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Sunday, Oct 20, 2019

Seven million girls go missing in India every decade, say reports

In many small families, the missing children are girls. In a family that already has a daughter, the chances of the second child being a girl drops by 38%.

india Updated: Jul 12, 2017 09:17 IST
Sanchita Sharma
Sanchita Sharma
New Delhi, Hindustan Times
Sabita Baria, 22, with her newborn at the special newborn care unit at the Government JP Hospital in Bhopal, Madhya Pradesh. Her child, a boy, has recovered from birth asphyxia from prolonged labour.
Sabita Baria, 22, with her newborn at the special newborn care unit at the Government JP Hospital in Bhopal, Madhya Pradesh. Her child, a boy, has recovered from birth asphyxia from prolonged labour.(Sanchita Sharma/HT)

Families are steadily getting smaller in India but in many homes the missing children are girls.

Around seven million girls go missing in India every decade, with the fall in sex ratio corresponding with rising affluence, increasing availability of sex-determination technology and declining family size.

The natural sex ratio at birth favours boys, with about 1,020 boys born to 1,000 girls. This bias in favour of boys is nature’s way of balancing the slightly raised risk of death in baby boys, which even outs the overall sex ratio by the age of six.

Yet not only are fewer girls born because of sex-selective abortions but more girls are also dying in the first five years of birth because of neglect.

Around 1.2 million children die before their fifth birthday in India, which puts the country’s under-5 mortality rate (under-5 deaths/1,000 live births) at 45.

While gender-wise data for 2015-16 is not yet available, the newborn death rate (death within 28 days of birth) in India was 41 for boys and 37 for girls per 1,000 live births in 2005-06, with states like Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Odisha, Jharkhand, Chhattisgarh, Uttrakhand and Assam registering a fall sharp in the under-5 gender ratio over the past decade because many families invest more effort, time and money to save a sick boy child than a girl.

India also has the world’s highest newborn deaths, more than 700,000 babies dying within the first 28 days of life every year. Here again, more boys are likely to be saved than girls.

Don’t girls get sick?

To save babies in the first most critical 28 days of life – 70% infants deaths occur in the neonatal period -- 662 special neonatal care units (SNCUs) with more than 11,000 beds have been set up at the district level to prevent deaths from low birthweight (below 2.5 kg), prematurity, birth asphyxia, sepsis, jaundice and other birth complications.

In 2016, 842,000 newborns were treated at these SNCUs across India. Only 41% of them were girls.

“The smaller percentage of girls is significant because SNCUs are referral units, with most sick babies being treated either being referred from within the hospital or from other hospitals in the vicinity,” says Dr Satish Maravi, paediatrician in-charge of the SNCU at government JP district hospital in Bhopal, Madhya Pradesh. “If the numbers are low for girls, it’s because parents are not bringing their girl child despite being referred,” he said.

Smaller families, fewer girls
Sex-selective abortions and neglect are leading to India missing 7 million girls in each decade
Sex ratio: Number of girls per 1,000 boys
*More boys are born than girls, but the ratio evens out by age 6 as boys are biologically more likely to die of illness in early infancy

His unit in the city centre has 23 beds, with 30-32 babies being admitted on any given day. Around 57.5% of these babies are boys, with the percentage of boys being higher in the 34% cases referred from private hospitals and clinics.

Sabita Baria, 22, is there with her second child, a boy, who suffered birth asphyxia from prolonged labour. Rainbow Children Hospital, a private clinic in Bhopal, charged her Rs 60,000 before referring her son to the JP hospital, where treatment is free.

Baria desperately wants the baby to live. “We have a five-year-old girl and have been trying for a boy. I won’t ask God for anything more if my boy lives,” she says, hugging her son in quiet desperation.

Her yet-to-be-named son is ready to be discharged, says staff nurse Meenakshi Pillai, who is more concerned about the 1.175-kg preterm baby Rinky in the next radiant warmer, who weighs less than half a healthy birthweight of 2.5kg. “She’s gained 40gm in a week, which is a sign she’s recovering. She’s started feeding on her own too, she’s a fighter,” says Pillai.

Fighting bias

In many homes, girls have to fight to survive.

India’s pre-natal diagnostic techniques act bans both pre-conception and pre-natal tests such as amniocentesis and sonography since 1994 and 2003, respectively. But illegal abortions have kept the sex-ratio at birth skewed in favour of boys: 919 girls to 1,000 boys were born in the five years preceding 2015-16.

With many states cracking down on doctors conducting illegal sex-determination, the sex ratio has registered a marginal increase to 914 in 2005-06, with Kerala being the most kind to its girls (1,047 girls born to 1,000 boys), followed by Meghalaya (1,009) and Chhattisgarh (977).

Some states like Maharashtra, Tamil Nadu and Haryana have registered a significant improvement in the sex ratio, but many others have shown a sharp decline.

Over the past decade, sex ratio at birth plummeted in Sikkim from 984 to 809, Manipur from 1,014 to 962, Mizoram from 1,025 to 946, Manipur from 1,014 to 962, and Jharkhand from 1,091 to 919.

In a family that already has a daughter, the chances of the second child being a girl drops by 38%, found a study in Nagpur.

The study found that the sex ratio for the third child was 1,000 in families with two sons, but dropped to 600 if one of the older siblings was a girl and to 455 if the first- and second born were girls, found a 2013 study at Indira Gandhi Government Medical College, Nagpur.

“India newborn action plan 2014 has a goal of attaining single-digit neonatal mortality and stillbirth rates by 2030, with efforts including setting up of SNCUs at the district level, starting birth-defect surveillance in medical colleges, and getting ASHAs (community health workers) to visit one crore newborns at home within 42 days of birth each year,” says a health and family welfare ministry official, who did not wish to be named.

How many children are saved depends on the last-mile reach. Unless community health workers ensure all sick babies, irrespective of gender, get the best possible treatment, India will continue to lose girls as families shrink.

First Published: Jul 12, 2017 07:41 IST

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