ANALYSIS OF TRENDS IN SEX RATIO AT BIRTH OF HOSPITALISED DELIVERIES IN THE STATE OF DELHI

ANALYSIS OF TRENDS IN SEX RATIO AT BIRTH OF HOSPITALISED
DELIVERIES IN THE STATE OF DELHI
 
 
 
 
 
 
 
Joe Varghese
Vijay Aruldas
Panniyammakal Jeemon
 
 
 
 
 
 
 
July, 2005
 
 
 
Christian Medical Association of India 
A-3, Janakpuri, New Delhi 110 058, India
 
 
 
 
 
Acknowledgement
This study has been undertaken with the help of  Office of the Registrar General of India
 
The authors have benefited immensely from the discussions with Dr. Jayant Kumar  Banthiya [Former Registrar General and Census Commissioner] and  Mr. Narayanan Unni [Deputy Registrar General, Census]. We are also grateful to Dr. Sunder Rao, Dr. Jayachandran, Mr. Ravi Duggal, Dr. Kumuda Aruldas and Dr. Amit Sen Gupta for providing valuable inputs at various stages of the study. We thank Mr. Varoon Kessop for helping us in data collection and data entry. Finally, we thank the administration and the department of medical records of the eight hospitals for sharing the information and helping us in the collection of data.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  2
Summary 
Increasing masculinity child sex ratio in different parts of India has been an important aspect noted in the last few census reports of India. The misuse of medical technology for the identification of the sex of the child before birth and selective abortion of female fetuses is considered as the major reason for that. The State of Delhi is one of the affected areas in the country with severe demographic imbalance in child sex ratio.  
The study is an attempt to identify the emerging pattern of sex ratio at birth [SRB] of hospitalised deliveries in the state of Delhi and various demographic and socio-economic factors affecting it based on certain available hospital data. 
In the first stage of the study, SRB of eight large hospitals for ten-year period from 1993 to 2002 is calculated to examine any emerging trend. In the next stage, certain socio-economic and demographic variables are correlated with the SRB estimates from about 11,268 birth information of the year 2000 and 2001 available with one of the hospital. Births are taken as the unit of analysis and SRB is used as the indicator for sex selective abortions.
Ten-year study of SRB of hospitalised deliveries shows sharp increasing trends in masculinity from the beginning of the study period 1993/94 till 1997/98 period and thereafter stopped further worsening. Existence of intensive son preference is evident from the estimation of SRB according to the order of birth and sex composition of the previous children. Most of the sex selective abortions are occurring for the second or
higher order of birth when the previous children are females. SRB is as high as 4.56 (219 girls per 1000 boys) for the 3rd  order of birth when both the earlier children are females. Contrary to the popular perception, education status of parents does not produce any desired result on family’s decisions to go for sex selective abortions. 
Result also indicates the positive influence of women’s employment status in bringing down the severity of son preferences. 
In the background of intense son preference, any vigorous measures for control of population growth in India will be disastrous for the SRB, which is already highly skewed against females. The families that are already having girl children should be given a major attention for actions for preventing sex selective abortions. Interventions focusing far-reaching social changes in improving value of girl child, increasing female autonomy and women’s opportunity in employment etc are likely to change the current scenario.    
  3
Introduction
Sex Ratio At Birth [SRB] refers to the ratio of male to female children born in a specific period or all the children ever born to a cohorts of women. In all human populations, there is a fairly stable Sex Ratio At Birth observed in countries with good vital registration which is approximately 104 to 106 boys
per hundred girls [Census of India, 2001]. This advantage is because of the conception more boys than the girls even though there is increased male foetal loss than female fetuses during gestation period. Evidences suggest that unless there is conscious effort at intervention by humans, the sex ratio at birth will not change even over a century [Visaria L, 2002]. However in some regions of the world especially in the south and East Asia the strong preference for sons have distorted the SRB. The abnormal SRB have been found to be due to widely
prevalent sex selective practices.
The strong patriarchal values in certain societies are reflected in their practices. Son preference has been one of the most evident manifestations of patriarchal society which depict the powerlessness of women within such societies. 1980 onwards, in countries  like China where there is strong population control programmes, the fertility decline intensified the manifestation of son preference [Zhao  2000]. In India too with the declining
fertility combining with the persistence of strong preference for sons, parents are taking steps to ensure the birth and survival of the sons compared with the females. 
Over the years, the son preference in India had worked against the female sex particularly in their infancy and early childhood. She is discriminated against in many ways – ranging from abandonment of girl children, fewer months of breast feeding, less of nurturing and play, lesser medical treatment if falls ill etc- all working against the very existence of girl children. The level of discrimination comparatively reduces the chances of survival girl children is clearly evident by the differential child mortality among boys and girls [Agnihotri, 2001, Miller 1989, Das Gupta,1987].  Dreze and Sen [1995] have pointed out that the persistence of gender inequality and female deprivation
are among India’s serious social failures. Today, with the technological advancement in medical diagnosis this discrimination begins even before her birth. Various medical technologies have been put into practice to identify the sex of the child before the birth and selective abortion, if found female. Of the various medical technologies, ultra sound machines are the most misused one in the sex selective practices [Ganathra, 2001]. Evidences shows growing
incidence of pre-birth elimination of the girl children in India [Sabu George,1998].  
 
