Summary
NFHS-6 (2023-24) shows that India's fall to below-replacement fertility has not changed who carries contraception. Female sterilisation stands at 36.5% and male sterilisation at 0.5%. Over three decades, female sterilisation has held near 36-38% while vasectomy fell from 3.4% to 0.5%.
Overall contraceptive use rose to 69.1%, but modern-method use fell to 52.7% while traditional methods rose by 6 percentage points. The data arrives just as the WHO has issued new guidelines on expanding contraceptive choice.
It has also published its first Target Product Profile for reversible male contraceptives.
WHY IN NEWS FOR UPSC & STATE PCS
The WHO has released new guidelines on expanding contraceptive options. For the first time, it has set benchmarks for a new generation of reversible male contraceptives. At the same time, NFHS-6 data shows that India met its population goal while leaving the gender imbalance in contraception untouched and in some respects deepened it.
Male sterilisation rose between NFHS-5 and NFHS-6 in 22 States, but only Telangana saw an increase above one percentage point.
Standard News
India's Demographic Success Was Built on One Gender's Bodies Between 1966 and 1970,
about 80.5% of all sterilisations performed in India were vasectomies. For most of the programme's first two decades, the typical sterilised person was a man. This has a history and the history explains the number in today's news.
NFHS-6 reports female sterilisation at 36.5% and male sterilisation at 0.5%. That is not a gap that always existed. India built it after 1977 and India's demographic success then made it permanent.
The Year the Programme Turned Away From Men
The turning point was the Emergency. In 1976-77, roughly eight million sterilisations were carried out, many under quota pressure and men were the principal targets. Vasectomy was quick to perform, so officials used it to meet targets.
Villages such as Uttawar in Haryana became bywords for coercion. The political verdict of 1977 was swift. The programme was renamed "Family Welfare" and within a few years official policy had identified women as its most dependable clients.
The shift was never announced as a gender policy. It was sold as a safety correction: move away from coercion, move towards voluntary choice. In practice, the state simply redirected its sterilisation machinery. By 1981-85, vasectomies had fallen to 14.8% of all sterilisations.
The camps, the targets and the health-worker incentives stayed. Only the body on the operating table changed.
Why Success Made It Harder to Undo This is
where the NFHS-6 data becomes more troubling than a simple gap. Female sterilisation climbed between NFHS-1 and NFHS-3 and has held near 36-38% ever since. Vasectomy has slid from 3.4% to 0.5%. States that reached low fertility early were no exception.
Vasectomy rose in 22 States between the last two surveys, but only Telangana moved by more than one percentage point. The female-centred model worked by the only measure the programme tracked: fertility fell. India met its National Population Policy target in 2021 and reached a TFR of 1.9 by 2025.
A model that delivers its target never faces a crisis that forces a rethink. The gendered burden was not a failure the system hid. It was a cost that success made invisible. Even the new shift in method mix points the same way.
Modern methods fell from 56.4% to 52.7% and rhythm and withdrawal rose by 6 points. That signals a move away from invasive and hormonal options and women still manage the consequences of those less reliable methods.
Where the
1970s Parallel Breaks The WHO's first Target Product Profile for male contraceptives invites an obvious comparison with India's vasectomy era. But the parallel breaks at one point. In the 1970s, the only male method on offer was permanent and coercion made permanence feel like punishment.
The new generation the WHO is benchmarking is reversible. The WHO also says its research has challenged the assumption that men would not use new methods. India has a candidate of its own: ICMR's injectable RISUG, whose phase III results were published in 2023.
The real question is whether a programme built around women can learn to counsel, count and reward men as clients again.
Quick Facts
Key numbers & takeaways — revise these first
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Female sterilisation in NFHS-6 (2023-24) is 36.5%, down from 37.9% in NFHS-5 (2019-21).
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Male sterilisation in NFHS-6 is 0.5%, up from 0.3% in NFHS-5 and down from 3.4% in NFHS-1.
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Married women aged 15-49 using any contraceptive method rose from 66.7% to 69.1%.
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Use of modern methods fell from 56.4% to 52.7%, while traditional methods such as rhythm and withdrawal rose by 6 percentage points.
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India reached the National Population Policy 2000 goal of a TFR of 2.0 in 2021 and TFR fell to 1.9 in 2025.
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India launched the world's first national family planning programme in 1952.
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The WHO's first Target Product Profile for male contraceptives sets benchmarks for safety, effectiveness, acceptability and affordability.
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Pascale Allotey heads the WHO department covering sexual and reproductive, maternal, child and adolescent health and ageing.
Connect the dots for your UPSC preparation.
Standard news covers the event. Log in to read our comprehensive analysis and uncover the hidden constitutional, structural, and ethical dimensions of this topic:
How the 1980 policy turn, the camp system and incentive structures locked female sterilisation in as the programme's default after the Emergency
Why the 6-point rise in traditional methods may be a hidden second burden on women rather than a sign of greater choice
The Bilaspur camp deaths and the Supreme Court's 2016 Devika Biswas ruling and what they revealed about how the programme treated women
A short-term and long-term roadmap for bringing men back into family planning, from counselling reform to WHO-benchmarked reversible methods
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