Result-based Management Committee discusses and approves the opening of a vasectomy and tubal ligation room at RHC Keamari.
Historically known as Karachi’s gateway to the sea, Keamari has played a central role in Pakistan’s trade and commerce since the 19th century. Today, it remains a vital economic hub, home to diverse communities and a rapidly growing population of more than 2 million, with an annual growth rate of 2.7%. Yet amid this growth, access to essential health services, especially family planning, has not kept pace with community needs.
To address this gap, The Challenge Initiative (TCI), in collaboration with the Population Welfare Department (PWD) and the Department of Health (DoH), has been implementing high-impact practices and other interventions (HIPs and HIIs) across eight districts in Sindh, including Keamari. As part of rolling out these interventions, TCI’s City Manager, Dr. Tahira Sehar, conducted a Knowledge, Attitudes, and Practices (KAP) survey with 175 men to better understand male perspectives on family planning. The findings revealed a familiar challenge: family planning is widely viewed as a “woman’s responsibility.”
The Challenge: Breaking the “Women’s Business” Mindset
In areas like Baldia Town and Lyari, social norms and misinformation continue to shape decisions around family planning. Many men believe contraceptive choices are solely for women, and despite awareness, the use of modern contraceptives among men remains low. Shazia, a Community Health Visitor in Keamari, explains:
Men think vasectomy means weakness. They worry they’ll lose their strength or respect in the community.
To address these misconceptions, the health department introduced the no-scalpel vasectomy (NSV), a quick, safe, and reversible male family planning method that requires no stitches and allows men to take equal responsibility in family planning decisions.
A recent study in Karachi and Hyderabad, including Keamari, shows that:
- 72% of men had heard of NSV
- Only 14% had chosen it
- The biggest barriers were cultural stigma (57%) and lack of accurate information (38%)
What Changed: Couple-Centered Counseling
New vasectomy and tubal ligation room at RHC Keamari, constructed in 2025 by district health leadership following advocacy from TCI.
Introducing joint counseling sessions for husbands and wives proved transformative. Men who attended these sessions were more than twice as likely to adopt contraception (42% vs. 18%).
Nadeem, a Keamari resident who opted for NSV, shared:
I didn’t know vasectomy was reversible. After the counseling, I understood the procedure. Now we plan our family together.
Following this approach, contraceptive use increased by 26% across Karachi, including Keamari, a strong indicator that male engagement drives results.
In June 2025, during the fourth Result-Based Management (RBM) committee meeting at Baldia Office – chaired by Dr. Talib Lashari (Technical Advisor and FP2030 Focal Person) and co-chaired by Dr. Wali M. Rahimoon (District Health Officer) – a milestone was announced: Keamari became the first district in Karachi to establish vasectomy and tubal ligation services directly within the labor room of a primary healthcare facility, RHC Keamari.
This integration ensures:
- Immediate access to family planning services
- Safe and voluntary vasectomy and tubal ligation procedures
- Routine counselling as part of maternal and reproductive healthcare
RHC Keamari is now successfully counseling and providing safe NSV services, helping shift family planning from a “women’s burden” to a shared household decision.
The Road Ahead
Progress is visible, but ongoing community engagement is crucial to dismantling stigma and normalizing male responsibility in family planning. As Dr. Wali Muhammad Rahimoon, District Health Officer Keamari, remarked:
Family planning is not just about preventing births. It’s about giving families control. When men participate, the entire community moves forward.
Keamari’s journey is now inspiring other districts, demonstrating that sustainable change begins when men receive accurate counseling from skilled providers and are offered a full range of family planning choices.
