Archive

Posts Tagged ‘child sex ratio’

With greater education and wealth come greater risks for India’s unborn females

STEPHANIE NOLEN

NEW DELHI— From Tuesday’s Globe and Mail

Published Tuesday, May. 24, 2011 1:30AM EDT

In India, the practice of aborting female fetuses increases as women become better educated and wealthier, defying the predicted decline of a widespread cultural preference for sons.

And as many as 12 million girls have gone “missing” from the population since 1985 because of the practice, according to new research released Tuesday by the leading medical journal The Lancet.

“There is really no change in stated son preference over the last 10 to 15 years,” said Prabhat Jha, an epidemiologist at the University of Toronto who led the study. “Fertility has dropped substantially due to economic growth and increases in literacy, which are all very good things, but that has also meant that ultrasound use and access is increasing. Families appear to be saying, ‘If nature – or God, if they’re religious – gives us a first boy, then we will have one more child and that’s it, but if we have a first girl we will use ultrasound [and abortion] to ensure our second and last child is a boy.’ ”

Recently released data mean he and colleagues are able to study the trends since 1985, when ultrasound gender testing was introduced here. “And it isn’t slowing down.”

The researchers used census data, and 265,000 birth histories collected in India’s National Family Health Survey, to estimate differences in the girl-boy ratio for second births in families in which the first-born child had been a girl. They found that the girl-boy ratio fell from 906 girls per 1,000 boys in 1990 to 836 in 2005.

But in cases where the first child born was a boy, there was no drop in the girl-boy ratio for the second child: evidence that parents are selectively aborting girls if their first-born child is a girl, Dr. Jha said.

This difference in the ratio of girls to boys born was much sharper in mothers with 10 or more years of education than in mothers with no education; the difference is also greater in better-off households compared with poorer ones.

The study says that there is not yet clear evidence of the selective abortion of first-born female fetuses, as is common in China, where son preference is also strong and where state policy restricts families to only one child. But that may come as growing numbers of families choose to have only one child, particularly in urban areas.

Dr. Jha, who directs the U of T’s Centre for Global Health Research, said the study makes clear that the steps taken by the government to end sex-selective abortion have not been successful. The law banning prenatal sex determination is a good one, he said, but the private health-care sector in India is so minimally regulated that the law has had little impact.

To calculate the number of female fetuses aborted for sex selection since the introduction of ultrasound gender determination in 1985, the authors calculated the expected number of births of girls, based on the ratio of 950-975 girls born to 1,000 boys in societies without son preference, and compared it against the actual number of births of girls enumerated by the censuses, done every 10 years.

After adjusting for excess mortality rates in girls, the authors estimated that there were between zero and two million selective abortions of girls from about 1985 to 1990; 1.2 million to 4.1 million in the 1990s, and 3.1 million to six million in the 2000s – for a total of between four million and 12 million by 2010.

Before the release of 2011 census data last month, there was speculation here that rising income levels and education levels for women, combined with public education campaigns and efforts at enforcement by government over the past 15 years, would show a slowing of sex-selective abortion.

“I was quite surprised that the ratios had gone down further,” said Dr. Jha, who has worked on this subject for a number of years.

In an interview in Delhi, he noted, sounding rueful, that he and his colleagues “can’t really explain why” son preference is persisting with such dramatic consequences, as they were not studying causes. Analysts in the Indian media frequently cite the practice of paying dowry for brides, which has been illegal for decades but is still widespread, as one possible explanation.

A further finding of the research is that a majority of Indians now live in states where selective abortion of girls is common. Until this year’s census data, which showed a decline in sex ratios in a majority of states, it had been believed that the practice was largely confined to a handful of states with deeply rooted cultural aversions to female children.

Source: The Globe and Mail

Advertisements

Recent story told a flawed tale of India

Article by: JESSICA MACKENZIE

“The country has problems, yes, but it is not brutal and backward on the whole.”As a woman who lived in India for nearly two years, is married to an Indian physician and gave birth to my daughter there, I was shocked and disappointed by the narrow perspective of the article “A Glimpse of Health Care in India” (May 8).

The article featured Dr. Donna Block, who recently traveled to India with the Women’s Leadership Board at Harvard University’s John F. Kennedy School of Government to gain insight into India’s health care system. Unfortunately, from what I read, what she left with was a jumble of misinformation and stereotypes.

Block talks about a hospital in Chennai, describing it as “one of the better clinics.” She then weaves a tale of horrors, unlike what I witnessed at top health care facilities in India. Are there clinics like the one she described? Absolutely. But they are not considered good, never mind “better.” Many hospitals in India practice evidence-based medicine and implement Western-style protocols. Her implication that Indian hospitals and doctors don’t have regulations, don’t pay attention to sterility and have no process for consent is misguided at best. While probably accurate at some government clinics and a few private hospitals, it is not an accurate generalization of Indian health care.

Block was given a strange piece of misinformation. She asked why patients couldn’t be told the gender of their unborn babies, and was told that Indian men divorce their wives if they are carrying a girl. This is patently false. Divorce is still uncommon among middle- and lower-class families in India. The truth behind the nondisclosure is that Indian law forbids notification of gender for unborn babies to deter the unfortunate practice of selective abortions.

