Indians need to share contraceptive responsibility

• India’s family planning programme, initiated in 1952, was a pioneering effort toward improving maternal and child health. Over the years, its objectives shifted toward stabilising the population. However, a significant gender disparity remains, with women predominantly bearing the burden of sterilisation. This imbalance presents challenges in achieving Sustainable Development Goal 5: gender equality and the empowerment of women.

Declining Vasectomy Rates:

• In the late 1960s, vasectomies accounted for over 80% of all sterilisation procedures in India. Over time, the emphasis shifted, and male participation steadily declined. According to the National Family Health Survey (NFHS), vasectomy rates stagnated at a mere 0.3% between NFHS-4 (2015-16) and NFHS-5, while female sterilisation stood at 37.9%. This disparity reflects deeply ingrained societal norms and policy gaps that continue to place the contraceptive burden almost exclusively on women.

Barriers to Male Participation:

• Cultural and Social Norms: Many men perceive sterilisation as a woman’s responsibility. Stereotypes around masculinity lead to misconceptions, such as vasectomy impacting libido or productivity.
• Lack of Awareness: Men in rural areas, in particular, are often unaware of vasectomy as a safe and reversible contraceptive option. Government incentives meant to offset wage losses during the procedure are also poorly publicised.
• Healthcare Infrastructure: Inadequate access to trained professionals and facilities for performing no-scalpel vasectomies discourages adoption, especially in underserved regions.

Strategies for Change

Awareness Through Education

• Sensitisation must begin early, with school-based programmes encouraging conversations about shared responsibilities in family planning. Community-level campaigns can complement this effort, dispelling myths and normalising vasectomies as a safe and effective procedure.

Incentivising Male Participation:

• Conditional cash incentives have proven successful in encouraging vasectomies. For instance, a 2019 study in Maharashtra’s tribal areas showed increased male participation when financial compensation was offered. States like Madhya Pradesh have enhanced these incentives, setting examples for broader adoption.

Strengthening Healthcare Systems:

• Investing in training healthcare workers and ensuring accessibility to no-scalpel vasectomy services in rural areas are crucial steps. Expanding service delivery will help overcome logistical barriers and promote trust in the procedure.

Learning from Global Examples:

• Several countries provide valuable lessons:
• South Korea: The highest global prevalence of vasectomy is driven by progressive gender norms and shared responsibility in family planning.
• Bhutan: Government-run vasectomy camps and quality services have normalised the procedure.
• Brazil: Mass media campaigns have effectively increased awareness and acceptance, raising vasectomy rates from 0.8% in the 1980s to 5% in the last decade.

Conclusion

• The disparity in sterilisation rates highlights the need for a comprehensive approach to family planning. Increasing male participation through awareness, incentives, and improved healthcare infrastructure is essential. India must move beyond mere policy intent to implement targeted, actionable measures that ensure contraceptive responsibility is shared equally between genders. This effort will not only advance family planning goals but also contribute significantly to achieving gender equality.