Health
Vasectomy Gains Popularity Among Polish Men as Fertility Rates Fall
In Poland, vasectomy is emerging as a more popular method of permanent contraception among men, while female tubal ligation remains illegal on request. The trend comes amid growing concern over the country’s declining fertility rates and shifting attitudes toward family planning.
The State of the Young 2025 report found that 15 percent of adults born between 1995 and 2006 have no children and do not intend to have any. While permanent contraception options for men are increasingly sought, women in Poland have no equivalent choice: tubal ligation is prohibited except for strict medical reasons, and performing it on request can carry prison sentences of three to 20 years under Article 156-1 of the Penal Code.
Statistics on vasectomy in Poland are limited, as most procedures are carried out privately. It is estimated that around 5,000 vasectomies take place annually, with clinics advertising the services online and on roadside billboards. Mateusz Siwik, owner of a Warsaw clinic, told Euronews Health that interest in the procedure has been steadily growing, with year-on-year increases of around 15 percent. He said patients are socially diverse but often men in stable relationships with two or more children who have consciously decided to end family expansion.
One example is Kamil Pawelski, a psychologist and influencer who underwent vasectomy in 2020 after the birth of his second child. Pawelski said the decision was motivated by concern for his wife’s health and their mutual decision not to have more children. He noted that public reactions were mixed, with more criticism coming from men than women. “I think this is a very masculine decision,” he said, stressing that the procedure is only suitable for those certain about not having future children.
The restriction on female sterilisation has contributed to medical tourism, with Poles travelling to Germany, Czechia, and Slovakia for tubal ligation. Rafał Zadykowicz, an obstetrics and gynaecology specialist, said foreign gynaecologists are often surprised by the strict legal limits in Poland, where access is limited to medical necessity.
Vasectomy is increasingly preferred across Europe and North America due to its relative simplicity and low invasiveness. France has seen vasectomies rise from 1,940 in 2010 to over 30,000 in 2022, especially among men under 40. In Canada, 22 percent of women rely on their partner’s vasectomy, while rates in the UK, New Zealand, and South Korea range from 17 to 21 percent. In contrast, Italy sees only around 1 percent of men undergoing the procedure. No official figures exist for Poland, but interest is clearly rising.
Poland faces some of the lowest fertility rates globally. The total fertility rate fell to an estimated 1.10 children per woman in 2025, leaving the population at 37.3 million. Within the OECD, Poland ranks third from last, ahead of only Chile and South Korea. Social policy programmes offering financial support for children have been in place since 2016, but debates continue over why many young adults choose not to have children despite the incentives.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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