Dr. Block then spoke of the slums she toured. I was floored by the apparent lack of understanding of poverty in India evident in her assertion that poor rural families sell their daughters into prostitution. Those young girls in the red-light district aren’t knowingly sold by their parents. I won’t say it never happens, but in general, most are victims of trafficking — stolen from Nepal and northern states near the border. Many other families are duped into letting their children work in shops in large cities, and instead the children are sold into sexual slavery. Again, a large misunderstanding that unnecessarily paints Indians as brutal and backwards.

Finally, there is Block’s assumption that all slums lack health care and immunization programs. India has the second largest public health system in the world. And while this system is admittedly rife with corruption and other problems, one thing it gets right is immunization drives. Many people living in colonies like Dharavi are immunized, not to mention educated.

There’s a mind-set of many Westerners when they travel to Third World countries that the place they are visiting somehow needs to be saved, and that only we have the answers. Many times we ride the thin line of colonialist thinking without realizing that we’re making assumptions that don’t fit the full picture. To assume we have the right to go in and fix what is not ours is dangerous to begin with, especially given the U.S. ranking for maternal mortality (31st, well behind countries like Albania and Poland). The complex social and socioeconomic strata of India make the country nearly impossible to understand in a lifetime, never mind within a few weeks.

I would never say India is without its problems. It is in dire need of an overhaul to many of its systems. And surely the marginalized people of Dharavi and other “slums” deserve a more permanent solution to their educational and health care challenges.

However, prestigious programs such as the Women’s Leadership Board should look at ways to partner with indigenous programs. In the end, this should be less of a parent-child relationship and more of a sisterhood. In this way they will gain the cultural understanding that, as this article illustrated, is so sorely needed.

Jessica MacKenzie lives in Alexandria, Va.

Source: StarTribune

Pyramid-structure health service planned to check infant, maternal mortality

April 20, 2011 Leave a comment

Adam Halliday,ADAMHALLIDAY Posted: Apr 20, 2011 at 0355 hrs IST

Ahmedabad: The Commissionerate of Health, Medical Services and Medical Education is putting together a pyramid-structured
organisation in an attempt to arrest the infant and maternal mortality rates, senior health officials have said. The move comes in the wake of a report by the Comptroller and Auditor General of India (CAG) which states that Gujarat
has been unable to bring down IMR from 57:1000 in 2005-06 to 30:1000 by March 2010 despite launching of the Chiranjeevi Yojana. Dr N B Dholakia, Deputy Director, RCH at the Commissionerate, said the structure will seek to look at the grassroots level and strengthen penetration through training of workers at the primary level . He said 36,000 ground-level workers have been trained under the Integrated Management of Neo-Natal and Childhood Illnesses scheme. The target, expected to be complete by the year-end, is 45,000 workers. These workers will be responsible for identifying unhealthy children and reporting such cases to paediatricians. Above this level will be 333 Newborn Care Corners in PHCs across the state, to be manned by Auxiliary Nurse Midwives (ANMs). Above these care corners will be 148 Newborn Stabilisation Units in as many Community Healthcare Centres. The top-level will have 41 Neo-
Natal ICUs at various locations in the state. Dr Dholakia further said the effort to arrest the deaths of newborns and mothers will be coupled by setting-up of “family-friendly ” hospitals. Dr Prakash Vaghela, assistant director, said the postpartum care is sometimes missing in the care of pregnant mothers. Postpartum care is the care given to mothers who have just delivered, at least for the 48 hours following delivery. They said the hospitals in the state will be equipped with space for attendants, and services like food will be also taken care of. The concept is a result of observations that many people shun institutional deliveries because attendants sometimes find it difficult to be in the hospital.

Source: Pyramid-structure health service planned to check infant, maternal mortality

Top Stories in Public health and Medicine, Manipur, India.

April 17, 2011 Leave a comment

1. Five die of rare fever in Mizoram- Alert sounded in state

Five Mizo villagers died of a rare viral fever, diagnosed as the Indian tick typhus, that surfaced in south Mizoram’s Thanzamasora last week. Three other persons in the same village were also afflicted with the disease and are now undergoing treatment in a rural health clinic in nearby Chawngte. The occurrence of the disease in Mizoram has rung an alarm not only in the state, but also in New Delhi.

2. Just what India needs – a green toilet, Berlin-based Israeli engineer designs a product the slums can afford.

The lack of toilets and other proper sanitation facilities in India, which forces many Indians, even in cities, to relieve themselves outdoors, takes a heavy toll on the country’s economy and public health. An Israeli designer is now completing a project of mobile toilets for slums and densely populated areas with no sewage system.

3. Boy Bias: India Census Results Point to Selective Abortion

The results of India’s 2011 Census reveal that far fewer girls than boys are born in the country each year, indicating a rapidly declining child gender ratio that reflects pervasive sex-selection practices. The census results for children age 6 and younger count 914 females to every 1,000 males: a number that’s declined from 927 to 1,000 in 2001 and is at its lowest since India gained independence. Comparing the number of girls actually born to the number that would have been born under a normal ratio suggests that “600,000 Indian girls go missing every year,” the Economist reports. In the past twenty years, India has seen 10 million female lives lost to abortion and sex selection.