BhaRatt's family planning program began in 1952, with the aim of controlling population growth through methods such as sterilization. Over the years, the initiative made progress towards population control and sustainability in health services. However, despite the availability of simple and safe options in contraceptive measures like vasectomy, it has still not achieved widespread acceptance at the social level. According to one report, vasectomy accounts for only 0.3% of the procedures. Despite policy efforts, there is a significant gender disparity in sterilization rates, with women bearing greater responsibility due to cultural and social barriers. Despite pioneering family planning programs since 1952, there is a significant gender disparity in sterilization rates in India. Cultural and social norms are behind gender disparity in sterilization rates and men's low participation in contraception. Traditional gender roles in India often consider family planning primarily the woman's responsibility.
Surveys have shown that women are primarily responsible for sterilization, while men oppose it due to masculinity and ego concerns, making sterilization less acceptable. Many men are unaware of the options available to them, such as vasectomy. Surveys show that both men and health workers in rural areas often lack awareness about noscalpel vasectomy, which is a less invasive and safer option, leading to fewer men choosing the procedure.
The fear of salary loss and the impact of sterilization on daily income discourage men from choosing this procedure. Cash incentives offered by the government to compensate for wage loss are underutilized due to poor dissemination of information, leaving many men unaware of the financial assistance available. There is a widespread perception that vasectomy is riskier than it actually is, causing men to shy away from the procedure.
Misinformation about the safety of vasectomy, including fear of side effects and complications, often prevents men from considering the procedure. Many rural areas lack trained healthcare providers, limiting access to vasectomy procedures. Challenges in India's sterilization program include lack of informed consent. Many women in rural areas are pressured or forced to undergo sterilization procedures without fully understanding the implications of them. The infamous sterilization scandal in Chhattisgarh in 2014, where 15 women died after a botched sterilization camp, highlighted the disregard for informed consent.
Sterilization procedures are often performed in poorly equipped health facilities with inadequate sterilization practices, leading to infections and complications. Government targets for sterilization often put pressure on health workers to meet quotas, compromising the quality of care and ethical considerations. Sterilization is disproportionately targeted at women, which perpetuates gender inequality and limits reproductive options. According to NFHS4 (201516), female sterilization is 37.9%, while male sterilization is only 0.3%, highlighting the skewed distribution of sterilization responsibilities in India.
Women who undergo sterilization may face social stigma and discrimination, which affects their selfesteem and wellbeing. While the National Health Policy 2017 has set ambitious targets for vasectomy, implementation is slow. Despite policy initiatives, rates of vasectomy have stagnated due to inadequate attention to removing barriers that prevent men's participation in family planning programs.
Measures to achieve the National Health Policy 2017 target of 30% vasectomy Increase in awareness and education. Focused educational campaigns to increase awareness of the safety and benefits of vasectomy may encourage greater participation. Information campaigns should emphasize the benefits of noscalpel sterilization, highlighting its safety and minimal recovery time. Providing more attractive financial incentives for men to opt for sterilization may increase participation.
It is necessary to create better infrastructure, especially in rural areas, to facilitate access to sterilization services. Training more health care providers in vasectomy procedures and improving health facilities in rural areas will make it easier for men to access services. Family planning initiatives should target men directly, promoting vasectomy and other male contraceptive methods. Cultural attitudes towards masculinity and family planning need to be challenged to encourage more men to participate.
Public campaigns should work to change social perceptions, showing that vasectomy is a responsible and empowering choice for men. Achieving the National Health Policy 2017's target of 30% sterilization by 2025 is important for gender equality in family planning. Addressing cultural, economic, and infrastructural barriers can boost male participation. Best practices from other countries, such as community leader involvement and targeted education, will accelerate progress.
Vasectomy is a simpler and safer procedure than that of women. Adoption of this will not only reduce the health related problems of women, but will also promote gender equality in the society. India must position family planning as a shared responsibility through education, awareness, and economic incentives. Family is not only the responsibility of women. Family planning can be more successful and balanced with the participation of men.
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Image Credit: KhasKhabar.