 
Trends in juvenile sex ratio in India 
The data on child sex ratio provides a broad indicator of the ground realities as they exist in the fabric of our society  in its attitude and outlook towards the girl child.[Census of India, 2001]  The Juvenile sex ratio in India as published by the last few census reports show enormous masculinity. According to the 2001 census report, while the overall sex ratio has increased from 927 females per 1000 males to 933 females per 1000 males,  the Child Sex Ratio of 0 – 6 has reduced from 945 to 927girl children per 1000 male children. The child sex
ratio at birth of 927 for the country as  a whole is less than the universal sex ratio at birth. Of the total of 577 districts in the country, 48 districts showed inordinately low levels of child sex ratio of below 850. In the 1991 census report not a single district showed child sex ratio below 800. It is shocking to
note that in next 10 years, 16 districts fell under this category. There were as many as forty eight districts where child sex ratio is under 850 during 2001, while there was only one districts in 1991. It is difficult to comprehend that as many as 456 districts constituting 79 per cent of all districts in the country have registered a decline of child sex ratio between 1991-2001. Of these, in seventy districts the decline is in the order of over fifty points.  
The State of Delhi is one of the severely affected areas with severe demographic imbalance in child sex ratio. The over all child sex ratio in Delhi is 865 with 6 out 9 of its districts showing a drastic drop [more than 50 points] over the past one decade.   
 
 
Factors determining the son preference
Son preference is deeply entrenched and has its social and economic basis. Various earlier studies and the census figures are suggestive to a certain extent the association of son preference to  various socio-cultural, economic and
certain demographic factors. In south  Asian countries such as India, South Korea and China not only do sons have important roles in rituals, they may be the only source of support for the parents for the old age [Zhao,2000; Chen et al, 1981; Dasgupta, 1987]. 
One anticipated correlation was that between the rising women’s status in terms of entry into education and employment and reduced son preference or dependence. However a number of demographic researches show that daughter discrimination continues to occur in populations where women enjoy education and employment [Croll, 2002]. A study on the impact of son preference among north Vietnamese community suggests  ‘more empowered female adults are more likely to resort to modern strategies in order to have a son, such as sex selective abortions’ [Belenger, 2002]. The national census data shows that most regions characterized by the adverse child sex ratio are the advanced regions of India in terms of per capita income as well as literacy level [Census
of India, 2001]. The data also shows  more adverse child sex ratio in urban areas, though the urban areas are characterized by higher literacy level especially among the females, more employment opportunities for women etc. 
A study of the sex ratio at birth [estimated indirectly from SRS data] of select six states in India indicates its association with the socio-economic conditions, total fertility rate and mother’s mean age at fertility [Dutta P, 2001]. The examination of the patriarchal societies of Asia noted that the combination of
fertility decline and son preference triggers the incentive for sex selective abortion [Zhao,2000, Bairagi, 2001]. The  effect of the sex composition of previous children on subsequent fertility reveals the intensity of son preference in the Chinese society [Wen 1992]. Various studies looking at the India context
are also showing that when the fertility declines and the preference for male children remains strong, parents still take the steps to ensure the birth and survival of male children [Sudha and Irudaya Rajan: 1998, Clark and Shelly, 2000]. A study of female foeticide in rural Haryana by Sabu and Dahiya [1998] had pointed at the linkages between sex of the living children with the family organising strategies. The assessment of sexual preferences of women in NFHS 2 also reveals the same. It shows among women with two living children, the
proportion wanting more children is far greater among those with two daughters [53%] than those with two sons [17%] [Remez L, 2001].  Another assessment of NFHS 2 data reveals the association of high sex ratio at birth with geographic region, child’s birth order and mothers number of living sons and two socio economic characters – mother’s education and mother’s media exposure [Retherford, 2003]. A community based study of the reasons of induced abortions shows that husbands of the women undergoing sex selective abortions were less educated than the husbands of other abortion seekers [Ganathra et all, 2001].  
The study is an attempt to identify the emerging pattern of sex ratio at birth of hospitalised deliveries in the state of Delhi and various demographic and socio-economic factors affecting it based on certain available hospital based data.
The study is to evaluate the impact of son preference under conditions of social and economic development, changes in fertility etc on sex ratio at birth. 
 
