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FOURNIER'S GANGRENE COMPLICATING VASECTOMY
Abstract
ABSTRACT
Quality of care of services provided to family planning clients is a source of major
concern in reproductive health care, especially in resource-poor settings. It may be
measured in terms of safety of the method or service provided and may be influenced
by the knowledge, skills and experience of the service providers, the environment in
which the services are provided and the care thereafter. As a result of various efforts
by the government and other stake-holders there have been tremendous developments
in the family planning programme in Malawi in the past ten or so years. The
contraceptive prevalence rate (CPR) more than doubled between 1992 and 2000.
Secondly there has been expansion of facilities providing contraceptive services and the
method mix such as introduction of voluntary surgical contraception (VSC) for both
females and males. The increased demand for contraceptive services has outstripped
the available services and as a result led to lapses in the quality of care. These have
resulted in some apparently healthy individuals either dying in the course of or following
service provision or suffering serious morbidities. This paper presents two cases of
Fournier's gangrene following vasectomy in previously healthy male adults in Malawi.
It discusses their diverse management and results thereof, and explores the potential
impact on the programme in Malawi, in the context of adverse publicity on contraceptives.
The possible operational factors for the complications are explored and preventive
strategies proposed to ensure sustenance of the already registered gains in fertility
control in Malawi.
Quality of care of services provided to family planning clients is a source of major
concern in reproductive health care, especially in resource-poor settings. It may be
measured in terms of safety of the method or service provided and may be influenced
by the knowledge, skills and experience of the service providers, the environment in
which the services are provided and the care thereafter. As a result of various efforts
by the government and other stake-holders there have been tremendous developments
in the family planning programme in Malawi in the past ten or so years. The
contraceptive prevalence rate (CPR) more than doubled between 1992 and 2000.
Secondly there has been expansion of facilities providing contraceptive services and the
method mix such as introduction of voluntary surgical contraception (VSC) for both
females and males. The increased demand for contraceptive services has outstripped
the available services and as a result led to lapses in the quality of care. These have
resulted in some apparently healthy individuals either dying in the course of or following
service provision or suffering serious morbidities. This paper presents two cases of
Fournier's gangrene following vasectomy in previously healthy male adults in Malawi.
It discusses their diverse management and results thereof, and explores the potential
impact on the programme in Malawi, in the context of adverse publicity on contraceptives.
The possible operational factors for the complications are explored and preventive
strategies proposed to ensure sustenance of the already registered gains in fertility
control in Malawi.
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