A matter of choice

During the seventies and early eighties, walls, buses, and public utilities were plastered with the ‘Hum Do, Hamare Do’....

During the seventies and early eighties, walls, buses, and public utilities were plastered with the ‘Hum Do, Hamare Do’ and ‘Chhota Parivar, Sukhi Parivar’ slogans. And the best way to go about planning a family, we were told, was to use the Nirodh, condoms for men. Clearly, the government at that stage believed that men were equally responsible for a small family as women, although it was the latter who had to bear the biological burden of child-bearing.

Gradually, one saw a shift in the focus of family planning campaigns in the country, even as a wider choice of contraceptives was made available — but mainly for women. Primary health centres, government dispensaries and hospitals began promoting IUDs, tubectomy, contraceptive pills, and so on. The consequence? Female sterilisation continues to be the dominant form of contraception in India according to the National Family Health Survey-3, which was released this month. Except in Delhi, Assam, Manipur and Tripura, females account for 90 per cent of contraceptive users, especially in Andhra Pradesh, Karnataka and Tamil Nadu. In contrast, male sterilisation is as low as 5 per cent all states —except Himachal Pradesh with 6 per cent!

Even as contraceptive use has increased in both urban and rural India, the share of female sterilisation fell only slightly — from 67 per cent in NFHS-1 to 66 per cent in NFHS-3.

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While knowledge about contraceptive methods is practically universal, female sterilisation is still the “most widely known methods among women (97 per cent) and men (95 per cent) in 26 out 29 states”, says the survey.

Surely, a government, which claims to be gender-sensitive and boasts of electing the first woman president of the country, could have done better on this front. Its own figures are reason enough for it to rethink the direction in which its reproductive health programme is going.

“It is time the government shifted the onus on the use of family planning methods from the women to the men. Since contraception is a complex matter in Indian families, men need to be educated on the issue and motivated to use condoms. This will have other important benefits too. As Ranjana Nirula, senior leader of the All India Democratic Women’s Organisation, observes, “It could also prevent the spread of HIV/AIDS, especially among women who unknowingly contract the deadly disease from their partners.”But the onus lies with the government to ensure that both men and women are helped to make an informed choice regarding their method of contraception, and then provided access to safe, effective and affordable contraceptives. Not too difficult a task in this age of information and technology — provided there is sufficient political will.