 
Objectives of the study
1.  To understand the trends in sex ratio at birth of last 10 years among hospital deliveries in Delhi
2.  To identify the effect of different demographic and socio-economic factors on the sex ratio at birth. 
 
 
Justification of the study   
The widespread misuse of medical technologies for the selective elimination of the female foetuses had evoked the civil society response for long in India.
Unfortunately, a law enacted in 1996 to regulate pre-natal diagnostic techniques and prevent sex selection was very laxly implemented resulting in the rampant malpractice. Very recently,  for the last three years, the country had witnessed an intensification of campaign against sex selection by the civil society with the judicial intervention following a public interest litigation by Cehat, Masum and Sabu George and also with the alarming revelation of demographic profile [0-6 sex ratio] brought out by the national census 2001.
The Law implementation machinery was  also revamped as evident by the increase in the registration of the  ultra-sound machines thoughout the country. In the state of Delhi, both the civil society action and the government law enforcement mechanisms were on an upsurge over this period. Whether
this has changed the ground realities in terms of reduction in the elimination of female fetuses need to be further probed. Studying the trend in the sex ratio at birth from different hospitals over the last 10 years is expected to provide
this information.   
Much of the evidence on the spread of sex selective abortion in India is anecdotal. There is no reliable statistics on the practice at either state or national level [Retherford, Roy 2003]. The main determinants in the child sex ratio are sex selective mortality, sex selective migration and sex selective omission on enumeration and sex ratio at birth. The first three reasons can
confuse in drawing conclusions on the actual severity of sex selective abortions. In a state like Delhi selective migration of families coming only with the male children are often sited as one reason for the skewed child sex ratio
[Times of India, 2002]. Visaria [2002] opinions that the contribution of sex selective abortion on the sex ratio at birth requires a careful analysis of data from various sources, such as SRS, census and birth records  from hospitals or institutions. It was further stressed that more data is needed on the extent of
female foeticide, the demographic and socioeconomic status of women who undergoes sex selective abortions. Information on sex ratio at birth is likely to reflect more light in to the actual  scenario. According  to Sudha and Raja [1998], in India available data help us to understand the juvenile sex ratio rather than sex ratio at birth. They too emphasis the need to have future research examining the demographic behaviors in India from a gendered perspective that scrutinises the nexus between cultural and economic factors and household organisation and strategies. Vina Mazundar in comparison of
studies on sex selection practices using foeticide and infanticide have pointed out the lack of information on cast,  culture and life styles of those who practice foeticide practices. 
 
Data and Methods
The study is based on the data available with the birth records of select large hospitals in Delhi. Births are the unit of analysis and sex ratio at birth [SRB] based on the hospital birth is the indicator for sex selective abortions. The study is designed in two stages. In the first stage of the study each year’s SRB
of eight hospitals for the previous 10 years will be calculated and plotted on a graph to examine any emerging trend. The birth data was collected from three public sector hospitals and five private hospitals belonging to various
geographical areas of the state. The state of Delhi, being well connected with
roads and public transport system, it is assumed that people do not have
geographical preference in accessing any of these large hospitals. 
In the next stage of the study, socio-economic and demographic variables were
correlated with the SRB estimates from about 12,000 birth information of the
year 2000 and 2001 available with one of the hospital. The hospital is purposely
selected for the study because of the availability and accessibility of the data. 
Based on the existing evidences and data availability the study conceptualises
the relationship between sex ratio at birth with the following predictor
variables.
 
