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Establishment of a Regional no-scalpel vasectomy (NSV) training center
of
Background
The Urmia No. 9 Health Center is
an
The center is headed by Dr. Eslamlou, who has established the NSV center
within that center. Dr. Eslamlou is a MD, who has a PhD in public Health
and is the only master trainer in
NSV Service Delivery in the Center
The center offers NSV services of very good quality. Clients are welcome
during health center working hours.
In case a person wants to undergo NSV, he will be guided to the
reception area of the NSV center. There he is counseled by a trained
counselor on not only NSV, but on all family planning methods. This is
done by using the newly developed family planning flipchart. After being
counseled, the client is given a brochure on vasectomy and other FP
methods to take home and study. The brochure includes instructions on
what to do prior to a vasectomy.
In case the client chooses to undergo a vasectomy, on the day of
vasectomy, he has to come together with his wife. There the wife also
has to sign the informed consent form, after the couple has again been
counseled for all FP methods and the particular case of vasectomy. The
management of the center is well aware that this procedure might reduce
the number of clients for vasectomy, however they believe in the
importance of holding up a high quality of counseling and ensuring a
fully informed choice.
The clinic has two entrances, and there is one direct entrance form the
street, so that the vasectomy client who does not want to go through the
whole clinic can directly access the NSV clinic from the street.
Having chosen to undergo a vasectomy, the client is directed to a
changing room, which has lockers. He can change into the operation gown
and can lock his private belongings. Washing rooms are available next
door.
Next to the changing room is the physician’s change and examination
room. The room is used for pre-operational and follow-up examinations of
the client.
The center has two neighboring operating theatres, which comply with the
latest international standards and can even accommodate big operations.
This is different from other centers, in which NSV is performed in
normal rooms.
Staff of the center is constantly coming up with new ideas, which
improve the quality of the services. As an example, Dr. Eslamlou has
introduced a new mode of operation site bandage, which reduces the
possibility of hematoma occurrence.
The operation theatre is equipped for emergencies with a standard
emergency box that contains, among others, the full range of emergency
drugs. Furthermore the center is in the immediate neighborhood of a
specialized hospital.
Since scrotum elevation is one of the key steps of post-operational
care, the client is given a testicular suspensor, free of charge, along
with the instruction on how to wear it after the operation. The client
has to put on the suspensor in front of the physician. This is unique to
the Urumieh center. In other centers, clients are advised to either wear
tight briefs or buy a suspender.
Due to the above-mentioned measures, the center has a significantly
lower complication rate than the globally stated complications rates of
1-2%. In Urumieh NSV center the complication rate is one tenth of
this figure.
Follow-up
Immediately after the operation the client is given a package, which
includes brochures on postoperative care, 20 anti-inflammatory tablets,
10 condoms and a form to request for a sperm count after three months.
The fact that the post operative sperm count is done in the center
itself and free of charge is another unique feature of the center.
Follow-up examinations of the client include one sperm count after three
months and one after four months. In case needed, more sperm counts are
done. The laboratory follows WHO standards, which include several other
indicators in addition to the sperm count.
One of the problems of other centers is the low rate of follow-up. This
is due to the fact that clients are asked to refer to the private sector
for the sperm count. However, the center does active follow-up for the
clients to refer to the center. Since the services are free of charge
and the clients already know the staff, they are more inclined to use
the follow-up services. The results of the sperm count are entered in
the computer and documented in the file of the client.
Training facilities
Trainees of this center receive training not only in NSV, but also in FP
counseling. The training follows a high standard and only 8 out of 10
trainees manage to receive the certificate, which has a limited duration
of 2 years. After two years the trainees have to undergo another
assessment. In case required, they have to attend either refresher
training or even undergo the full course again.
The director of the NSV center has managed to obtain refresher training
course credits for the NSV training for physicians. Since all physicians
are required to obtain a certain amount of refresher training credits,
this has led to a high number of requests for participation in NSV
trainings.
After
successful completion of course, each trainee is given a full package
with training manual and other material, including readily packed NSV
set
Accommodation for trainees from outside Urumieh is available and very
close to the center.
In 2005, the center conducted a successful country-level seminar,
examining and certifying senior trainers of NSV, with the presence of
professor Li Shunqiang , founder of NSV technique in the world. In a
report to the United Nations Population Fund (UNFPA), Dr. Li praised and
confirmed the physical possibilities, equipment, and professional
manpower of Urmia vasectomy training center and suggested transforming
it to an international center for training vasectomy. Therefore, in the
past two years, UNFPA, the MOHME, the "population, family and health
training office of the Ministry of Health", and the West Azarbaijan
University of Health and Medical Education have been supporting the
center, and so far more than Rials 800 million have been spent by the
university, the health undersecretary and UNFPA, in order to achieve
international standards in areas of NSV services and NSV training.
Some staff from UNFPA and physicians from
Availability of educational kits, curriculum, reference books and
leaflets, educational guides for senior trainers, educational texts for
the trainers, etc.
1. Quality of service providing, number of applicants, level of access
to the equipments and tools of surgery, potential of preventing
infections, (ensuring quality of surgery by academic resources).
2. Trainers: quality of education and services provided, their work
experience, clinical training skills.
3. Trainees: cooperating in providing quality NSV services according to
the national standards.
It had been decided that before admission of the first group of foreign
physicians for training in Urmia regional NSV training center, a mission
from the Islamic Republic of Iran will visit the world’s sole
international vasectomy center. In this connection, in late 2007, Dr.
