Introduction: Fathers’ Absence in Reproductive Health Programs

Reproductive health interventions in India predominantly target women, with fathers largely missing from the narrative and practice. Despite the National Health Policy 2017 emphasizing reproductive, maternal, newborn, child, and adolescent health (RMNCH+A), explicit inclusion of men remains minimal. Data from the Ministry of Health and Family Welfare (MoHFW) shows only 15% of RMNCH+A programs involve fathers, and NFHS-5 (2019-21) reports a mere 10% of men accompany partners for antenatal care. This exclusion undermines holistic family health outcomes and perpetuates gender norms that frame reproductive health as solely a woman’s responsibility.

Constitutional and Policy Framework Highlighting Male Exclusion

Article 21 of the Constitution guarantees the right to health but does not explicitly address gender-inclusive reproductive health. The National Health Policy 2017 prioritizes RMNCH+A but focuses primarily on women and children. The Medical Termination of Pregnancy Act, 1971 and the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 concentrate on women’s health and foetal protection, sidelining men’s roles. The National Family Planning Programme under MoHFW has limited male-centric strategies, focusing mainly on female contraceptive methods.

• Legal framework prioritizes maternal and child health, reinforcing women-centric interventions.
• Male reproductive health is not explicitly guaranteed under current laws or policies.
• Policy documents lack provisions for psychosocial or behavioral engagement of fathers.

Economic Dimensions of Male Exclusion in Reproductive Health

India’s budget allocation for RMNCH+A under the National Health Mission (NHM) was approximately INR 28,000 crore in 2023-24, with less than 5% dedicated to male reproductive health. Studies published in The Lancet Global Health (2022) indicate that involving fathers can reduce maternal and neonatal healthcare costs by up to 20%. The male contraceptive market in India is valued at USD 200 million but remains underdeveloped due to low demand and awareness, as per Frost & Sullivan (2023).

• Underinvestment in male reproductive health limits program reach and effectiveness.
• Cost savings from male involvement remain unrealized due to policy neglect.
• Market potential for male contraceptives is untapped, reflecting cultural and informational gaps.

Institutional Roles and Programmatic Gaps

The MoHFW formulates reproductive health policies, while the NHM operationalizes RMNCH+A programs across states. The National Institute of Public Cooperation and Child Development (NIPCCD) conducts research and training but has limited focus on fathers. Globally, the World Health Organization (WHO) and United Nations Population Fund (UNFPA) advocate for male involvement, yet Indian programs lag behind.

• NHM programs involve fathers in only 15% of reproductive health activities (MoHFW Annual Report 2023).
• NIPCCD research rarely translates into father-inclusive program design.
• WHO guidelines emphasize male involvement to improve maternal mental health and contraceptive uptake.

Data Evidence of Low Male Participation and Its Consequences

NFHS-5 data reveals only 10% of men accompany partners for antenatal care, and male participation in family planning is 12% compared to 88% female participation. States like Kerala, with 25% male involvement, show better maternal outcomes. A 2022 WHO report states male involvement reduces postpartum depression in mothers by 30%. Globally, countries with father-inclusive policies have 40% higher male contraceptive uptake (WHO, 2023).

• Low male participation correlates with poorer maternal and neonatal health indicators.
• Psychosocial benefits include reduced maternal depression and improved family dynamics.
• Father-inclusive policies demonstrably increase contraceptive use and shared responsibility.

Comparative Analysis: India vs Sweden on Male Involvement

Critical Gaps in Indian Reproductive Health Interventions

Current policies overlook fathers’ psychosocial and behavioral roles, focusing narrowly on women’s biological health. This perpetuates gender stereotypes and misses opportunities for comprehensive family health promotion. The absence of targeted male involvement programs results in underutilization of potential benefits such as improved maternal mental health, increased contraceptive use, and reduced healthcare costs.

• Policy documents lack explicit male engagement strategies beyond contraceptive promotion.
• Health workers receive minimal training on involving fathers in reproductive health.
• Cultural norms discourage men from participating in antenatal and postnatal care.

Way Forward: Integrating Fathers into Reproductive Health

• Revise RMNCH+A guidelines to mandate father-inclusive interventions, including counseling and antenatal visits.
• Increase budget allocation for male reproductive health awareness and services within NHM.
• Train healthcare providers to engage fathers and address gender norms inhibiting male participation.
• Leverage successful models from states like Kerala and countries like Sweden to design culturally sensitive programs.
• Promote male contraceptive options and awareness campaigns to expand market and acceptance.

Jharkhand & JPSC Relevance

• JPSC Paper: Paper 2 – Health and Family Welfare; Gender and Social Issues
• Jharkhand Angle: Jharkhand reports low male participation in antenatal care (<10%), correlating with high maternal mortality rates.
• Mains Pointer: Highlight Jharkhand’s socio-cultural barriers to male involvement; emphasize need for state-specific father-inclusive programs under NHM.