Only 1 in 10 men use condoms, female sterilisation most common contraceptive

• According to the latest National Family Health Survey-5 (2019-2021) Only 9.5% men used condoms but 37.9% of women underwent sterilisation.
• Though condom use in urban India is better than rural parts, the overall trend is vastly similar — 7.6% men in rural India and 13.6% men in urban India use condoms, while 38.7% women in rural India and 36.3% in urban India underwent sterilisation.

• Female sterilisation has gone up for the entire country from 36% in NFHS-4 (2015-2016) to 37.9% in NFHS-5. In 19 of the 36 States/UTs, female sterilisation increased in NFHS-5 compared to NFHS-4.
• Female sterilisation is also the preferred choice of contraception than other reversible methods such as pills (5.1%), injectables (0.6%) and intra-uterine devices (2.1%).
• The States with the highest increase in female sterilisation were Bihar (14.1% points to 34.8%), Goa (13.6% points to 29.9%) and Madhya Pradesh (9.7% points to 51.9%) .
• In 23 of the 36 States/UTs for which data were available, condom use was less than 10%.
• The State with the highest condom use was Uttarakhand (25.6%) and the Union Territory Chandigarh (31.1%).
• The silver lining, however, is that use of condoms has gone up between the two surveys — from 5.6% to 9.5%.

Contraception

• It is an artificial method or other techniques, mainly used to prevent pregnancy as a consequence of sexual intercourse.
• When a sperm reaches the ova in women, she may become pregnant.
• Contraception is a method that prevents this phenomenon by:

1. Stopping the egg production.
2. Keeping the egg distinct from the sperm.
3. By stopping the fertilized egg attaching to the lining of the womb.

• There are around fifteen to twenty different types or methods of contraception. Out of them 3 most safest are as follows:

1. Hormonal Contraception

• It is a birth control method that acts on an endocrine system. It is composed of steroid hormones that comprise both oral and injectable methods. It is proved to be highly effective when taken on a prescribed schedule.
• The methods that are available currently can be used only by women.
• Some of the different methods of hormonal contraception include patches, IUD’S, implants, oral pills, injections and a vaginal ring.

2. Barrier

• Barrier contraceptives are devices that are used to prevent pregnancy by blocking sperm from entering the uterus.
• Some of them include female condoms, male condoms, contraceptive sponges with spermicide, diaphragms and cervical caps.
• Among them the most common birth control methods are condoms.
• They help in protecting against HIV and sexually transmitted diseases. Most of the modern condoms are made up of latex.

3. Emergency Contraceptive

• Emergency contraceptive is medications that primarily prevent fertilization or ovulation.
• There are lots of options namely mifepristone, ulipristal, levonorgestrel and high dosage control pills.
• These methods do not affect the rates of sexually transmitted diseases, condom use, sexual risk-taking behaviour and pregnancy rates.

Reason for refusal to use condoms

• NFHS 5 data shows that 82% men were aware that consistent use of condoms can reduce the chance of getting HIV/AIDS.
• Studies, however, show that promotion of condoms for protection from HIV/AIDS creates confusion in their acceptance among married couples.
• Acoording to Poonam Muttreja, Executive Director, Population Foundation of India :
• Condom usage is also low because family planning is considered the responsibility of women. For men, sex stands purely for pleasure. For women, it is often either about procreation, or involves the fear of getting pregnant. Men also believe that condoms reduce pleasure. According to NFHS-4 data, 40% of men think it is a woman’s responsibility to avoid getting pregnant,”
• According to a study published in the Indian Journal of Medical Research by Balaiah Donta, other barriers include lack of privacy in stores while buying condoms, perceived ineffectiveness, less comfort, lack of sexual satisfaction with condoms and husband’s alcohol use.

Way forward

• Mass media campaigns are needed to promote a greater involvement of men in family planning.
• Social and behaviour change communication should not only promote condoms but also break gender stereotypes and position men as responsible partners.
• Values such as spousal communication and shared decision making should be inculcated.