 
 
 
 
 
Socio-economic factors
•  Occupation of father
•  Occupation of mother
•  Education of mother
•  Education of father
 
Sex of the child
 
 
 
  9
Demographic factors
•  sex of the living
children
•  order of birth
•  Age of the mother 
• Age of father
In the analysis of the data, births are the unit of analysis. SRB for various
categories were calculated as number of boys born divided by number of girls
born based on the indexed birth of hospital records during the year 2000 and
2001. SRB is used as an indirect indicator for sex selective abortions. Each of
the variables is correlated with the SRB to identify the relation between them.
Education of parents is taken as a continuous variable and is calculated as the
minimum number of years of study required in reaching the reported
educational qualification.  Religion is categorised into three as Hindu, Muslim
and other religions that include Sikh, Christian and others. The occupation of
mother is categorised into following three- 
1.  high-end professional job which are comparatively high salaried and require
professional education [doctor, engineer, advocate, teacher, nurse], 
2.  all other employed as employed and 
3.  those who are reported as housewife as ‘not employed outside home’
Occupation of father is categorised into five 
1.  ‘high end professional job’ as defined in the case of mother
2.  business
3.  ‘working in unorganised sector’ as those who are likely to have
comparatively minimal daily wages [servant, auto driver, carpenter,
sweeper, coolie, milkman, gardener, helper, tailor, driver, hawker,
security guard, labourer] and
4.  all other employed as ‘employed’
 
 
 
 
 
 
 
 
 
 
  10
Results
Part 1
 
Trends in the Sex Ratio at Birth of Hospitalised deliveries of Delhi
 
The trend is calculated from the data of hospitalised deliveries of eight large
hospitals of Delhi for ten year period between the year1993 and 2002. These
hospitals belong to various geographical locations in the state of Delhi. Analysis
is pertaining to a total of 375499 births in ten years of which 249964 are from
the government hospitals and 125535 are from the private hospitals. The SRB of
total births of the study hospitals in ten year is 115, that of the government
hospitals is 113 and private hospitals is 120 boys per 100 girls. The total number
of births in each year is as given in the table no. 1. On an average, the data is
pertaining to about 37550 births per year. As per the SRS data [2002], the birth
rate for the state of Delhi is 20.3 for the year 1996-1998. Applying the same
crude birth rate to the population  of Delhi according to the 2001 census
[13,782,976], it can be estimated that 279794 births are taking place in Delhi
every year. Since only 59% of births are taking place in health facilities [NFHS–
2] the sample is roughly about 23% of hospitalised deliveries of Delhi.
Table No. 1 Total Number of births in the study hospitals each year
 
Year   Number of births
1993  34707
1994  36064
1995  37262
1996  36512
1997  37701
1998  35317
1999  39852
2000  40039
2001  39229
2002  38816
 
 
 
  11
The trend in SRB over the ten year period is verified by calculating the floating
average of three years and plotted on the graph as given below [Figure 1]. 
 
Figure 1 Three-year floating average SRB of hospitalised deliveries of Delhi [
between 1993- 2002]
 
Sex Ratio At Birth
106
108
110
112
114
116
118
120
1993-94-95
1994-94-96
1995-96-97
1996-97-98
1997-98-99
1998-99-00
1999-00-01
00-01-2002
 
The above figure shows increasing SRB trend from 1993-95 period [111 boys per
100 girls] onwards up to the period of 1996-98 where it reached 117 boys per
1000 girls. There after SRB shows slight reversal of the trend. The data shows
that for the next few years it remains between 116 to 118 boys per 100 girls. 
  12
Part 2
Correlates of Sex Ratio at Birth of hospitalised deliveries
 
The results are pertaining to the detailed birth information for the year 2000
and 2001 that was collected from one of the study hospital. There were 11267
births occurred in the hospital in the two-year study period, SRB of which is
1.24. The SRB for the year 2001 is 1.18 and that of the year 2000 is 1.30.  All
the following analysis are done for  both the years together. The birth
information are taken from the labour room records which are entered in the
just before and after the delivery as reported by the mother. 
 
