Indians need to share contraceptive responsibility Premium

Sustained social and behaviour change communication initiatives will be instrumental in debunking myths around and destigmatising vasectomies as it is a safe and simple procedure compared to tubectomy

In 1952, India pioneered a national programme for family planning, whose focus has since changed — from improving maternal and child health to stabilising the population. As this programme evolved, so too did permanent methods of contraception.

During 1966-70, about 80.5% of all sterilisation procedures in India were vasectomies. This percentage declined every year due to changing policies that, together with other factors, placed less and less of an emphasis on vasectomies. The five rounds of the National Family Health Survey (NHFS) also show the use of male sterilisation, especially in the last three decades, to be steadily decreasing in all States. In fact, the vasectomies percentage remained constant at around 0.3% in NFHS-4 (2015-16) and NFHS-5.

This trend goes against Section 4.8 of the National Health Policy 2017, which aimed to increase the fraction of male sterilisations to at least 30%. Even today, India is far from meeting this target. Official data also show a large disparity between the rates of female and male sterilisation — 37.9% and 0.3%, respectively. Such huge differences indicate that women continue to bear virtually all of the burden of sterilisation, which in turn poses a challenge for India to achieve Sustainable Development Goal 5 — ‘gender equality and empowerment of all women and girls by 2030’ — among others.

In one attempt to bridge this gap, the world observes Vasectomy Day on the third Friday of November (it was on November 15 this year). In 2017, India observed a ‘vasectomy fortnight’ as well.

The initiative is to revitalise the procedure by increasing awareness, generating demand among men, and debunking misconceptions. In the end, the goal is for people already looking for contraceptives as well as those who would if they knew about safe options to consider vasectomies more favourably.

But for these concerted efforts, policies still overlook multiple issues on the ground, keeping them ineffective and allowing the gap between male and female sterilisation rates to persist.

For example, two of the three writers of this article surveyed a village in Chhatrapati Sambhaji Nagar, Maharashtra, in March 2024 as part of a field exercise. The women said sterilisation was their responsibility and that the men do not believe they need to have vasectomies. Most of them also expressed a belief that men should not be “burdened” by it because they already work hard to make ends meet, and that undergoing the procedure could rob the men of their day’s wages, worsening their hardship.