Vasectomy knowledge, attitudes, and intentions among men in Ethiopia: a systematic review and meta-analysis
摘要
Vasectomy is a highly effective (99.9%) and safe permanent family planning method for men. Despite these advantages, it remains one of the least utilized and most misunderstood contraceptive options. This systematic review and meta-analysis aimed to explore men’s knowledge, attitudes, and intentions toward vasectomy in Ethiopia by synthesizing scattered evidence to present a comprehensive national picture.
MethodsThis systematic review and meta-analysis were conducted according to the Joanna Briggs Institute methodological guide and were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for relevant literature in major databases, including PubMed, Google Scholar, ScienceDirect, Web of Science, and Scopus. Citation tracking and reference lists were also reviewed to ensure a complete search. The search was conducted from inception to 31 December 2024; the final search was run on 5 January 2025. Pooled prevalence estimates were calculated using the DerSimonian–Laird random-effects model. Heterogeneity was assessed with the Cochrane Q-test and the I² statistic, and publication bias was evaluated using funnel plots and Egger’s test. All analyses were performed using Stata version 17.
ResultsOf the 393 articles initially identified, nine met the inclusion criteria, with a combined study population of 3,705 men. Only 39.8% (95% CI: 25.3–54.4) of men had good knowledge of vasectomy, 29.3% (95% CI: 16.8–41.7) had a positive attitude, and 20.8% (95% CI: 16.7–25.0) intention to use vasectomy. Higher education was linked to better knowledge, and having ≤ 4 children was associated with lower likelihood of having knowledge about vasectomy. Positive attitude toward vasectomy use was the strongest predictor of intention to use vasectomy.
ConclusionAmong Ethiopian men, knowledge, attitudes, and intentions regarding vasectomy remain low. Educational attainment and family size play important roles in knowledge, and attitude is a key driver of intention. To boost vasectomy uptake, efforts must focus on dispelling myths, fostering positive perceptions, and encouraging male engagement in family planning decisions.
RegistrationThis review was registered with PROSPERO (CRD420250634669).