Male Perceptions on Female Sterilization: A Community-Based Study in Rural Central India

This paper from International Perspectives on Sexual and Reproductive Health examines attitudes toward use of modern contraceptive methods in India since the 1970s, characterised by a predominance of female sterilisation. According to the researchers, there has been considerable investigation into women's choice of female sterilisation, but little from the male perspective.

As part of the study, 7 focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data.

The study found that men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Specifically, according to the survey, 58% reported television or radio as their primary source of information. Only 24% reported receiving information primarily from village health workers, 9% from non-governmental organisation (NGO) workers, 7% from friends, and 2% from family or other sources. During the focus groups, men indicated that women had better and more direct access to information through the village health workers. As a result, men sometimes saw their wives as important sources of information on family planning. Men went on to state that male sterilisation is almost never discussed, either with women or men. "Why talk about male sterilisation when women are ready to get sterilised?" was reportedly a common response among discussants. This partly reflects the fact that male sterilisation is not often brought up as an option by the local health workers.

The study found that men understood family planning and contraception to be two separate issues: They viewed "family planning" as synonymous with female sterilisation, whereas they saw "contraception" as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilised; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilised. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so.

The researchers conclude that men are interested in acquiring family planning information but lack knowledge about available information sources, which "results in most men encouraging their wives to adopt female sterilization, as it is the method most often discussed in the community." The researchers suggest that "policymakers and program planners need to understand local concepts, experiment with multiple information channels and design strategies for reaching men. In addition, programs must continue to encourage couple communication, so that couples' family planning decisions are made jointly." Some potential strategies suggested by the researchers' findings for involving men in family planning programmes involve face-to-face dissemination of information by knowledgeable persons, encouraging couple communication within communities, training male health workers to discuss family planning with male groups, and strengthening access to and availability of reversible methods, so that dependence on female sterilisation is reduced.