Family Planning Not Just Women's Responsibility: Behaviour Change Key For Male Engagement

Savita Patil, an ASHA supervisor working in Dindori district's predominantly tribal Shobhapur village in Madhya Pradesh, has faced innumerable barriers in her professional journey. Patriarchy has often come in the way of her attempts to enable the community to adopt safe family planning practices, the lack of which resulted in an increasing number of maternal and infant mortalities.

The challenges, however, did not deter Savita from making continued efforts to sensitize her community on the need to plan for their families. While her determination is noteworthy, she credits her husband for the crucial role he played in setting an unimaginable precedent. Mangesh Patil became the first man in the village to opt for male sterilization (no-scalpel vasectomy or NSV). What started as an individual step soon became a movement and today every third household in Shobhapur has an NSV beneficiary.

Savita’s journey reflects the experiences of countless women in this country. Unfortunately, Mangesh happens to be an outlier. Historically, society has long perpetuated the stereotype that family planning is solely a woman's responsibility.

Male Engagement In Family Planning

Global and national evidence have evaluated the factors behind the lack of male involvement in family planning. Although the contexts vary, these factors can be rationalized across five themes: (i) the prevalent notion that contraceptives disrupt sexual activity (ii) limited choices of available male contraceptives (iii) fear and concerns pertaining to NSV (iii) patriarchal norms which put the entire burden of family planning on women (iv) family planning programmes have traditionally focused on women as their key beneficiaries (v) concerns that women's use of contraceptives leads to promiscuity.

Data from the Government of India’s fifth National Family Health Survey (2019-21) echo the widely accepted barriers to contraceptive uptake among men described above. According to the survey findings, although knowledge of contraceptive methods is almost universal in India, with more than 99% of currently married women and men aged 15-49 years knowing at least one method of contraception, it does not fully translate into the use of modern contraceptive methods.

The weightage of female sterilization in the total use of modern contraceptives is 67%. Condoms and male sterilization contribute 17% and 1% respectively in the method mix.

More than one-third (35%) of men believe that contraception is a woman’s business and that men should not have to worry about it. According to the survey, 1 in 5 men (20%) believe that a woman who uses contraception may become promiscuous.

At first glance, the solution to limited male engagement in family planning may seem to start and end with the provision and uptake of male contraceptives, namely, condoms and male sterilization. However, a deeper look unearths the many facets of this longstanding barrier which family planning programmes across the world have grappled with for decades.

Indian women have witnessed many ‘firsts’ in the 21st century. The needle has been moving gradually with more and more women taking on non-traditional careers in India. In 2021, the Indian Army inducted women as soldiers for the first time, breaking another glass ceiling. At 15%, India has a higher proportion of female pilots than anywhere else in the world today. Women who excel in athletics challenge gender conventions and prejudices, serve as positive role models, and promote gender equality in India.

Yet, traditional gender roles and expectations continue to pull women down with the double burden of working (in the formal or informal sector) to support their families and the expectation to single-handedly plan and care for their families.

The situation is much worse for those women who get married early or are economically dependent. Much of their health and fertility decisions are taken by others in the family, on their behalf of them.

Societal menaces like the much prevalent son preference in India force women to continue having children until a son is born. In the process, another generation of ‘unwanted’ girls is born who are destined to face similar discrimination as their mothers. This is how the vicious cycle of gender inequality persists generation after generation.

Challenging these stereotypes and getting men to recognise that family planning is a shared responsibility requires a comprehensive approach that addresses social and behavioural factors responsible for this practice.

Going forward, family planning programmes need to target both men and women equally. There is an urgent need to ensure access and availability of all contraceptives at all public and private health facilities, accompanied by appropriate counselling on usage and management of side effects for couples to be able to make an informed decision.

Building a cadre of male healthcare workers and encouraging health providers to actively involve men in conversations on family planning is a much-needed step. Promoting open spousal communications can encourage men to actively listen to their partners' needs, desires, and concerns. Involving community influencers can play a crucial role in encouraging behaviour change within their communities. Facilitating support groups or peer networks where men can share their experiences, challenges, and success stories related to family planning can be a powerful motivator.

Leveraging the media to highlight stories of male role models like Mangesh Patil who have embraced family planning can motivate other men to follow suit. Developing culturally sensitive and context-specific social and behaviour change communication campaigns can help address common barriers surrounding male involvement. And finally, we need conducive policies like paternity leave and flexible work arrangements that can create an enabling environment for men.

By breaking stereotypes, cultivating positive relationships and empowering men and women to be able to take informed health and fertility decisions, we pave the way for a more equitable and inclusive society.

Embracing male engagement in family planning is not just an individual choice; it is a collective responsibility to build a brighter and healthier future for all.

Authored by Sanghamitra Singh, Chief of Programmes at the Population Foundation of India

Photo Credit: The tory Mug

Suggested reading: Is Family Planning Still Considered A Woman’s Responsibility?