A sterilisation drive across Bihar from July 11 to July 31 as part of the family planning initiative in the wake of the World Population Day (July 11), saw only 2% men among 15,033 participants, state health officials said on Sunday. This highlights that women continue to share the larger onus for permanent family planning despite male sterilisation (vasectomy) being a simpler, safer and less invasive procedure.
Of the total procedures during the campaign, 14,728 were female sterilisations, while only 305 were male sterilisations, meaning men accounted for just around 2% of all sterilisations carried out. Women continued to shoulder nearly 98% of the burden of permanent contraception, according to government data.
Bihar has historically been among the lowest-performing states in India in male sterilisation, with vasectomies accounting for only a tiny fraction of total sterilisation procedures, even as the state continues to record one of the country’s highest fertility rates among all Indian states, despite the gradual decline from 3.4 in NFHS (National Family Health Survey)-4 (2015-16) to 3.0 in NFHS-5 (2019-21).
Bihar continues to record the country’s highest fertility rate, with the latest Sample Registration System (SRS) 2024 placing the state’s total fertility rate (TFR) at 2.9 children per woman, significantly above the national average of 1.9. Public health experts have repeatedly stressed that improving male participation is critical for achieving balanced and equitable family planning.
Against this backdrop, Patna emerged as the state’s best-performing district in female sterilisation, recording 1,210 procedures, followed by West Champaran (820), Vaishali (809), East Champaran (752) and Gaya (702).
In contrast, Vaishali and Siwan jointly topped the state in male sterilisation with 52 procedures each, becoming the only districts to cross the 50-mark during the campaign. Aurangabad ranked third with 27 procedures, while Begusarai and Patna shared the fourth position with 21 procedures each.
Despite these encouraging performances by a handful of districts, male participation remained weak across much of the state. Samastipur, Araria, Banka, Darbhanga and Muzaffarpur reported no male sterilisation procedures, while Munger, Purnia, Supaul, Jamui and Sheohar recorded only one procedure each.
Among female sterilisations, Jamui (108), Jehanabad (124), Munger (132), Darbhanga (155), Sheohar (169) and Arwal (177) were among the comparatively lower-performing districts.
Commenting on the campaign, Dr Vivek Kumar Singh, Patna’s district programme manager, District Health Society, said the achievement reflected the dedicated efforts of healthcare workers, programme managers, field teams and community support.
“This achievement reflects the dedicated efforts of our healthcare workers, programme managers and field teams, along with the support of the community. We will continue to strengthen awareness and counselling activities to improve male participation in family planning and ensure equitable responsibility among couples,” said Dr Singh.
Health officials said the campaign’s overall performance was encouraging but emphasised that sustained awareness drives, myth-busting campaigns, better counselling and stronger community engagement would be essential to increase acceptance of male sterilisation and promote shared responsibility for family planning among couples.
“Deep-rooted social stigma, misconceptions linking vasectomy with loss of masculinity or physical strength, limited awareness, gender norms that place the burden of contraception on women, and inadequate counselling continue to discourage men from opting for sterilisation, particularly in rural areas,” said Prof Gyanendra Yadav of the department of sociology, College of Commerce, Arts & Science, Patliputra University, Patna.
He said that the higher participation of women in sterilisation also reflected growing awareness, empowerment and a greater role in household decision-making. “Women bear the primary responsibility of childbirth and childcare, and having more children increases their physical, mental and economic burden. As awareness and decision-making ability have improved, more women are choosing sterilisation despite the government offering a higher monetary incentive for male sterilisation,” Prof Yadav added.
