By Graham Holliday and Themistocle Hakizimana
KIGALI (Reuters) - Rwanda's health ministry has launched a campaign encouraging men to undergo vasectomies, in an effort to curb population growth in Africa's most densely populated country.
Family planning is seen as an important factor in the development of the small east African nation with a population of 11 million people and which is hoping to compete with regional powerhouses Kenya, Tanzania and Uganda.
The government insists population policy is calibrated to match economic growth and estimates that to keep the economy growing at an average 7-8 percent per year, the birth rate must be below three children per family.
The health ministry offers the "no-scalpel" procedure for free, to encourage Rwandan men to share the burden of family planning which has traditionally been the lot of women.
But some men balk at the procedure, in which the sperm tubes are heat-sealed, divided and placed back into the scrotum.
"I can't use vasectomy for family planning because I could lose my children and if I have it I cannot have others. You never know what might happen in the future," said Jean Baptiste from Rulindo province in northern Rwanda.
"For that (reason) I don't want to have a vasectomy even though I am willing to help my wife limit the number of children we have."
According to Rwanda's 2010 Demographic and Health Survey, the use of contraception has increased substantially over the past five years. Forty-five percent of married women used contraception in 2010, up from 10 percent in 2005.
Arthur Asiimwe, a communications official at the health ministry, said the campaign targets families who have more than five or six children.
"It's quite unfair that different family planning initiatives we had were only focusing on women," Asiimwe said.
"With this we think also men can contribute ... because men are also sexually responsible to be part of these family planning initiatives," he said.
The community-driven initiative works by men going door to door extolling the benefits of the procedure, following on from education and awareness campaigns.
Fulgence Bizimana, who has had a vasectomy, said he has to convince skeptics the procedure will not affect their sexual performance.
"In our teachings ... we tell them that the rumors saying that when you undertake vasectomy you don't meet your partner properly or your sexual performance is affected, we tell them that is not true," he said.
"Since I had my vasectomy my family has changed a lot. Before we had family disputes. Right now we share activities, we plan for family and we see that life goes well," he said.
Anne Marie Kanyana, whose husband was one of the first to go through the procedure in Rulindo, said she was glad he had opted for the vasectomy.
"There are rumors saying that after a man has had a vasectomy he has health problems, especially during sexual relationships. I want to tell you that is not true," she said.
(Editing by Yara Bayoumy and Louise Ireland)