Bridging the Gender Gap in Family Planning:   

Context:

India's journey with family planning dates back to 1952 when a national program was introduced to enhance maternal and child health while controlling population growth. Over time, this initiative has seen considerable evolution. However, a notable trend persists: a pronounced gender disparity in the adoption of permanent contraceptive methods. This disparity reveals systemic barriers to achieving gender equality, particularly within the framework of Sustainable Development Goal (SDG) 5, which aims to empower women and girls globally by 2030.

The Decline in Male Sterilisation:

In the late 1960s, vasectomy was the predominant sterilisation method in India, accounting for more than 80% of all such procedures. However, due to policy changes, societal attitudes, and misinformation, its adoption has significantly declined over the years. Data from five rounds of the National Family Health Survey (NFHS) consistently shows a drop in male sterilisation rates, with the latest surveys (NFHS-4 and NFHS-5) showing stagnation. This is despite the National Health Policy of 2017, which set a target of achieving 30% male sterilisation rates.

Factors Contributing to Gender Disparity in Sterilisation

1. Societal Perceptions of Responsibility

In many Indian communities, the responsibility for family planning is overwhelmingly assigned to women. This stems from traditional roles where women are seen as caregivers, making reproductive health their perceived duty. In contrast, men are often exempt due to their roles as breadwinners. These entrenched societal norms lead to women shouldering the physical and emotional costs of sterilisation, while men remain largely uninvolved.

2. Myths and Misconceptions About Vasectomy

False beliefs about vasectomy, such as its impact on masculinity, libido, or physical strength, deter men from considering the procedure. Misinformation, including myths that vasectomy causes impotence or emasculation, exacerbates these fears. Even though medical evidence refutes these claims, a lack of reliable information perpetuates these misconceptions, discouraging its adoption.

3. Economic and Practical Challenges

Economic considerations often discourage male sterilisation. For families reliant on male earnings, the idea of even a day’s missed wages is daunting. Although government cash incentives aim to compensate for this, low awareness about these schemes limits their effectiveness. A 2024 field study in Chhatrapati Sambhaji Nagar, Maharashtra, revealed that families fear financial burdens from vasectomy, highlighting inadequate communication about available support systems.

4. Resistance Rooted in Patriarchy

Resistance to male sterilisation extends beyond men to include women in patriarchal households. Many women internalise societal norms, believing that reproductive responsibilities are theirs alone. In some rural areas, women feel asking their husbands to undergo a vasectomy could be seen as disrespectful or cause marital discord. This mindset further entrenches gender imbalances in family planning.

5. Healthcare Accessibility Issues

Limited access to skilled healthcare providers in rural regions adds to the problem. Even when men are willing, a shortage of trained professionals often prevents them from proceeding. Furthermore, community health workers, who are the primary sources of information in these areas, are frequently uninformed about modern vasectomy techniques like no-scalpel vasectomy, reducing its visibility as a viable option.

Implications for Gender Equality

The burden of sterilisation falling predominantly on women not only increases health risks but also reinforces harmful gender stereotypes. This imbalance hinders broader efforts to achieve gender equality and perpetuates unequal marital and familial dynamics. Promoting shared responsibilities in family planning is crucial for advancing women's empowerment and achieving SDG 5.

Strategies to Encourage Male Sterilisation

1. Education and Awareness Campaigns

Introducing concepts of gender equality and shared reproductive responsibilities through school-based programs can challenge traditional norms. Awareness initiatives must focus on dispelling myths about vasectomy, emphasising its safety and simplicity compared to female sterilisation methods like tubectomy.

2. Enhanced Financial Incentives

Cash incentives can be an effective tool for increasing male sterilisation rates. In 2019, a study in rural Maharashtra found that financial support encouraged more men to opt for vasectomies. States like Madhya Pradesh, which raised incentives by 50% in 2022, provide promising models for other regions.

3. Learning from International Practices

Countries such as South Korea, Bhutan, and Brazil offer valuable lessons. For instance, South Korea's high vasectomy rates are linked to progressive gender norms, while Bhutan's government-run camps and Brazil's mass media campaigns have normalised male sterilisation. Replicating such strategies in India could significantly improve adoption rates.

4. Strengthening Healthcare Systems

Investing in training healthcare providers and adopting advanced techniques like no-scalpel vasectomy can make male sterilisation more accessible. Improved infrastructure, coupled with awareness campaigns, can create an environment conducive to its adoption.