Mohammad Reza Tarjomaan, Deputy of the University in Health Affairs and
Dr. Hameed Reza Farrokh Islamloo, faculty member and head of the
international center of training vasectomy in West Azarbaijan University
of Medical Science, along with Dr. Mohammad Eslami, head of the family
planning office in the Ministry, visited the international center for
training vasectomy in Sichuan province of China with financial support
from UNFPA.
The initial agreement to establish the research center for reproductive
health in the location of the regional vasectomy training center was
given by the Undersecretary for Research and Technology of the Ministry
of Health in 2008.
The average number of vasectomies performed in the center is 100 cases
per month.
Activities of the Center:
a) Research activities:
* Conduct of fundamental and applied research in various fields
connecting to reproductive health based on research priorities in this
area.
* Preparing appropriate conditions for students, assistances and
researchers to develop their thesis and research by providing proper
data bases
* Cooperation with national and international organizations in
connection with reproductive health, especially UNFPA, to conduct joint
research projects
b) Educational activities:
* Training reproductive health counseling and no-scalpel vasectomy to
local physicians.
* Classical training of matters related to reproductive health for
medical, nursery, assistants to gynecologists and urologists and M.A.s
in epidemiology.
* Training and retraining of graduates of medical disciplines,
specialists in urology and gynecologists in the areas related to
reproductive health, especially NSV, IUD, and IVF.
* Training of country-level reproductive health counseling trainers and
trainers of NSV technique and IUD insertion, and practical periodical
monitoring of trainers in cooperation with the health undersecretary of
the Ministry.
* Arranging research method workshops.
* Arranging workshops based on the WHO method to train how to analyze
sperm.
c) Service and therapeutic activities:
* Public education in the field of protection and promotion of
reproductive health of the society.
* Providing reproductive health counseling services, providing all
contraception methods (temporary methods and infertility), counseling,
prevention and treatment of behavioral, venereal diseases and HIV /
AIDS, counseling, prevention and treatment of infertility.
d) Personnel and management:
*Urmia country- level center of vasectomy training works as an
independent unit since 1381 and has close connections with health,
educational and research undersecretaries the Ministry.
* President of the university selects its dean.
* IVF center of the university and the country-level center of vasectomy
training, constituted " reproductive
health research center" in 1384.
* Public health education, urology and gynecology departments of the
university cooperate in scientific and educational areas.
* 5 full-time, 9 half-time faculty members and 8 full-time
paramedical
personnel cooperate with reproductive health research center.
Vice president
Vice president
Vice president
for education
for health affairs
for research
Public health
Regional vasectomy
Reproductive health
educational group
training center
research center
Urology educational group
Gynecology educational
IVF center
group
----------------------------------------------------------------------------------------------------------------
Conducted Research Projects:
* "Review of time and number of ejaculations required to produce
azoospermia (or severe azoospermia
or severe oligozoospermia) after NSV, Urmia 1383" with
rials 37,300,000 credit , which was provided by the general office of
family health and population of health undersecretary of the Ministry.
-
* "Comparative study of the two
injectable contraception
methods of
Depo medroxy progesteron acetate (DMPA)
and Cyclofem by clinical tests
phase III (Urmia 1385-86)" , with rials 71,570,200 credit ,
that was provided by the general office of family health and
population of health undersecretary of the Ministry.
-
* " Monitor and assessment of conducting fillip chart for
presentation performance
ratings of family planning in selected units and centers of four
pilot cities (Noor, Urmia, Semnaan and Chahbahaar) " with rials
221,000,000 credit that is provided by the United Nations Population
Fund (UNFPA).
-
*" Raising quality of family planning services, through integrating
the presentation of services guide into the family planning program
in the selected health-treatment centers of Urmia-1386" with rials
11,000,000 credit that was provided by the research vice presidency
of the University.
-
* Securing vasectomy standards in NSV method with rials 100,000,000
credit that has been
provided by UNFPA.
-
Situation
Financial
-
* So far costs of equipping the center have been paid by UNFPA,
health undersecretary of the Ministry of Health and Urmia University
of Medical Science.
-
* Current and staff costs are paid by Urmia University of Medical
Science.
-
* Credits for research are provided by health undersecretary of the
Ministry of Health, Urmia
University of Medical Science and international organizations like
UNFPA.
-
Successes Achieved :
-
*More than 400 medical students, 550 nursing students, and 250
health students have been trained and retrained.
-
*More than 80 general practitioners and 25 assistant urologists have
successfully passed short-term NS V training courses and received
related certificates.
-
*Performance of more than 200 general practitioners who conducted
no-scalpel vasectomy has been monitored and assessed.
-
* 16 reproductive health counseling workshops have been conducted in
country level.
-
* More than 9,000 men have undergone no-scalpel vasectomy.
-
* 50
paramedical personnel
have successfully passed IUD insertion training courses.
-
* Successful holding of a country level seminar for testing senior
trainers of NSV with presence of professor Li Shunqiang , the
founder of NSV in the world.
-
Buildings:
-
Building No. 1: Regional NSV training center and related
laboratories in 1,500 square meters area.
-
Building No. 2: Kousar section with laboratory and IVF clinic in
1,000 square meters area.
-
Laboratories and Workshops:
-
* Central laboratory of Urmia health center.
-
* Professional laboratory of IVF section.
-
* Skill Lab workshop, specific to training of no-scalpel vasectomy
(NSV).
The West Azarbaijan University of Health and Medical Education believes
that the center is now ready to conduct NSV trainings for foreign
physicians, and would like to announce to neighboring countries their
readiness to accept the first group of physicians from neighboring
countries. The first
training round is suggested to be held in October, which would coincide
with the visit of Professor Liu from the Sichuan RH Center.
