In an unprecedented move to increase the participation of men in its family planning programme, the Madhya Pradesh government has warned male multi-purpose health workers (MPHWs), who failed to mobilise even one man for sterilisation in 2019-20, that their salaries would be withheld and they would be compulsory retired.
Citing the National Family Health Survey-4 report, which recorded that only 0.5 per cent men were opting for sterilisation in the state, MP’s National Health Mission (NHM) has asked top district officials and Chief Medical and Health Officers (CHMOs) to identify male workers with “zero work output’’ and apply the “no work no pay’’ principle — if they don’t log at least one case in the 2019-20 period that ends next month.
The circular, dated February 11 and issued by the state’s NHM Mission Director, states that if the situation does not improve, proposals recommending compulsory retirement of MPHWs will be sent through District Collectors to the NHM headquarters in Bhopal from where they will be forwarded to the Health Directorate for action.
The circular states that all MPHWs should mobilise at least five to 10 “willing beneficiaries” when camps are held in districts.
The number of men opting for sterilisation has been declining in the state over the last five years. For 2019-20, the number was 3,397, as on February 20, 2020, compared to 3.34 lakh women. In 2015-16, the state conducted 9,957 vasectomies. In the three subsequent years, the numbers were 7,270, 3,719 and 2,925, respectively.
According to NHM Deputy Director Dr Pragya Tiwari, there was “almost no participation” of men in the family planning programme. “We are not saying you use coercive methods. We want them to strength advocacy. There are many who want to limit their family size but lack awareness. It’s their job. If you can’t motivate even one person in one full year it shows your work output. What’s the use of spending tax payers’ money on salary?’’ she said.
Tiwari said that unlike auxiliary nurse midwives (ANMs), there was no monitoring of MPHWs until she started “vigorous monitoring” after taking charge of the family planning programme last October. Those who do well are rewarded under the “carrot and stick approach’’, she said.
Officials said the decline in male and female sterilisation figures began in 2015-16 when the courts ruled against a coercive approach and the state government did away with “targets”.
Deputy Director (Maternal Health) Dr Archana Mishra said male vasectomy was “very simple and yet few males come forward, especially in rural areas because they fear losing their masculinity or sex drive”. “Instead of sterilisation, the focus should be on spacing methods,’’ she said.
Indore CMHO Dr Praveen Jadia said “it’s for the first time that such a circular has been issued by the government”. “Indore’s total target was 22,500 and nearly 19,500 sterilisations have been done but the district is not likely to meet the vasectomy target of 2,250,” he said.
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