Understanding Sociocultural Factors Shaping Married Men's Vasectomy Decisions: A Qualitative Study in Bihar

Wider acceptance of vasectomy among married men can play an important role in controlling population growth in India. It helps take shared contraceptive responsibility and reduces the health risks and social burden that often fall on women. This study mainly aimed to explore the barriers and perceptions influencing vasectomy acceptance among married men and to identify strategies that could enhance its uptake as a family planning option. A descriptive qualitative study was conducted between March and October 2024 in urban and rural field practice areas of a tertiary care hospital in Bihar. Eighteen married men were recruited using purposive sampling, and in-depth interviews were conducted until thematic saturation was achieved. Data were analyzed using thematic analysis. Participants reported persistent myths and misconceptions about vasectomy, including fears of impotence, weakness, and infertility. Historical distrust stemming from coercive sterilization campaigns and entrenched gender norms placing family planning responsibility on women further discouraged uptake. Spousal disapproval, fear of irreversibility, and social stigma around masculinity were frequently cited. Suggested solutions included community-based education, peer advocacy by satisfied vasectomy users, and counseling by Accredited Social Health Activist (ASHA) workers and other frontline health professionals. Misinformation, gender norms, and historical mistrust are significant barriers to vasectomy acceptance in Bihar. Targeted interventions, including myth-busting campaigns, male-inclusive counseling, and strong government promotion, are needed to normalize vasectomy as a safe, acceptable contraceptive choice.