Our Gender Gap in Contraception needs public policy intervention

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The recently-released fifth round of our National Family and Health Survey (NFHS-5) highlights that there has been a more than 10 percentage-point increase in the use of contraception among currently married women aged 15-49 years.

However, it also highlights that female sterilization continues to be the most popular choice of contraception despite the availability of Cheaper and safer procedure of male vasectomy.

What are the possible explanations for this gender divide in the method of contraception in India?

The divide could imply two things. First, it may indicate greater bodily autonomy exercised by women today or it also indicate the deep-rooted patriarchy that exploits and subjugates women.

How the data supports ‘subjugation’ explanation over the ‘bodily autonomy’ hypothesis?

According to the NFHS-4, only about 8% of women were found to make independent decisions on the use of contraception. However, despite not having the authority to make decisions, the burden of contraception falls on women.

As female sterilization is the most wide-spread method, with more than a third of India’s sexually-active population opting for it, despite the availability of cheaper and safer options available.

Also, NFHS-3 and NFHS-4 highlight that a higher proportion of women with college or higher levels of education tend to opt for male or female reversible methods of contraception over female sterilization.

All these facts give credence to the ‘subjugation’ explanation of the divide over the ‘bodily autonomy’ hypothesis outlined above.

How pandemic has adversely affected the family planning?

Exceptional pandemic measures like lockdowns and the exigencies of essential supplies have interrupted contraceptive supply chains. According to the World Health Organization (WHO), family planning has been severely affected during this period, with seven out of ten countries affected.

What have been recent government initiative in this area?

Government has recently increased the age of marriage for girls from 18 to 21 years. There have been studies that confirm that an increase in the age of marriage for females reduces the total fertility of women. It also leads to an improvement in the bargaining power of women, as it may reduce age gaps between husbands and wives.

What should be the way forward?

As seen in many parts of the country that increase in education translates into increased use of contraception and increased family planning. However, in addition to this, there is need for awareness about the benefits of different methods of contraception to the community at large.

Special emphasis should be given to bring awareness specially among men about the relevance of family planning. Also, they should be made aware about the use of several male contraceptive methods that are safer, cheaper and procedurally simpler than female sterilization. This can be done by utilizing the country’s existing network of community health workers, like Asha workers or Anganwaadi workers. Some additional male workers can also be employed to ease the direct communication.

Law on contraception-This will make access to a sound sexual health every citizen’s legal right. This would facilitate access to information and knowledge by removing unnecessary restrictions on the advertisement and publicity of contraceptives. It can also be used to make the availability and accessibility of contraceptives easier by enrolling the services of Primary Health Centres, particularly in rural areas.

Source– This post is based on the article “Our Gender Gap in Contraception needs public policy intervention” published in Live Mint on 17^th Feb 2022.