Conclusion

Bridging the Gender Gap in Family Planning:

Context:

India's journey with family planning dates back to 1952 when a national program was introduced to enhance maternal and child health while controlling population growth. Over time, this initiative has seen considerable evolution. However, a notable trend persists: a pronounced gender disparity in the adoption of permanent contraceptive methods. This disparity reveals systemic barriers to achieving gender equality, particularly within the framework of Sustainable Development Goal (SDG) 5, which aims to empower women and girls globally by 2030.

The Decline in Male Sterilisation:

In the late 1960s, vasectomy was the predominant sterilisation method in India, accounting for more than 80% of all such procedures. However, due to policy changes, societal attitudes, and misinformation, its adoption has significantly declined over the years. Data from five rounds of the National Family Health Survey (NFHS) consistently shows a drop in male sterilisation rates, with the latest surveys (NFHS-4 and NFHS-5) showing stagnation. This is despite the National Health Policy of 2017, which set a target of achieving 30% male sterilisation rates.

Factors Contributing to Gender Disparity in Sterilisation

1. Societal Perceptions of Responsibility

In many Indian communities, the responsibility for family planning is overwhelmingly assigned to women. This stems from traditional roles where women are seen as caregivers, making reproductive health their perceived duty. In contrast, men are often exempt due to their roles as breadwinners. These entrenched societal norms lead to women shouldering the physical and emotional costs of sterilisation, while men remain largely uninvolved.

2. Myths and Misconceptions About Vasectomy

False beliefs about vasectomy, such as its impact on masculinity, libido, or physical strength, deter men from considering the procedure. Misinformation, including myths that vasectomy causes impotence or emasculation, exacerbates these fears. Even though medical evidence refutes these claims, a lack of reliable information perpetuates these misconceptions, discouraging its adoption.

3. Economic and Practical Challenges

Economic considerations often discourage male sterilisation. For families reliant on male earnings, the idea of even a day’s missed wages is daunting. Although government cash incentives aim to compensate for this, low awareness about these schemes limits their effectiveness. A 2024 field study in Chhatrapati Sambhaji Nagar, Maharashtra, revealed that families fear financial burdens from vasectomy, highlighting inadequate communication about available support systems.

4. Resistance Rooted in Patriarchy

Resistance to male sterilisation extends beyond men to include women in patriarchal households. Many women internalise societal norms, believing that reproductive responsibilities are theirs alone. In some rural areas, women feel asking their husbands to undergo a vasectomy could be seen as disrespectful or cause marital discord. This mindset further entrenches gender imbalances in family planning.

5. Healthcare Accessibility Issues

Limited access to skilled healthcare providers in rural regions adds to the problem. Even when men are willing, a shortage of trained professionals often prevents them from proceeding. Furthermore, community health workers, who are the primary sources of information in these areas, are frequently uninformed about modern vasectomy techniques like no-scalpel vasectomy, reducing its visibility as a viable option.

Implications for Gender Equality

The burden of sterilisation falling predominantly on women not only increases health risks but also reinforces harmful gender stereotypes. This imbalance hinders broader efforts to achieve gender equality and perpetuates unequal marital and familial dynamics. Promoting shared responsibilities in family planning is crucial for advancing women's empowerment and achieving SDG 5.

Strategies to Encourage Male Sterilisation

1. Education and Awareness Campaigns

Introducing concepts of gender equality and shared reproductive responsibilities through school-based programs can challenge traditional norms. Awareness initiatives must focus on dispelling myths about vasectomy, emphasising its safety and simplicity compared to female sterilisation methods like tubectomy.

2. Enhanced Financial Incentives

Cash incentives can be an effective tool for increasing male sterilisation rates. In 2019, a study in rural Maharashtra found that financial support encouraged more men to opt for vasectomies. States like Madhya Pradesh, which raised incentives by 50% in 2022, provide promising models for other regions.

3. Learning from International Practices

Countries such as South Korea, Bhutan, and Brazil offer valuable lessons. For instance, South Korea's high vasectomy rates are linked to progressive gender norms, while Bhutan's government-run camps and Brazil's mass media campaigns have normalised male sterilisation. Replicating such strategies in India could significantly improve adoption rates.

4. Strengthening Healthcare Systems

Investing in training healthcare providers and adopting advanced techniques like no-scalpel vasectomy can make male sterilisation more accessible. Improved infrastructure, coupled with awareness campaigns, can create an environment conducive to its adoption.

Conclusion