Gender disparities in contraceptive use and sterilisation, Pg7

Key Highlights:

• The World Health Organization (WHO) has released new guidelines, including benchmarks for a new generation of reversible male contraceptives.
• India's fertility rate has fallen below the replacement level, as indicated by the National Family Health Survey (NFHS-6) 2023-24 data.
• NFHS-6 reveals a persistent gender imbalance in contraceptive responsibility, with women predominantly using both temporary and permanent methods.
• The use of modern contraceptive methods in India declined from 56.4% in NFHS-5 (2019-21) to 52.7% in NFHS-6 (2023-24).
• Female sterilization marginally decreased from 37.9% (NFHS-5) to 36.5% (NFHS-6), while male sterilization (vasectomy) remained very low at 0.5% (NFHS-6).

Detailed Insights:

• The decline in modern contraceptive use is accompanied by a sharp rise of 6 percentage points in traditional methods like rhythm/fertility-awareness and withdrawal.
• Possible reasons for this shift include concerns about side-effects, convenience, privacy, partner preferences, and access to methods.
• Male sterilization (vasectomy) is a less invasive procedure than female sterilization (tubectomy) and can be performed under local anaesthesia.
• Historically, male sterilization has significantly declined in India, from 3.4% in NFHS-1 to 0.5% in NFHS-6 over three decades.
• Even states that achieved low Total Fertility Rate (TFR) early show a similar trend of low male sterilization rates, with only Telangana seeing more than a one percentage point increase between NFHS-5 and NFHS-6.
• The WHO emphasizes that contraceptive choice is a gender equality issue, challenging the long-standing assumption that men would not use new contraceptive methods.

Key Concepts Involved:

• World Health Organization (WHO): A specialized agency of the United Nations responsible for international public health.
• National Family Health Survey (NFHS): A large-scale, multi-round survey conducted in India providing data on health and family welfare.
• Total Fertility Rate (TFR): The average number of children a woman would have over her lifetime if she were to experience current age-specific fertility rates.
• Replacement Level Fertility: The level of fertility at which a population exactly replaces itself from one generation to the next, typically around 2.1 children per woman.
• Vasectomy: A surgical procedure for male sterilization or permanent contraception.
• Tubectomy: A surgical procedure for female sterilization, commonly known as "tying the tubes."