India Needs to Share Contraceptive Responsibility

Evolution of Family Planning in India

• The program was launched to reduce birth rates and stabilize population growth, aligning with national economic needs.
  • Over time, it expanded to include reproductive health and reduce maternal and child mortality rates.
• In 1966, a separate Department of Family Planning was established.
• In 1977, India’s Family Planning Department was renamed the Family Welfare Department after the government adopted a new population policy that emphasized voluntary participation in family planning.
• The National Population Policy (NPP) 2000 was established by the Government of India on February 15, 2000, as a comprehensive framework to address the challenges posed by rapid population growth. This policy aims to ensure sustainable development through responsible family planning and reproductive health services.

Awareness Initiatives

• World Vasectomy Day is observed annually on the third Friday of November (November 15 in 2024).
• In 2017, India observed a ‘vasectomy fortnight’ to raise awareness, debunk misconceptions, and encourage uptake.
• Mission Parivar Vikas: Launched in 2016, Mission Parivar Vikas (MPV) aims to improve access to contraceptives and family planning services in 146 high-fertility districts across 7 states (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Chhattisgarh, Jharkhand, and Assam).
  • Key initiatives include:
    • Saarthi Vaahans: Mobile awareness campaigns.
    • Saas Bahu Sammelens: Addressing social barriers for young women.
    • Nayi Pahel Kits: Sensitizing newlyweds on family planning and responsible parenthood.
  • A robust logistics system ensured uninterrupted contraceptive supplies, leading to a significant uptake of modern contraceptives.
  • The success prompted the government to scale up MPV to all districts in these states and six North-Eastern states in 2021.

Ground Realities and Challenges

• Survey findings (Chhatrapati Sambhaji Nagar, Maharashtra, March 2024):
  • Women perceive sterilisation as their responsibility and a belief that men should not be “burdened” by it as men’s work burden and financial loss due to a day’s wages forfeited for the procedure.
  • Awareness of government-provided cash incentives for vasectomies is low.
• Barriers to vasectomy adoption:
  • Illiteracy, male ego, misconceptions (e.g., its effect on libido), and family opposition.
  • Lack of trained providers and limited knowledge among community health workers about no-scalpel vasectomies.

Recommendations and Solutions

• Early Sensitisation and Awareness Building: Introduce awareness programmes and peer discussions during adolescence in schools.
  • Conduct social and behaviour change communication (SBCC) campaigns to dispel myths and destigmatise vasectomies.
• Enhanced Incentives: Increase conditional cash incentives for vasectomies to boost male participation.
  • Examples:
    • Maharashtra (2019): Men in rural tribal areas responded positively to incentives.
    • Madhya Pradesh (2022): Increased vasectomy incentives by 50%.
• Lessons from International Success:
  • South Korea: High vasectomy prevalence due to progressive norms and gender equality.
  • Bhutan: Popularised vasectomies through social acceptance, government-run camps, and quality services.
  • Brazil: Mass media awareness campaigns increased uptake from 8% in the 1980s to 5% in the last decade.
• Strengthening Health Systems: Train more health professionals to perform vasectomies.
  • Invest in technical advancements like no-scalpel vasectomies.
  • Align the national health system with policy objectives.
• Public Awareness Campaigns: Promote vasectomy as a safe and simple alternative to tubectomy.
  • Ensure both partners make informed family planning decisions.

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