Answer

India’s family planning program, launched in 1952, aimed to control population growth through methods like sterilization. According to NFHS-4 (2015-16), male sterilization accounts for only 0.3% of procedures. Despite policy efforts, there is a significant gender disparity in sterilization rates, with women bearing most of the responsibility due to cultural and societal barriers.

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Reasons Behind Gender Disparity in Sterilisation rates and Low Male Participation in Contraception

• Cultural and Societal Norms: Traditional gender roles in India often view family planning as primarily the woman’s responsibility.
  For example: Surveys revealed that women are primarily responsible for sterilization, while men resist due to concerns about masculinity and ego, making vasectomy less acceptable.
• Lack of Male Awareness: Many men remain unaware of the options available for male sterilization, such as vasectomy.
  For example: Surveys show that both men and health workers in rural areas often lack awareness about no-scalpel vasectomy, which is a less invasive and safer option, leading to fewer men opting for the procedure.
• Economic Concerns: The fear of wage loss and the impact of sterilization on daily earnings discourage men from opting for the procedure.
  For example: Government cash incentives to offset wage loss are underutilized due to poor information dissemination, leaving many men unaware of available financial support.
• Perceived Health Risks: There is a widespread perception that male sterilization is riskier than it actually is, leading to reluctance among men.
  For example: Misinformation about the safety of vasectomy, including fears of side effects and complications, often deters men from considering the procedure.
• Lack of Healthcare Infrastructure: Many rural areas suffer from a lack of trained healthcare providers, limiting access to vasectomy procedures.

Challenges in India’s Sterilization Program

• Lack of Informed Consent: Many women in rural areas are pressured or coerced into sterilization procedures without fully understanding the implications.
  For example: The infamous Chhattisgarh sterilization scandal in 2014, where 15 women died after a botched sterilization camp, highlighted the disregard for informed consent.
• Poor Quality of Services: Sterilization procedures are often conducted in poorly equipped health facilities with inadequate sterilization practices, leading to infections and complications.
• Target-Based Approach: Government targets for sterilization often lead to pressure on health workers to meet quotas, compromising the quality of care and ethical considerations. 
• Gender Bias: Sterilization is disproportionately targeted towards women, perpetuating gender inequality and limiting reproductive choices.
  For example: According to NFHS-4 (2015-16), female sterilization stands at 37.9%, while male sterilization is only 0.3%, highlighting the skewed distribution of sterilization responsibilities in India.
• Stigma and Discrimination: Women who have undergone sterilization may face social stigma and discrimination, impacting their self-esteem and well-being. 
• Lack of Political Will and Policy Implementation: While National Health Policy 2017 has set ambitious targets for male sterilization, implementation remains slow.
  For instance: Despite policy initiatives, male sterilization rates have stagnated due to insufficient focus on addressing barriers preventing male participation in family planning programs.

Measures to Achieve the National Health Policy 2017 Target of 30% Male Sterilization

• Increased Awareness and Education: Focused educational campaigns to raise awareness about the safety and benefits of male sterilization can encourage greater participation.
  For instance: Information campaigns should emphasize the advantages of no-scalpel vasectomy, highlighting its safety and minimal recovery time.
• Incentivizing Male Participation: Introducing more attractive financial incentives for men to opt for sterilization can increase participation.
• Strengthening Healthcare Infrastructure: Building better infrastructure, particularly in rural areas, to facilitate access to sterilization services is essential.
  For example: Training more healthcare providers in vasectomy procedures and improving healthcare facilities in rural regions would make it easier for men to access services.
• Engaging Men in Family Planning Campaigns: Family planning initiatives should directly target men, promoting vasectomy and other male contraceptive methods.
• Addressing Societal Norms: Cultural attitudes towards masculinity and family planning need to be challenged to encourage more men to participate.
  For instance: Public campaigns should work to shift societal perceptions, showing that male sterilization is a responsible and empowering choice for men.

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Achieving the National Health Policy 2017 target of 30% male sterilization by 2025 is crucial for gender equality in family planning. Addressing cultural, economic, and infrastructural barriers can boost male participation. Best practices from other countries, like community leader partnerships and targeted education, will accelerate progress, supporting SDG Goal 5 (Gender Equality) by 2030.

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