India fares worse than all its neighbours except Pakistan and Afghanistan on social and health indicators, according to a UNICEF review of child rights data from eight countries in South Asia.
Children in the region are disadvantaged right from the start.
The sex ratio in India was the lowest in the region, with only 924 girls per 1,000 boys, compared to Bhutan’s 987 and Pakistan’s 985.
In India, the sex ratio at birth is higher in wealthier households and near normal in the poorest.
The report predicts that with economic progress and smaller family sizes, this trend may lead —not only in India, but also in Nepal — to more women being aborted.
India tops the list of countries where people defecate in the open, exposing them to soil and water-borne infections like diarrhoea, which is the second biggest cause of death of children under five.
More than one million newborns die within the first 28 days in South Asia, with almost 70% of the deaths due to avoidable causes. The report shows marked disparities in neonatal deaths between countries, with numbers ranging from six deaths per 1,000 live births in Sri Lanka and the Maldives to 31 in India and 42 per 1,000 in Pakistan.
India has had some successes, such as Madhya Pradesh’s use of text-messaging and customised software-based tracking system to halve the deaths of underweight and premature babies after discharge from government-run Special Newborn Care Units.
“Investing in family planning and reproductive health services for girls and women is one of the most effective interventions,” said Katja Iversen, CEO, Women Deliver, a global advocacy organisation on women and child health, in an email interview.
“Another great intervention is girls’ education … Finally, interventions that focus on women’s economic empowerment are critical.”