India’s problem of gender imbalance may be deepening, with virtually all corners of the country now affected by a skewed sex ratio at birth, data from the latest round of the National Family Health Survey (NFHS) shows.

The survey of over 6 lakh households conducted in 2015-16 shows that districts with the lowest sex ratios at birth now include several districts of states such as Assam and Nagaland in the north-east and Tamil Nadu and Karnataka in the south. These are states where overall sex ratio is higher than the rest of the country, and where social outcomes—such as literacy, work participation rates etc.—are more favourable to women than in most other parts of the country.

As the accompanying map shows, districts marked in deep red—those with sex ratio at birth below 800—are spread across the length and breadth of the country. This is in contrast to the patterns observed for the overall sex ratio. Districts with low sex ratios (overall) are largely clustered in the north-western parts of the country. Sex ratio refers to the number of females per 1,000 males. NFHS records both the overall sex ratio in the year of the survey, and the sex ratios at birth for those born in the past five years.

To be sure, there are silver linings in the data. Some of the states with the most skewed sex ratios such as Punjab and Haryana have witnessed an improvement in the sex ratios at birth over the past decade. India’s aggregate sex ratio at birth has also improved, albeit marginally, from 914 in 2005-06 (when the previous NFHS round was conducted) to 919 in the latest round of the survey. But states where the sex ratio at birth has either declined or stagnated over the past decade outnumber states where the sex ratio at birth has improved.

Also, for an overwhelming majority of states as well as for India as a whole, the sex ratio at birth figures remain below normal. Globally, more males than females are born but because of higher survival chances, more females survive compared to males. Thus, the normal sex ratio at birth is not exactly 1,000. According to UN estimates, the average range for developing countries is 943-971. By that yardstick, two-thirds of Indian states have below-normal sex ratios at birth. Among large Indian states, only Kerala, Tamil Nadu and West Bengal have normal or above-normal sex ratios at birth.

In many of the states where sex ratios at birth has declined, the urban areas fare worse than the rural areas. For instance, some of the districts with the lowest sex ratios include relatively urbanized districts such as Jorhat and Kamrup in Assam, Coimbatore in Tamil Nadu, and Udipi in Karnataka. Overall, India’s urban sex ratio at birth at 899 is significantly lower than that in rural India at 927. Many of the districts with extremely skewed sex ratios at birth are urbanized, and tend to have a higher proportion of richer households (those with TV, computer, phone, and motorised 2-wheeler/ 4-wheeler as per census 2011 data) compared to other districts.

The problem of a skewed sex ratio at birth is not entirely new in India but it has spread and grown over time. An analysis of the 1901 census data by US-based demographers Tanika Chakraborty and Sukkoo Kim showed that the sex ratio was lowest in the northern parts of the country, slightly higher in the east, and significantly higher in the south. Their research published in 2012 shows that sex ratio was lower among upper castes than lower castes, and lower among Hindus than among Muslims. The authors linked the divergence in sex ratio to different kinship patterns and inheritance norms prevailing within the country. India’s sex ratio was below-normal primarily owing to the low sex ratio in the northern parts at that time, Chakraborty and Kim showed.

According to some scholars, the regional differences in sex ratios may have arisen because of historical farming and occupational patterns. According to these scholars, rice-growing regions have traditionally witnessed greater female participation in farming compared to wheat-growing regions, and hence may have always valued women more.

There has been a convergence in sex ratios over the past century but this has largely been due to southern states (except for Kerala) regressing to the mean rather than due to northern states progressing.

The latest data from the NFHS can be seen largely as a continuation of that trend.

Dipti Jain contributed to this story

This is the concluding part of a three-part series on health and social outcomes in India based on data from NFHS 2015-16. The first part of this series looked at the growing problem of obesity among adults, and the second part examined the variations in child nutrition outcomes across Indian districts. The district-level data for the story has been scraped and visualized by Mint’s partner, HowIndiaLives

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