 
SRB by birth order and sex of previous children
 
The study population comprises of 56.2% first order births, 36.8% are second
birth order and 10.6% as third or higher  order of birth. Sex Ratio at Birth by
number of existing children indicates the intensity of sex selection in the
higher order of births. It can be seen from the figure 3 that the SRB for the first
order of birth is 107, which falls slightly above the normal range showing that
only minimal sex selection happening for the first child. However for the 3rd
 
and above order of birth, SRB is significantly masculine at 247 boys per 100
girls. This in other words explains that there are only about 30 percent chance
for a girl to be born in 3+ birth orders. The Chi-squire trend analysis has also
produced the same results as presented in the table No.2. Trend is statistically
significant (∝ 2 P value < 0.000)
Figure 2 SRB by Birth Order
Sex Ratio At Birth
107 138
247
0
100
200
300
123 +
Birth Order
SRB
Table 2 Sex selection at higher birth order; chi-squire trend analysis
 
  13
Birth Order  Present child
male
Present child
female
Mental Haenzel
Odds Ratio
(∝2 P value)
1  3085  2853  1
2  2412  1763  1.27
3+  855  348  2.27
 
< 0.000
 
SRB by birth order may conceal the intensity of the sex selective abortions, if
the sex selective abortions are happening  to eliminate both boys and girls to
achieve ideal sex composition of children.  Therefore to capture the realistic
picture of sex selective abortions that are occurring, it is necessary to examine
SRB by both birth order and sex composition of the previous children. Table 3
shows that, as expected, the sex composition of the existing children is an
important determinant for the sex of the next child. The difference is very
conspicuous for the second child depending on whether the first child is a boy
or a girl. The SRB for the  second order birth for those who have already one
male child is 1.04 [959 girls per 1000 boys], which is within the range of
normally occurring SRB. However when the first child is a girl, the SRB for the
second order of birth is as high as 1.85 [542 girls per 1000 boys]. Similarly, SRB
is as high as 4.56 [219 girls per 1000 boys] for the 3rd
 order birth when both the
earlier children are girls. 
 
Table 3 SRB by sex of the previous children
 
 
Birth
Order
Sex
composition of 
previous
Children
 
 
N
 
Number of
female birth per
1000 male birth
SRB Hospitalised
Deliveries
One male child  2091  959  1.04 
2nd
 
order
One female
child
2075  542  1.85
One male child
and one female
child
391  558  1.79
Two male
children
161  894  1.12
 
3rd
 
Order
 
Two female
children
474  219  4.56
 
 
 
  14
Irrespective of order of birth the number of previous children had a significant
impact on the sex of the present child.  Conversely, there is a ‘dose response’
relationship as presented in table 4. Additionally, the impact of number of
previous male children on the sex of the present child is still in favour of having
male child as explained in table no.5. 
 
Table 4 Sex selection and number of previous female children; chi-squire trend
analysis
 
No. of previous
female
children
 
Present child
male
Present child
female
SRB  Mental
Haenzel Odds
Ratio
(∝ 2 P
value)
0  4243  3948  1.07  1
1  1610  864  1.86  1.73
2+  499  125  3.99  3.71
 
< 0.000
 
Table 5 Sex selection and number of previous male children; chi-squire trend
analysis
 
No. of previous
male children
 
Present child
male
Present child
female
SRB  Mental
Haenzel Odds
Ratio
(∝ 2 P
value)
0  4874  3664  1.33  1
1  1370  1184  1.16  1.15
2+  109  89  1.23  1.09
 
0.004
 
Age of parents 
In the sample the average age of mother is 25. 73 years and that of the father
is 29.19. The table 6 shows direct relation of high sex ratio at birth with the
increasing age of parents. However this is inconclusive as the increase in SRB
could be due to high SRB in higher birth orders as suggested in the figure 2.
Additionally, we analysed the SRB across mother’s age group [categorised
above below the average age for first order birth] in first order birth alone. The
difference was not statistically significant (∝ 2 P value = 0.409).
 
