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Painless male contraception pays dividends in Sirmour

To increase male participation in reproductive health, No Scalpel Vasectomy, a new pain-free method of male contraception, is being promoted in Sirmour district of Himachal Pradesh.

In a pilot initiative, the state government plans to hold NSV camps in the district, the most backward in Himachal Pradesh.

Previous family welfare programmes did not encourage communication between the husband and wife. But that is an integral part of the Sirmour project which hopes to break through socio-cultural barriers and men's perceptions and fears about vasectomy. For this, they get medical officers speak directly to the client through counselling sessions.

Launched last June, the project is a joint collaboration between the central and state governments and the United Nations Population Fund.

The first NSV camp was held in Poanta Sahib in Sirmour district last November and, according to health workers, it was very successful.

"A total of 83 vasectomies were done. Prior to this, there were no cases of vasectomy since the trend was for women to go for tubectomies," says K R Barwal, health educator at the civil hospital, Poanta Sahib.

Ramlal Bhatia, 29, opted for NSV because he felt spacing methods were not foolproof. A clerk in the forest department with two sons aged one-and-a-half years and four months respectively, Ramlal favoured the new contraceptive procedure after learning it was painless and risk-free.

"My wife wanted to go for tubectomy but I dissuaded her. It was easier for me to get NSV done," he says. "It took about 10-15 minutes. I just felt the prick of the injection and nothing after that."

Ramlal's decision is a welcome step in a social environment that focuses almost exclusively on female sterilisation at the cost of modern spacing methods that give women the freedom to exercise their contraceptive choices. This gender discrimination is apparently reflected in the approach of the medical fraternity.

According to a surgeon who asked not to be named, doctors sometimes feel easier doing tubectomies rather than vasectomies because if the former procedure is unsuccessful, as has happened in the past, women do not take action against the offending doctor.

But there is a fear that men will retaliate if things go wrong as happened some time ago when a male patient took a doctor to court.

But others claim this is not the most important issue. Apart from the fact that the family planning programme has no specific emphasis on men, a major drawback is the lack of trained doctors or surgeons, especially in the interior and backward areas, to perform vasectomies. The new NSV technique also requires specialised training and the Sirmour project is addressing this aspect. "

"We undertook extensive media campaigns including posters, wall paintings, advertisements, melas and folk plays'', said Dr Manmeet Kaur.

The success of such campaigns was evident from the positive response it evoked at the first NSV camp in the district, she said. However, male involvement in reproductive health is more than merely accepting a male method of contraception. The objective is to bring a change in men's behaviour and attitudes, she said.

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