New Delhi, December 18
When it comes to family planning, Indian men would rather have women
make the efforts. The trend is real, even in so-called empowered states
like Karnataka and Tamil Nadu. Not just this, Lakshadweep reported only
one voluntary vasectomy in three years and Mizoram just two!
The first-ever performance audit of UPA’s flagship programme — the National Rural Health Mission (NRHM) — tabled in Parliament today shows that vasectomy accounted for a mere four per cent of total sterilisation operations across India between 2005 and 2008, reflecting the gender imbalance that mars population control efforts. Quite naturally, the NRHM has failed to address gender issues in the system and has been found to be lagging on the target of reducing total fertility rate to 2.1 per cent by 2012.
State-wise performance reveals a grimmer picture, with vasectomy making up less than one per cent of the total sterilisations in 10 states — some with high literacy — including Karnataka, Tamil Nadu, Puducherry, Dadra and Nagar Haveli, Tripura, Lakshadweep, Mizoram, Arunachal Pradesh, Bihar and Uttar Pradesh.
Not that the NRHM — launched in 2005 with the objective of promoting family planning through terminal methods (vasectomy for males, tubectomy for females) — managed to inspire women. Audit records show the performance of laparoscopic tubectomy between 2005 and 2008 was also low, ranging between just 11 and 27 per cent in 10 states and UTs.
In Bihar and Lakshadweep, it was nil; in Jharkhand it was just 1.58 per cent, followed by Puducherry with 1.36 per cent. Scout for reasons behind the trend and you find there were no trained doctors at the said locations to conduct tubectomies.
Interestingly, northern states — except Haryana with 27 per cent tubectomies — fared well on the count, exhibiting women’s willingness for small families. Himachal tops the list with 87 per cent tubectomies, followed by Manipur at 85, Uttarakhand at 67, Chandigarh at 64, Jammu and Kashmir at 63 and Punjab at 47 per cent.
In Tamil Nadu — a state with high female literacy — tubectomies make up just 11 per cent
of all sterilisations. Karnataka follows at 20 per cent.
If that was less, 3,074 sterilization operations failed in 13 states. The highest failures occurred in Tamil Nadu, Himachal, Uttar Pradesh, Delhi, Maharashtra and Rajasthan.
As regards use of spacing methods - oral pills, condoms and inter uterine devices (IUD) - for family planning, most states appear disinterested, with CAG revealing that state health societies in Delhi, Chandigarh, Himachal, Arunachal, Bihar, Kerala, Lakshadweep and Puducherry had not even fixed annual targets under NRHM for spacing methods. Bihar and Orissa has no nurses trained in IDU at the 730 audited sites.
Interestingly, condoms are still preferred in most states, with audits revealing a shortfall in the achievement of IUD insertion and oral pill distribution under NRHM in 18 and 15 states, respectively. The highest shortfall in these categories is in Jharkhand at 68 and 81 per cent, respectively.
Oral pill usage has been below 38 per cent in 25 states, lowest being in Chandigarh at 0.9, Punjab at 4.51, Haryana at 14, Uttarakhand at 16 and Himachal at 19 per cent. Interestingly, all these states have high condom use percentages, with Chandigarh topping the list at 98 per cent, followed by Punjab at 95.