 
 
 
  15
 
 
 
Table 6 Age of parents 
 
 
Age of mother
[Number of
birth]
 
SRB
Number of
female birth
per 1000
male birth
 
Age of father
[Number of
birth]
 
SRB
Number of
female
birth per
1000 male
birth
Less than 24
years [3371]
1.11  902  Less than 27
years
1.16  860
Between 24
and 28
[ 5631]
1.26  792  Between 27 and
32
1.23  814
More than 28
[2325]
1.58  634  More than 32  1.6  627
 
 
Education of Parents
The sample shows the average years of education of the mother is 12.59 years
and that of father is 13.26 years. 
SRB of current births of those parents who have more than high school
education is 1.24 [806 female birth per 1000 male birth]. At the same time SRB
of parents with less than 10 years of education is 1.35 [739 female birth per
1000 male births]. A separate detailed examination SRB by education of father,
mother and both parents together [Table 8]shows similar trends as the level of
education goes up. It is interesting to  note that the only category that has
normal SRB is when both the parents have minimal education. It also shows
that SRB is highest among those with medium levels of education [high school
education]. 
Analysis of SRB of hospital deliveries shows that among parents who are
educated [more than 10 years of education] SRB is increasing with increase in
education. While SRB of the graduate parents is 1.23 [813 girls per 1000 boys]
for parents with postgraduate qualification it is 1.31 [769 girls per 1000 boys]. 
However the distribution of male and female children across various
educational categories (both parents) were not statistically significant at 5% ∝
level. 
  16
 
Table 8 SRB by education of parents
Mother  Father  Both Parents 
 
 
N
 
 
 
SRB
 
No. of
female
birth
per
1000
male
births
 
 
N
 
 
SRB
No. of
female
birth
per
1000
male
births
 
 
N
 
 
 
SRB
No. of
female
birth
per
1000
male
births
0 to 7years of
schooling
[up to middle
school
complete]
 
880
 
1.31
 
763
 
409
 
1.19
 
840
 
265
 
1.07
 
934
8 to 10 years
of schooling
[<middle school
to high school
complete]
 
2365
 
1.35
 
741
 
2051
 
1.45
 
690
 
1050
 
 
1.45
 
690
11 to 15 years
of schooling
[<high school to
graduate]
 
6135
 
1.26
 
794
 
 
6995
 
1.24
 
807
 
4762
 
1.23
 
813
 
More than 15
years of
education
[higher than
graduate
education]
 
1887
 
1.30
 
769
 
1811
 
1.31
 
763
 
943
 
1.31
 
769
 
Occupation of Parents
The table 9 shows different pattern of SRB for father and mother according to
their different occupational status. Mother’s better employment status has a
positive impact on SRB [as reflected by the declining masculinity of SRB] as it
moves from mothers who are not working outside home to those are employed
in high end job professional job. 
Table 9 SRB by Occupation of Mother
 
 
 
 
  17
 
 
Employment status of
mother
 
N
 
SRB
Number of female birth
per 1000 male birth
High-end professional
job
469  1.19  839
Employed  981  1.24  809
Not working outside
home
9904  1.28  783
 
Further analysis of SRB among educated mothers [higher secondary complete
and above] categorised according their employment status is also showing
association of SRB with mothers’ employment status [Figure 3]. SRB for
mothers who are employed is 1.21 [827 girls per 1000 boys] compared to those
who are not working outside home [787 girls per 1000 boys].  
 
Figure 3 Sex ratio at birth among Educated mothers [12 years or above of education]
Sex Ratio At Birth
1.21
1.27
1.18
1.2
1.22
1.24
1.26
1.28
Employed Not working outside home
 
Father’s employment status, the SRB value does not show any such trends, as
seen in the case of mothers [table 7]. In contrast to low SRB among mothers
with high-end professional jobs, SRB is relatively high when father is having
high-end professional employment.   
 
Table 7 SRB by Occupation of Father
 
Employment status of
Father
 
N
 
SRB
Number of female birth
per 1000 male birth
High end professional job  645  1.29  777
Employed  6930  1.26  793
Business  2896  1.26  796
Employed in the
unorganised sector
 
644
 
1.36
 
736
  18
Analysis of SRB according to both the parent’s occupation reinstate the fact
that SRB is consistently masculine when mother are not employed outside
home.
 
