No-Scalpel Vasectomy: An Illustrated Guide for ... - EngenderHealth

AppendixWorld Health Organization (WHO) Eligibility Criteriafor Vasectomy Procedures*IntroductionConsidering the irreversibility or permanence of sterilization procedures, specialcare must be taken to assure a voluntary informed choice of the method by theclient. Particular attention must also be given in the case of young people, menwho have not yet been fathers, and clients with mental health problems, includingdepressive conditions.The national laws and existing norms for the delivery ofsterilization procedures must be considered in the decision process.There is no medical condition that would absolutely restrict a person’seligibility for sterilization. Some conditions and circumstances indicatethat certain precautions should be taken.The classification of the conditions into the different categories is based on an indepthreview of the epidemiological and clinical evidence relevant to medicaleligibility. The programmatic implications of these updated medical criteria arestill to be addressed, taking into account the various levels of service delivery.However, for the particular case of sterilization procedures, the following categorydefinitions were developed.DefinitionsA (Accept):C (Caution):D (Delay):S (Special):There is no medical reason to deny sterilization to a person withthis condition.The procedure is normally conducted in a routine setting, but withextra preparation and precautions.The procedure is delayed until the condition is evaluated and/orcorrected. Alternative temporary methods of contraception shouldbe provided.The procedure should be undertaken in a setting with anexperienced surgeon and staff, equipment needed to providegeneral anesthesia, and other back-up medical support. For theseconditions, the capacity to decide on the most appropriateprocedure and anesthesia regimen is also needed. Alternativetemporary methods of contraception should be provided if referralis required or there is otherwise any delay.*Adapted from: WHO, 2000.EngenderHealth 55