Gender Inequality in Family Planning

Reference:

Mass Sterilization Day is celebrated every year on the third Friday of November at the global level. This year this day was organized on 15 November. Its objective is to revive this process by removing misconceptions related to sterilization among men regarding family planning and increasing awareness among them. Also, the discussion on safe options and shared responsibility regarding contraception is to be taken forward.

Important statistics related to family planning:

• In India, most of the burden of family planning has fallen on women and that is why female sterilization has also been given priority on a large scale. In the year 1952, India started a national program for family planning, whose objectives included improving maternal and child health to stabilization of population.
  • With the development of this program, permanent methods of contraception also developed in which male sterilization has also been a major method.
• During the year 1966-70, about 80.5% of all sterilization procedures in India were male sterilization. However, due to changes in policies, this percentage kept decreasing every year and due to various socio-cultural-religious reasons and faulty attitude, the participation of men in the family planning program has not been satisfactory.
• According to the data of the fifth round of the National Family Health Survey (NHFS), male sterilization has been continuously declining in all the states in the last three decades.
  • Apart from this, the percentage of male sterilization has remained stable at about 0.3% in NFHS-4 and NFHS-5. Official figures show a huge disparity between the rates of female and male sterilization.
• Currently, in a developing country like India, due to various reasons, almost the entire burden of sterilization falls on women, which presents a challenge in achieving Sustainable Development Goal-5 (gender equality and empowerment of all women and girls by the year 2030).
• This type of trend is also contrary to the goals of the National Health Policy, 2017, which aimed to increase male sterilization to at least 30% in the context of family planning. At present, India is far from achieving this goal. Despite various efforts in this context, government policies still remain ineffective at the ground level and the difference between male and female sterilization rates is clear.

Causes of gender inequality in family planning

• Economic factors: According to the traditional system of Indian society, the responsibility of earning has been put on men, in such a situation, it becomes a double burden on them as an additional responsibility.
  • According to a recent survey of a village in Maharashtra, most women believed that sterilization is their responsibility. Also, they said that men should not be burdened with this because they already work hard to meet their needs and this procedure can take away a few days of wages from men, which can increase their troubles.
• Social factors: According to many studies in this context in India, male sterilization has received low acceptance due to illiteracy, male chauvinistic mindset, misconceptions about its effect on libido and family opposition.
• Unavailability of skilled health providers: Unavailability of skilled health providers in rural areas has made the situation even worse. Since many trained community health workers themselves have very little knowledge about no-scalpel vasectomy.
  • No-scalpel vasectomy: This is a modern, safe and effective method of male sterilization in which complications are less and patient compliance is also high. It has become a standard method of male sterilization globally.
• Lack of awareness: Women in Indian society, especially in rural areas, lack awareness about gender equality and their rights, which can have a clear impact on family planning as well.

Suggestions for Gender Equality in Family Planning:

• To promote gender equality in family planning, sensitization should begin during adolescence in schools where awareness programs and monitored peer-group discussions can lay the foundation for accepting sterilization as a shared responsibility.
• Sustained social and behavior change communication initiatives will help dispel myths about male sterilization and increase its adoption.
• In this context, information, education and communication activities should be complemented with more conditional cash incentives for male sterilization, aimed at improving men’s participation.
  • For example, a study conducted in Maharashtra in the year 2019 showed that most men in rural tribal areas opted for sterilization after being offered conditional cash incentives.
• Apart from this, India should also look at the models of those countries which have promoted male sterilization in the context of family planning.
  • For example, South Korea has the highest prevalence of vasectomy in the world and reports that men are more likely to take up contraceptive responsibilities as a result of progressive social norms and greater gender equality.
  •  Similarly, Bhutan has popularised vasectomy by making the procedure socially acceptable, providing good quality services and organising government-run vasectomy camps.
  • Brazil has promoted vasectomy through mass media awareness campaigns and the rate has increased from 0.8% in the 1980s to 5% in the last decade.

Conclusion:

Greater public awareness about vasectomy helps both partners in a marriage make informed decisions about family planning. In this context, the government will need to strengthen the national health system in line with policy objectives. Investments in training more health professionals for the procedure and technological advancements need to be promoted to increase the use of non-scalpel vasectomy. Apart from this, the resulting policy should also contain concrete steps to achieve the goals. The need of the hour is to make demand and service-oriented efforts instead of just manufacturing.