 
Table 8 Occupation of Parents
 
Occupation of
father
Occupation of
Mother
 
   N
 
SRB
Number of female
birth per 1000
male birth
High-end
professional job
Employed  197  1.17  859
High-end
professional job
Domestic Work  448  1.35  743
 
Business + Farmer  Employed  196  1.25  847
Business + Farmer  Domestic work  2815  1.26  800
Employed   Employed  1050  1.22  823
Employed  Domestic work  6524  1.28  783
 
 
Discussion and Conclusions
 
In our analysis of ten-year hospital birth data of Delhi shows increasing trends
in SRB from 1993-94 period and then  stabilises after 1997-98 period. The
information assumes importance when we relate this data with another set of
birth data of hospitalised deliveries of Delhi collected by Registrar General’s
office for five-year period of 1987 –92 [Raju and Premi, 1992]. The study, based
on about 35000 hospitalised births noted an increase in SRB from 1.06 in the
initial year to 1.09 in the last year. The present study also shows the
continuation of such trend up to the year 1997/98. The SRB of overall births of
Delhi estimated from the NFHS 1 [for the period 1978-92] and NFHS 2 [for the
period 1984-98] also shows an increase  from 1.11 to 1.12 [Retherford, Roy
2003]
From 1997-98 period onwards the sex ratio is hovering around 860 female birth
per 1000 male birth. This is slightly  worse than the child sex ratio of 865
according to 2001 census for the state of Delhi. Even at this level the SRB is at
a dangerous point to produce serious social consequences in the coming future.
  19
However it should be kept in mind that our estimate of hospital data has been
from large hospitals of Delhi, which may tend to differ from that of smaller
nursing homes, though we argue otherwise.
It is unclear that whether the stabilization of sex ratio from 1997-98 period has
any relation to the PNDT Act 1994, which came in to existence from 1996
onwards. If at all we attribute the stabilization factor to the 1994 Act, it could
only able to arrest further spread of misuse of technology and could not reduce
the level of malpractice that had been already happening.  
Existence of intensive son preference is evident from the estimation of SRB
according to the order of birth and sex composition of the previous children.
Most of the sex selective abortions are occurring for the second or higher order
of birth when the previous children are  females. There is also evidence that
some amount of sex selective abortions  of girls are taking place for the third
order birth even while the families have existing children of both the sexes.
NFHS-2 survey [2000] has reported that women in Delhi wanted more number
of sons than the daughters. It shows that for an average ideal family size of 2.4
children, the desired number of sons is 1.2 and daughters is 0.9 and 0.3 of
either sex. It also reports that the proportion of women expressing desire for a
son increases with the number of living children. Among women with two living
children, 71 percent want their next child to be a son, 10 percent want a
daughter, and only 19 percent say that the sex of the child is up to God or does
not matter.
Pressure on families to have male children is clearly evident from table 1
showing SRB by order of birth and sex of previous children. It also helps us to
visualize the picture of the probable nature of India’s population under any
coercive population control policies. Experience of China shows that coercive
population control policies did reduce  couple’s demand for children, but did
not change their attitude towards having male children [Wen 1992, Zhirong
[2000]. Any vigorous measures for control of population growth in India will be
disastrous for the SRB, which will be highly skewed against females.  
The impact of parent’s education on SRB appears to be rather inconclusive.
Analysis shows a better SRB values for parents who are educated more than 10
  20
years compared to those who are less educated. In the NFHS 2 report [2000] for
the state of Delhi has also noted that the son preference [as indicated by the
percentage who want more sons than daughters] is relatively week among
mothers with high school or more of education and also for women whose
husbands had completed higher secondary school. However study data hint that
there is no difference in the son preference among parents with different
levels of education.
This finding contradicts the popular belief that education helps to bring down
the gender disparities. The probable explanation for this unexpected finding is
the decreasing levels of fertility among the educated women forcing families to
resort to sex selective abortions to have their desired number of sons in a small
family. 
SRB according to employment status of mothers suggest the influence of
women’s economic empowerment in shaping the family organization strategies.
Women who are not working outside home show worse SRB figures compared to
those who are employed. Comparison of SRB figures according to the women’s
employment status and number of years of education strengthens the argument
that even improvements in women’s education unless resulted in employment
and therefore economic empowerment, may not alter the status of women in
the society.  A community based study of sex selective abortions in the state of
Maharashtra also noted that women who seek abortions for sex selective
reasons appear to be differ from other abortion seekers; they have lesser
autonomy, weaker decision making power within the households and therefore
more vulnerable to produce male heirs [Ganatra,2001].       
 
