Shifting Contraception Trends in Andhra Pradesh: Male Sterilization Declines, Female Sterilization Increases

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In Andhra Pradesh, the use of male sterilisation or vasectomy as a form of contraception has decreased from 6.6% to 0.4% in the past three decades, according to national family health surveys. On the other hand, the use of permanent female sterilisation or tubectomy has increased from about 38% in 1992-93 to 68% as per the latest national family health survey. In 2020-21, only 515 males underwent permanent sterilisation compared to 1.13 lakh women opting for tubectomy, and a similar trend was observed in 2021-22. This shift towards female-centric contraception has been attributed to the increased adoption of contraceptive methods by women, such as intrauterine contraceptive devices, combined oral pill cycles, emergency contraceptive pills, and recently introduced injectable contraceptives.

A recent study by two researchers from the International Institute for Population Sciences (IIPS), Mumbai, titled “Disappearing male sterilisation in India: Do we care?”, highlighted the disproportionate share of contraceptive use by women and the lack of shared responsibility of contraception between men and women, making fertility regulation women-centric. The National Health Policy-2017 aims to increase the proportion of male sterilisation from less than 5% to at least 30%, but current trends challenge this target.

Noted paediatrician from Visakhapatnam, Dr T Venkateswara Rao, stated that male sterilisation promotion campaigns are largely absent now compared to a few decades ago. As the majority of couples are settling with one or two children, the sterilisation burden seems to be falling on women, particularly post-partum, and the trend needs to be changed.