KOLLAM: Pathanamthitta, Kollam, Idukki, and Palakkad districts reported some of the lowest male sterilisation figures in the state, underscoring a persistent gender gap in permanent family planning.
According to the latest Health Management Information System (HMIS) report of the state health department, only 457 men underwent non-scalpel vasectomy (NSV) in 2023-24, while 51,740 women underwent sterilisation procedures — including laparoscopic, mini-lap, post-partum sterilisation (PPS), and post-abortion sterilisation (PAS).
Pathanamthitta had the lowest uptake with only eight male sterilisations, while Kollam and Palakkad each reported just 11 NSVs. Idukki followed with 15. The data highlights how the burden of permanent contraception continues to fall overwhelmingly on women despite years of awareness drives and cash-incentive schemes.
In 2014-15, the state conducted 91,471 sterilisation procedures, including 1,262 NSVs. Since then, numbers have steadily declined. The sharpest fall came during the Covid pandemic in 2020-21, when just 53,461 sterilisation procedures were performed — just 73 of them NSVs. In 2021-22, 299 NSVs were recorded out of 54,788 procedures. The number rose slightly to 635 in 2022-23 before dipping again to 457 in 2023-24.
While the overall decline is attributed to a growing preference for temporary methods like oral pills and intrauterine contraceptive devices (IUCDs), experts say the entrenched gender imbalance remains unaddressed. “The stigma around male sterilisation continues to persist in society, despite it being a quick and safe procedure.
NSV is a minimally invasive method that doesn’t require incisions or stitches. It takes just 10-15 minutes, and neither erection nor ejaculation is affected. But many men still refuse, believing they’ll lose their virility or ability to remarry,” said Dr Sasi Kumar, a senior gynaecologist with over three decades of service in the health department.
Social attitudes play a key role, he added. “In our society, remarriage among men is more common than among women. Many men believe sterilisation would harm their prospects for a second marriage. That fear and the myth that it affects their manhood deter them.”
Dr Unnikrishnan, a senior gynaecologist from Kollam, said the increasing rate of C-sections in Kerala has further reduced male participation. “With more women undergoing C-sections, PPS is now routinely performed during delivery. The surgeon can access fallopian tubes immediately after childbirth, and no additional surgical step is needed. While this is medically efficient, it reinforces the idea that family planning is a woman’s responsibility,” he stressed.
“In many hospitals, PPS is carried out via mini-lap sterilisation during C-sections. Neither the patient nor the doctor wants to take the risk of normal delivery these days. And once the abdomen is open, sterilisation becomes convenient. But this convenience, in a gender-biased society, means that men continue to opt out entirely,” Dr Unnikrishnan said.