Objective="Male participation in Family Planning."
Details for Reform Option "No-Scalpel Vasectomy Centres, Madhya Pradesh"
The acceptance of male contraception methods is abysmally low in India. According to the second National Family Health Survey (NFHS), 1998-99 condom usage is only 3% and male sterilisation 2%. Female sterilisation, by contrast, stands at 36%. In order to promote male participation in family planning, the Union Ministry of Health & Family Welfare, launched the “No-Scalpel Vasectomy Project” in 1998.Government of Madhya Pradesh (MP) followed soon after, by introducing NSV in the state in 1999-2000 under the Integrated Population and Development Project (IPD Project) supported by UNFPA.
NSV was promoted systematically in the 5 districts. The first NSV camp was organised in Satna district in November 1999. The doctors trained in NSV played a major role in popularising the procedure. The encouraging results led to upscaling NSV services to other districts the same year. European Commission’s Sector Investment Programme (SIP) supported the state government in upscaling NSV services; it was made part of by incorporating it in the State Action Plan. Government of MP decided to establish a NSV Resource Centre in Gwalior within the premises of State Institute of Health Management and Communication, Gwalior with the following mandate:
1. Impart training to Medical Officers (MOs) for expanding the Male Sterilisation Programme.
2. Undertake IEC for promotion of male participation in family welfare programme.
3. Organise NSV camps in all districts of the state.
4. Serve as a technical repository for NSV services.
This state level NSV resource centre (NSVRC), the first of its kind in the country, was inaugurated on 12 April 2006. NSV camps are being organised by NSVRC in collaboration with the district administration. The camps are conducted on the first Thursday of every month.
The technique has become very popular with the medical fraternity. A total of 225 surgeons have so far undergone hands-on training in NSV. Those who have not acquired functional competence and are still willing to perfect their skill are being re-trained. Until now, 75 surgeons have been certified to perform NSV and 25 surgeons have been identified as Camp Surgeons.
There has been a steady increase in acceptance of NSV by the community. In 1998-99, only 97 NSV operations were conducted and by 1999-2000, the number of operations went up to 26700). Ever since, there has been a consistent rise in NSV’s acceptance (see Reference). The statewide impact has become perceptible only from 2004-05 onwards.
UNFPA provided a support of INR. 9.15 crores for capacity building.
INR 6, 18,000 was spent in IPD districts for training of MOs in NSV and organisation of NSV camps.
INR 69,00,000 spent under SIP for establishment of State NSV resource centre at Gwalior.
Initially, in 5 IPD district of UNFPA – Chhatarpur, Panna, Rewa, Satna and Sidhi. Later, the programme was upscaled to all 48 districts of the state.
NSV was being promoted since 1999. It took about one year to set up the State NSV Resource Centre.
Capacity building: Facilitated in providing on-going training to MOs to perform NSV. The resource centre has created a critical mass of trained NSV surgeons and organised mega NSV camps in the state.
Advocacy: The resource centre created a body of IEC material for promoting male sterilisation in the community.
Coordination: The camps are organised well in advance with support from the district administration. The success of the programme is because of effective co-ordination between service delivery and IEC activities.
Quality: Maintenance of quality of care in the camp approach poses difficulties.
Integration: NSV is yet to become a part of routine family planning service in the health institutions.
Future uncertain: There is no long-term plan to strengthen and sustain the state NSV resource centre.
Counselling: There is a need to build on the resource centre’s counselling capacity.
1. Commitment of the State Government.
2. Institutional capacity for sustainability
Who needs to be consulted
1. Coordinator, State NSV Resource Centre/Regional NSV resource centres.
2. Director, Public Health & Family Welfare.
3. Joint Director, RCH.
Adequate resource allocations have been made for NSV services in the state under RCH II.
Chances of Replication
Excellent, in view of its efficacy and operational feasibility. Under RCH II, the state planning implementation programme has decided to create three Regional NSV Resource Centres—at Satna, Indore and Bhopal.
NSV services were available only in three districts of Gwalior, Bhopal and Jabalpur in 1998-99; it increased to 7 districts in 1999-2000. The NSV programme in the state received focussed attention in IPD project districts from 2000-2001. Subsequently, NSV services were made available in more and more districts and from 2005-06, all districts, except Vidisha, have been providing the services on a regular basis. Although there is inter district variation in acceptance of NSV 10 districts of the state have recorded higher acceptance consistently.
RCH -II has made provisions for strengthening state and regional NSV resource for counsellors have been made.
Dr. Nandini Roy, National Institute of Medical Statistics, September, 2006.