Girls born in states where sex determination is high — likely to lead to sex selective abortions resulting in fewer girl children — received better nutrition and medical care because they are wanted, an international study has said.
Published last month in the Economic Journal, the study looked at data from the National Family Health Survey periodically released by the Union government and at analysis of how healthy children are in states where there is a sex ratio imbalance, because of prenatal sex selection and sex-selective abortion.
For every 0.07 point increase in the male-female ratio (MFR) — the natural sex ratio at birth is 1.06 — there was a four percentage point drop in the number of underweight girls.
In other words, states where prenatal sex selection is rampant — while illegal — produced girls who were healthier. In states where the sex ratio is better balanced, perhaps because families do not have access to illegal prenatal sex-determination clinics, more girls were born, but were not cared for, leading to many of them being undernourished.
“Various factors are responsible. One, that girls are born into families that want them… they are better fed,” said the study’s co-author Analia Schlosser from The Eitan Berglas School of Economics, Tel Aviv University, Israel.
So, while the sex ratio in Punjab, Haryana and Delhi are skewed towards boys, fewer girls are underweight. But there was near to no change in the proportion of underweight girls in Kerala or Nagaland – states with lower prenatal sex selection.
Schlosser and lead author Luojia Hu from the Economic Research, Federal Reserve Bank of Chicago, studied sex ratio at birth and nutritional outcomes in children between zero and 35 months.
“In the study, we look at changes in health outcomes of girls relative to changes in health outcomes of boys. We believe that economic prosperity would affect children of both genders, so any improvement we observe in girls’ outcomes relative to boys is after taking into account possible changes in the economic situation in those states,” explained Schlosser. said the financial situation of the families was also taken into account: “We look at changes in health outcomes of girls, relative to changes in health outcomes of boys. Economic prosperity will affect children of both genders.”
While many Indian experts agreed with the study, some others found holes in the findings, specific to our culture’s biases against the girl child.
Dr Sutapa B Neogi, additional professor, Public Health Foundation of India, Delhi, said the study was right in pointing out the association between prenatal sex selection and malnutrition among girls.
“But, to interpret that prenatal sex selection leads to a drop in malnutrition is misleading. It is well-known that sex selection practices are more common in relatively wealthier states, where malnutrition is bound to be less,” said Neogi.
“Prenatal sex selection has become the biggest reason for missing girls over the past decade in India. Traditional causes, such as deliberate neglect, will become lesser as infanticide was rare in India,” said Dr Sabu George, a social activist and researcher who has studied female foeticide in several Indian states.
The study also pointed to research on breastfeeding in India – that girls tend to be breastfed for a shorter period.
“The bias against the girl child begins at her birth, from the reactions of the relatives when the doctor announces the baby’s sex. When the second child is a girl, these responses only get stronger, so mothers refuse to breastfeed or take the child home,” said Dr Basab Mukherjee, chairperson, family welfare committee, The Federation of Obstetric and Gynaecological Societies of India (FOGSI).
Mukherjee said a child who has not been breastfed is vulnerable to infections.
“This affects the overall health and malnutrition is not surprising in such cases. Families with several children have little resources; they choose always feed the boy.”
With study highlighting the issue of malnutrition, activists have stressed on the need for schemes to tackle it among girls, as they are at a greater risk of neglect.
“The research shows discrimination. It will be wrong to interpret the research to allow free access to prenatal sex determination techniques. The state needs to increase the value of the girl child and help her access healthcare and education,” said Dr Neelam Singh, founder of Vatsalya, a non-profit working in Uttar Pradesh to reduce female foeticide.