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Women's groups in India call on men to take more active role in contraception

BMJ 2004; 329 doi: (Published 26 August 2004) Cite this as: BMJ 2004;329:476
  1. Manjulika Das
  1. Calcutta

    Women's rights activists in India have launched an initiative to improve men's contribution to the country's family planning programme.

    Recent statistics have shown the poor effect of population control strategies. The 2001 census report showed India's population to be just over a billion, about 20% higher than the 1991 figure of 850 million.

    Women's groups have not only called on men to take more responsibility for family planning but also urged the government to take note of the situation.

    “The present scenario must be changed in all parts of India,” said Jasodhara Bagchi, an activist from the West Bengal chapter of the State Commission for Women. “Working amid the common people, we would make them understand the importance of male participation in the population control initiative of India.”

    Niayati Sarkar, an activist affiliated to a women's rights organisation called Matri Mandaly, said, “In 1977-8 there were 731 070 cases of female sterilisation just in West Bengal, in comparison to 151 512 cases of male sterilisation. But in the last financial year there were 38 794 cases of female sterilisation, in comparison to only 271 cases of male sterilisation.”

    She added, “The scenario is the same in other parts of India as well, according to surveys. This suggests that not only the total number but also the rate of male participation has decreased with time, causing a sharp increase in the country's population.”

    “Male domination in Indian society is no longer acceptable. Population control is a matter of immense importance—males can't avoid this,” said Dr Pranati Sinha, a professor of obstetrics and gynaecology and a women's rights activist.

    “For male sterilisation, no-scalpel vasectomy is available now, which can be safely done without a cut or stitch. Still, we had only 11 vasectomies in the last financial year in Calcutta … It reflects the dismal situation, which needs to be changed at the earliest,” she said.

    Dr Sinha said women's groups were also encouraging the use of condoms and oral contraceptives. “But in India in order to achieve our goal in population control we have to go with the concept of sterilisation. Temporary contraception faces three major problems in India: illiteracy, lack of health consciousness, and superstitions … We've encountered many people who can't properly follow how to use condoms or pills. So, sterilisation is the priority of the campaign, though it's routine to advise the women to use oral pills or to tell their husbands to use condoms for family planning.”

    However, according to experts in social health, the activists will not succeed in their campaign unless they can counter persistent myths about male sterilisation, especially in Indian villages.

    Swapan Jana, secretary of the Society for Social Pharmacology, a non-governmental organisation involved in several social health issues in India, said, that a study done in Andhra Pradesh at the initiative of the national Ministry of Health and Family Welfare found that most manual labourers, such as farmers, avoided the no-scalpel vasectomy for fear of physical weakness. He said, “Even females in the society don't want their husbands to opt for sterilisation, as they think their husbands won't be able to do manual work after the operation.”

    Sudip Kumar Saha, former chief of the family planning unit at the North Bengal Medical College Hospital, Darjeeling, said, “Women activists should work for improvement of both male and female participation, as the success rate of male sterilisation is low. And since 1978 female sterilisation has also gradually declined in India.”

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