Despite a great awareness of birth-control methods, the male contribution in family planning services is on a constant decline suggests the NFHS (2015-16) report.
Most common birth control methods include contraceptive pills, inter-uterine device, post-partum IUD, male and female condoms, emergency contraception and sterilization. The most sought after method is female sterilization, putting the onus of reproductive planning on women.
While there has been a 14 percent increase in the literacy rate over the last decade, the usage of condoms and male sterilizations have gone down. The national average shows that only 5.6% of the total male population use condoms as a means of family planning. This is despite the fact that 77.4% of the male population is aware that usage of a condom can reduce the risk of HIV/AIDS. Chandigarh with 27.3% is the highest and Andhra Pradesh with 0.2% is the lowest in terms of condom usage.
“A lot of contraceptives are there, but there is no right direction. It is unfortunate that successive governments have thrown the family planning agenda in the backyard. Also, there are cultural and sociological reasons why contraception among men is unpopular. Neither are there any conversations about birth control among men nor are there any role models for them,” says Dr. Gita Bambzai, former Associate Professor at National Institute of Family and Health Care.
On the other hand, the rate of male sterilization is abysmally low in the country. The reliance on female sterilization as a way of birth control is observed in all the states. In-fact, male sterilization’s share in the planning methods is as low as 0.3% on an all India level. One of the primary reasons for this, according to Population Foundation of India is that 85 percent of India’s family planning budget is used to promote and conduct sterilizations on women. This is inspite of the fact that female sterilization has become a cause of concern among the women population. Danger to life and lack of hygiene has led to Supreme Court ordering a complete shutdown of all the state sterilization camps in the next three years. The apex court delivered its judgment while observing that 363 women died between 2010 and 2013 due to poor management in the surgical camps.
Less number of vasectomies are seen despite they being a much safer, quicker and easier option than tubectomies. “Cultural taboo and myths related to sexual pleasure are one of the reasons behind this. This is one of the main reasons as to why female sterilization is much higher in few rural parts of India rather than their counterparts,” says Dr. Rekha Anil Kumar, Professor at College of Nursing, RML Hospital.
Pointing at the other reasons, Dr. Gita says, “tubectomy is non-reversible, unlike vasectomy. Hence, it gives a surety of protection. As a result, female contraception more than often gets the government sponsors at a larger scale which in-turn implies more advertisements and awareness about tubectomy rather than vasectomies.”
However, things look good in what are considered to be the matriarchal states of India. Sikkim with 3.4% is the highest in the country when it comes to male sterilization. Other all states perform poorly with many of them having zero percentage. In terms of female sterilization, the seven sisters fare way below the country average of 36%. The highest number of female sterilization can be seen in Andhra Pradesh with 68.3%.
However, experts in the country agree that male members need to be engaged in the family planning process on par with the women. Awareness, education, and communication are inadequate when it comes to men participation. Talking about how male participation in the family planning process can be encouraged, Poonam Muttreja Executive Director of Population Foundation of India, says, “It is important to understand that male engagement intervention needs a multi-sectoral approach. Education, age at marriage, health seeking behaviour and socio cultural norms need to be addressed simultaneously and concurrently. There also needs to involve male front-line health workers (Multi-Purpose Health Worker – Male, Doctors etc) in the program where family planning counseling is largely done by female workers such ASHA/ANM etc.”
“Patriarchal conditioning over generations has made reproduction and family planning a women’s affair where the responsibility of using the contraceptives is on them. In-fact most of our contraceptives are also centered around female bodies, making it a women’s issue,” adds Dr. Shashwati Goswami who is researching on Political Economy of Development Communication in India: The Family Planning Program. Poonam Muttreja seconds this and adds, “We need to stop referring to family planning and sexual and reproductive health and rights, as women’s issues. They are as much men’s issues, they are society’s issues; they are moral issues; they are ethical issues; they are issues of social justice and human dignity.”
(A collaborative story by Shreya Baldwa, Shreyasa Vijay and Gaura Naithani).