Changing Focus of Family Planning in India
India started a national family planning program in 1952, evolving from maternal health to population control.
Initially, male sterilisation (vasectomy) was prominent, but its use has steadily decreased, with a consistent 0.3% rate in recent National Family Health Surveys (2015-16 and 2020-21).
This decline contradicts India’s National Health Policy 2017, which aimed for male sterilisation to comprise 30% of procedures.
Gender Disparity in Sterilisation
Female sterilisation (37.9%) far outnumbers male sterilisation (0.3%), creating a gender imbalance in contraceptive responsibilities.
This disparity challenges gender equality goals (SDG 5) and the empowerment of women, as women bear most of the sterilisation burden.
Initiatives and Challenges for Male Sterilisation
Vasectomy Day (November) and ‘vasectomy fortnight’ in India aim to promote male sterilisation through awareness and debunking myths.
However, policies have not fully addressed practical barriers like male reluctance, misconceptions about the procedure, illiteracy, and lack of skilled providers, particularly in rural areas.
Many men are unaware of their role in family planning and government incentives for vasectomies.
Ground Realities and Solutions
In rural Maharashtra, women see sterilisation as their responsibility, with men hesitant due to beliefs about lost wages and job hardship.
Increased awareness and sensitisation from adolescence, especially in schools, could help normalize vasectomy as a shared responsibility.
Providing cash incentives, as seen in Maharashtra and Madhya Pradesh, could increase male participation, as demonstrated by a 2019 study.
International Comparisons and Learning
Countries like South Korea, Bhutan, and Brazil have successfully increased vasectomy uptake through societal acceptance, awareness campaigns, and government support.
India can adopt similar strategies, focusing on public awareness, training health professionals, and improving service availability, particularly non-scalpel vasectomies.
The government must align its policies with concrete actions and focus on demand- and service-oriented solutions to achieve gender equality in sterilisation practices.
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