down in many countries. In Kenya, for instance, births have fallen from nearly 8 per woman a decade ago to 5-and-a-half today. Still, that's nearly 2 children more than the average Kenyan woman says she would like. More contraception for women is one way to meet this demand, but what about men? One group that's beginning to address this is Nairobi's Population and Health Services Clinic. This private family planning agency used to serve just women, but it's now aggressively promoting voluntary sterilization for men. The program has so far reached mostly older, educated urban men, but its popularity is growing. Director Cyprian Awiti says the clinic decided to target Kenyan men for one very simple reason.

AWITI: In the African context, the man is the head of the family. And the man will definitely decide how many children they want to bring up.

CURWOOD: What are the attitudes and beliefs that have kept family planning agencies in Kenya, indeed in Africa, from addressing the role of men before now?

AWITI: Well, I think before the feeling of people were that family planning was meant for women. That is (A). (B), if the man got married to a woman and they got children, and because of the not very good health facilities in those days, the children could die because of diseases. That is what we call the high child mortality rate. Then it was possible for this person to be able to get another woman to get more children. But at the moment, the health facilities in Kenya has improved. The child mortality rate is low. Economically you cannot be able to bring as many children as you want. So agencies and government have been looking for ways and means of reducing the population growth so that at least they can be able to manage with the resources they have got.

CURWOOD: In working to change attitudes about birth control, getting men to take responsibility for birth control, what work are you doing to change that dynamic in the family, to encourage men to have an equal relationship with their women?

AWITI: First, we are approaching the families to convince these people that days are long gone where the decisions within the house are based on the man alone. This is in the line of the fact that there is the woman's right, human right. We are convincing men that even contribution within the house, the woman is also contributing. So at the end of the day, it is important that both the man and the woman must be seen as decision makers.

CURWOOD: What about the spread of disease, if men aren't using condoms any more? If they're getting sterilized instead?

AWITI: Oh, yeah. I mean, we are encouraging the use of condoms even after vasectomy. Because in Kenya, and I'm sure in other countries, the HIV /AIDS spread is very high. So, we are advising people to stick to their partners, that is one. But of course we know it is not possible. So we are encouraging people to use condoms, even those that have been vasectomized.

CURWOOD: So why bother to get a vasectomy?

AWITI: Condom is not a permanent family planning method.

CURWOOD: What's the most discouraging part of your work?

AWITI: Well, one of the issues that makes us discouraging is that people have not really understood the vasectomy well. It is a new method of family planning in Kenya. We are in the business of changing attitudes. We are in the business also of changing feelings, and in the business of changing the psychological behavior.

CURWOOD: Well, I want to thank you for taking this time with us.

AWITI: Yes.

CURWOOD: Cyprian Awiti is the Program Director for Population and Health Services in Nairobi, Kenya. Thank you, sir.

AWITI: Thank you very much.