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New Delhi: case of chhattisgarh 101 Female Sterilization The incident in Surguja district last week has thrown light on the process itself in a matter of hours.
Tubectomy or female sterilization is the most complicated of all available contraceptive methods. Still, it is the most commonly used family planning method in India, far ahead of condoms, intrauterine devices (IUDs), pills, and vasectomy.
According to data from the National Family Health Survey (NFHS) 4 – the latest survey where data is available for all states – female sterilization is 35.7 percent of all family planning methods practiced in India. Only 0.3 percent have vasectomy.
Among the states, Chhattisgarh has a large proportion of female sterilizations in India, higher than the national average.
When in 2015-16 NFHS-4 data Was collected, female sterilization accounted for 46.2 per cent of all family planning methods practiced in Chhattisgarh. In comparison, vasectomy was only 0.7 percent, IUCD 1.6 percent, pills 1.7 percent and condoms 3.9 percent.
In 2020, India changed its population policy to eliminate family planning based on predetermined targets. Four years before this, in 2016, a Supreme Court bench headed by Justice Madan Lokur ordered that the “camp” approach of sterilization be stopped within the next three years.
However, the Surguja case shows that the mass sterilization mentality is still alive, mainly because of the “fill it-close-forget it” approach by the government, activists claim.
Read also: 1.3 million Indian women lost access to contraception, abortion services in pandemic, study says
Why Tubectomy is Popular
Tubectomy procedure attaches a woman’s fallopian tubes – the tubes that carry eggs released by the ovaries to the uterus – To prevent future pregnancies. This is a permanent option and, unlike other contraceptive measures such as the IUD, does not require the patient to follow through with the health system in the future.
Explaining how tubectomy is different from vasectomy procedure, gynecologist Dr Prakash Trivedi, former president of Federation of Gynecological and Obstetric Societies of India, said, “Vasectomy is usually performed under local anesthesia. It is a simple process and recovery is fast. However, men do not come forward as there is a myth that their sexual power will decrease.
“Female sterilization is usually done under general anesthesia and the recovery period depends on whether it is done laparoscopically or otherwise. Ideally, vasectomy should be encouraged because it is an easy operation.”
The number of vasectomy remains low because it has never been completely cured emergency hangover When certain communities were targeted.
Health ministry officials told ThePrint that the targets set by the government were long overdue, leaving it to state governments to decide how they want to implement family planning.
A look at the figures reveals wide variations in numbers statewide. States with better health facilities perform more tubectomies. Officials say this is because the procedure cannot be done unless minimal facilities are available, such as at least a primary health center building.
According to NFHS-4 data, in Kerala, 45.8 percent of all family planning procedures were tubectomies; In Tamil Nadu, it was 49.4 per cent; and 17.3 percent in Uttar Pradesh. In Punjab this figure was 37.5%.
However, Poonam Muttreja, executive director of the Population Foundation of India, which works closely with state governments in this area, said the mindset is deeply embedded in the Indian psyche.
“Goals were dropped in national policy in 2000. Yet the target mindset continues. The message is not spread. We are a conspiratorial society..We make plans, but don’t see how it is implemented on the ground ,” Mutreja said.
“A 2015 study shows that 77 percent of women who had a vasectomy never used any other contraceptive method; She only had a miscarriage. On the other hand, with young marriages and anemia in girls, the focus should be on options such as preventing and postponing pregnancies, rather than sterilizing a woman who may already have multiple children. We’ve never really evaluated our sterilization program.”
Read also: Low population is good for the health of India. Time to recover from the ‘if and but’ approach
sterilization slant
The disparity in male-female sterilization procedures has been a problem in India for years. The Supreme Court in its 2016 order had said that 95.09 per cent and 96.7 per cent of women were sterilized in 2013 and 2014, respectively.
The decision also highlighted the continuity of the ‘Lakshya’ system.
“Although the Union of India has stated that no target has been set for the implementation of the sterilization programme, there appears to be an informal system of targeting. We leave it to the good sense of each State Government and Union Territory to ensure that such targets are not set so that health workers and other persons are subjected to forced or non-consensual sterilization only to achieve the target. Don’t force. ,” said the court.
While there is no additional incentive for doctors performing the procedure, there is a monetary incentive for both healthcare workers and the person undergoing sterilization. This is what allows mass sterilization camps to flourish.
“The Union of India is directed to persuade the State Governments to stop the system of conducting sterilization camps as has been done by at least four States across the country. In any case, the Union of India must adhere to its view that sterilization camps will be closed within a period of three years. In our opinion, primary health care centers across the country, both in terms of infrastructure and otherwise, would need to be strengthened simultaneously so that health care is available to all individuals,” the apex court said in the same 2016 judgment. Was.
Muttreja pointed to an additional problem – only 6 percent of the country’s health budget is spent on family planning, of which only 1.4 percent is spent on temporary contraceptive methods such as condoms and IUDs.
“The changing rhetoric of two-child norms etc. will only increase the trend of forced sterilization,” he warned, referring to plans to bring legislation on family planning in states like Assam and states. Uttar Pradesh.
(Edited by Mansa Mohan)
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