In richer and poorer States, differing periods of danger for girl children: data

Last year, 74,000 more girls under the age of 5 than boys died in India, numbers for which there is no biological explanation, researchers say. Moreover, while many richer States abort female foetuses at a higher rate than some poorer States, once the child is born, many poorer States have a worse record in ensuring her survival, two new sets of data show.

Low sex ratios at birth are seen as an indicator of sex-selective abortions. While 2011 Census data provides numbers for sex ratios at each year of age, the sex ratio at birth requires separate calculations. Since India’s birth registration data is patchy, demographers and economists use birth rate trends and apply those to official data. Nobel laureate Amartya Sen, in a recent article for The New York Review of Books, used age-specific mortality rates and applied these to Census data to work out the sex ratio at birth for Indian States in 2011. Using the lowest number among large European countries — 935 girls born for 1,000 boys — as a standard, he found that there were only 10 major Indian States above this standard, and they were all in the east and south. They included the poorer States of Chhattisgarh (which at 963 girls for every 1000 boys was India’s best State), West Bengal, Odisha and Bihar, as well as the developed southern States.

The 10 States that comprised the bottom half of Prof. Sen’s calculations were all in the west and north, and included the rich Gujarat, Maharashtra and Punjab, with Haryana bringing up the rear. “Using this method with the data provided by the 2011 census, it appears that all the States in the north and west of India, without exception, show absolutely clear evidence that sex-selective abortion is practised to a much greater degree than is generally the case in the States in the east and south,” Prof. Sen wrote.

Simultaneously, another new set of data has looked at what happens to girls and boys after they are born. Prof. Usha Ram of the Mumbai-based International Institute for Population Sciences (IIPS) and the Centre for Global Health Research (CGHR) at the University of Toronto, and Prof. Prabhat Jha of the CGHR led a team of researchers for a study of district-level child mortality in India published in The Lancet Global Health. Among their findings was a disturbing story of excess female mortality in India’s poorer States.

Female mortality between 1 and 59 months exceeded male mortality in 430 out of 597 districts, totalling about 74,000 excess deaths among girls in 2012 alone. “During the neonatal period, biologically more boys than girls die around the world and in India death rates are equal. Similarly, biologically, 1-59 month mortality should be equal between boys and girls [and is so in most other developing countries]. India is different with higher excess girl deaths,” Prof. Jha explained in an email to The Hindu.

“Biologically, female children are stronger than male children, so once allowed to be born they have a better chance of survival than the male children in the absence of any gender discriminatory practices,” Prof. Ram said.

Most of the excess deaths are accounted for by pneumonia and diarrhoea, Prof. Jha said, adding the excess female mortality indicated the neglect of girl children and favouring of boy children. “[Lo]ts of studies show parents will less often take a sick girl versus a sick boy to a clinic. By contrast, home outreach programmes, most importantly immunisation [or polio drive] don’t have this bias — they reach girls and boys equally,” Prof. Jha said. A comment piece in The Lancet recommended more vaccinations to reduce girl-boy gaps.

Nine States classified as ‘poorer’ by the researchers accounted for 77% of all of India’s excess female child deaths. Five of them — Chhattisgarh, Bihar, Jharkhand, Odisha and Assam — are, however, in the top half of Prof. Sen’s list of States that do well on the sex ratio at birth. Among the States classified as ‘richer’, Gujarat is the largest contributor to excess female deaths.

“It is extremely important to note that the richer States have far lower levels of child mortality while poorer States continue to experience higher mortality… However, it is important to note that under these extreme scenarios, the girl children who escaped selective abortion may be the ones who are more wanted as the very fact that they are allowed to be born says it all and thus may be at lower risk of gender discrimination,” Prof. Ram said.

While nearly every State had some excess female child mortality, in States like Tamil Nadu where child mortality rates are low, the female-male gap too was low. “[I]f India is going to reduce child mortality overall, it has to expand services that reach girls and boys, especially in the lagging districts,” Prof. Jha said. “Put simply — save all children born from dying from avoidable causes and India will also reduce girl-boy gaps in child deaths,” he said.