 
 
 
 
 
  21
References
1.  Agnihotri Satish, declining infant and child mortality in India, How do girl
children fare? Economic and Political Weekly, January 20, 2001
2.  Bairagi Radheshyam; Effects of sex preference on contraceptive use,
abortion and fertility in Matlab, Bangladesh, International Family Planning
Perspectives, 2001, 27(3); 137-143
3.  Belanger Daniele [2002], Son preference in rural village in north Vietnam,
Studies in Family Planning 2002; 33[4]; 321-334
4.  Clark, Shelly; 2000; Son Preference and Sex Composition of Children:
Evidence from India; Demography 37(1): 95-108
5.  Census of India 2001: Provisional Population Totals, Series 1; Registrar
General and Census Commissioner, India  
6.  Chen LC, Huq E, D’Souza: 1998, Sex bias in the family allocation of food and
health care in rural Bangladesh; Population and Development Review 7, No.
1, pp 55-70
7.  Croll Elisabeth J, 2002, Fertility decline, family size and female
discrimination; A study of reproductive management in east and south Asia,
Asia-Pacific Population Journal, Vol. 17, No. 2, PP 11-37 
8.  Das Gupta M; 1987; Selective Discrimination against female children in rural
Punjab, India; Population and Development Review (13), No. 1 P 77 – 100  
9.  Dreze, J, Sen, A, [1996]; India: Economic Development and Social
Opportunity, Oxford University Press, Delhi
10. Dutta Paramita: Factors associated with sex ratio at birth: a case study
based on six selected states in India: IIPS; 2001
11. Ganatra Bela, Hirve Siddhi, Rao VN, Sex selective abortion: Evidence from a
community based study in western India, Asia-Pacific Population Journal,
2001, Vol.16, No. 2, pp 109- 123. 
12. Miller DB 1989; Changing patterns of Juvenile sex ratios in rural India, 1961
to 1971; Economic and Political Weekly; June 3. 1989; P 1229 – 1236
13. Mutharayappa R, Choe MK, Arnold F and Roy TK ;1997, Effect of son
preference on fertility in India; NFHS subject report No. 3  
  22
14. National Family Health Survey [NFHS –2], India 2000; IIPS and ORC Macro:
International Institute for Population Sciences. 
15. Raju S, Premi MK; Decline in sex ratio: Alternative explanation re-examined. Economic and Political weekly, 1992; 27; 911-12. 
16. Retherford D R, Roy TK [2003]; Factors affecting sex selective abortions in
India; National Family health Survey; Bulletin; No. 17
17. Retherford D R, Roy TK [2003]; Factors affecting sex selective abortions in
India;National Family health Survey, Subject Reports Number 21
18. Remez L [2001], Prevention of unwanted births in India would result in
replacement fertility; Digests; International Family Planning Perspectives;
27; no. 2; pp 104-105 
19. Sabu M george,  Ranbir S Dahiya: Female foeticide in Rural Haryana:
Economic and Political Weekly 33(32): August 8-14, 1998: 2191-2198
20. Sudha S. Irudaya Rajan: Intensifying Masculinity of Sex ratio in India: New
Evidence 1981-1991: Centre for development studies, Thiruvananthapuram;
1998
21.  Visaria Leela, 2002, Deficit of women in India: Magnitude, trends, regional
variations and determinants; The National Medical Journal of India; vol 15,
supplement 1; pp 19-25
22. Wen Xingyan [1992], ‘The effect of sex preference on subsequent fertility in
two provinces of China; Asia-Pacific Population Journal; Vol. 7, No. 4, PP
25-40. 
23.  Zhao Zhirong [2000]; Controlling theskewed sec ratio at birth in China: An
implementation perspective;
http://www.wiapp.org/spapers/zhaozr01.html, Website in Institutional
Analysis and Public Policy

Advertisements

Author: savedaughters19

This is a coverage of my struggles to save my daughters.I am thank full to my parents not only for Not killing me ,but also helping me save my daughters... My dream- A big shelter house for women who want to give birth to their daughters and raise them up with dignity and self respect , but have to fight their own families to do so. Will have medical facilities and facilities for legal aid. will have training centers for vocational courses so that they can stand up on their own two feet and stop the dependency on their husbands for finances, A child care center run and managed by the inmates, A kitchen and a vegetable farm run and managed by the inmates. At present only a dream.... But with grace of God will become a reality. God will show the way and means to achieve the dream.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s