GENDER BIAS PREMA RAMACHANDRAN Director, Nutrition Foundation of India.

GENDER BIAS

PREMA RAMACHANDRAN

Director, Nutrition Foundation of India

IS THERE ANY EVIDENCE OF GENDER BIAS FROM

People’s Perception

Demographic Indices

Health Care & Indices Nutrition Indices

Are there any policies& programmes to reduce consequences of gender bias

Advocacy/legislation

Programme interventions in

Maternal and child health

Nutrition

0

10

20

30

40

50

60

70

2 Sons 1 Son No Son

2 Children

Using any modern method

SterilisationSource :NFHS-2

0

10

20

30

40

50

60

70

80

3 Sons 2 Sons 1 Son No Son

3 Children

Using any modern method

SterilisationSource NFHS-2

CONTRACEPTIVE USE – IS THERE A SON PREFERENCE ?

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

Utta

r Pr.

Goa

Del

hi

Biha

r

Sikk

im

Punj

ab

Raj

asth

an

Oris

sa

ALL

IND

IA

Wes

t Ben

gal

Har

yana

Guj

arat

Kera

la

Mah

aras

htra

Tam

il Nad

u

Karn

atak

a

Andh

ra P

r.

Perc

ent

2 Sons No SonSource: Dept. of FW

SON PREFERENCE -INTERSTATE DIFFERENCES

0.0

20.0

40.0

60.0

80.0

100.0

Perce

nt

3 Sons No SonSource: Dept. of FW

INTERSTATE DIFFERENCES - SON PREFERENCE

GENDER BIAS - IMPACT ON SEX RATIO & 0-6 SEX RATIO

Time trends

Interstate& inter district variations

Interventions to arrest & reverse the trend

Time Trends in Sex Ratio in India

900

910

920

930

940

950

960

970

980

19

01

19

11

19

21

19

31

19

41

19

51

19

61

19

71

19

81

19

91

20

01

Fem

ales

per

10

00

Mal

es

Source: RGI

Census Year

The changes till 1971 are mainly due to higher longevity among men; in 2001 women’s longevity is slightly greater than men’s

RURAL AND URBAN SEX RATIO: INDIA

820

850

880

910

940

970

10001

90

1

19

11

19

21

19

31

19

41

19

51

19

61

19

71

19

81

19

91

20

01

CENSUS DECADES

FE

MA

LE

S P

ER

10

00

MA

LE

S

Rural Urban

Urban sex ratio is lower partly due to urban migration of men

Sex Ratio Less than 900Number of Districts:

143or 31.6% districts

Total No. of Districts (excl J & K) in 1991:

452

District Map indicating sex ratio (census 2001)

700

750

800

850

900

950

1000

IND

IA

Punja

b

Hary

ana

Guja

rat

Raja

sth

an

UP

Mahara

shtr

a

MP

Bih

ar

Tam

il N

adu

Karn

ata

ka

Orissa

Kera

la

WB

AP

Assam

1991 2001

SR at Birth (International Average) SR at Birth (National Average)

Source: Registrar Genal India

Fem

ale

s/ 1000 M

ale

s Sex ratio 0-6 Years (Females per 1000 Males)

20

01

Cen

sus

Data

Child Sex Ratio in the Age Group 0 – 6 (1981 to 2001)

Census Year

Total Rural Urban

1981 962 963 931

1991 945 948 935

2001 927 934 903

Decline in child sex ratio in age group 0-6 from 945 in 1991 to 927 in 2001 has activated the socio-political, legal and administrative setup of the country.

Child Sex Ratio 2001(District level)

HIMACHAL PRADESHCHILD SEX RATIO IN AGE GROUP 0-6

(DISTRICTS)1991 2001

Lahul & Spiti

Chamba

Kangra

Kullu

Mandi KinnaurUna

Hamirpur

Shimla

Bilaspur

Solan

Sirmaur

HIMACHAL PRADESHCHILD SEX RATIO IN AGE GROUP 0-6

1991(DISTRICTS)

951

958

965

939

966

968

973

923

938

958

951

923

Lahul & Spiti

Chamba

Kangra

Kullu

Mandi KinnaurUna

Hamirpur

Shimla

Bilaspur

Solan

Sirmaur

HIMACHAL PRADESHCHILD SEX RATIO IN AGE GROUP 0-6

2001(DISTRICTS)

986962

836

960

916839

864

930

884

900

940

CHILD SEX RATIO800 AND BELOW801 - 850851 - 900901 - 950951 AND ABOVEData not available

North West

South West

West

East

NorthNorth East

New Delhi

Central

854

845

886

858870

868

867

882

902

South

North West

South West

West

East

NorthNorth East

New Delhi

Central

CHILD SEX RATIO800 AND BELOW801 - 850851 - 900901 - 950951 AND ABOVE

913

904

912

913920

918

917

919

937Central

New Delhi

North EastNorth

East

West

South West

North West

South

DELHICHILD SEX RATIO IN AGE GROUP 0 - 6

(DISTRICT)1991 2001

Gurdaspur

Hoshiarpur

Amritsar

Kapurthala

Jalandhar

Rupnagar

K

Nawanshahr

Firozpur

Moga

Ludhiana

Fatehgarh Sahib

Faridkot

MuktsarPatiala

Bathinda

Mansa

Sangrur

P

887873

861

871

878

877

884

860

886

858

867865

879

900

874

873

PUNJAB CHILD SEX RATIO IN AGE GROUP 0-6 1991 (DISTRICT)

884

FEMALES PER 1000 MALES IN AGE GROUP 0-6800 AND BELOW801 - 850851 - 900901 - 950951 - 10001001 AND ABOVE

775

810

783

775

797

791

K

810

819

819 814

754

805

807 770779

779

784

P

SangrurFirozpur

Amritsar

Patiala

Moga Ludhiana

Bathinda

Gurdaspur

Hoshiarpur

Mansa

Muktsar

Jalandhar

Rupnagar

Faridkot

Kapurthala

Fatehgarh Sahib

Nawanshahr

PUNJABCHILD SEX RATIO IN AGE GROUP 0-6

2001 (PROVISIONAL)(DISTRICT)

20011991

PUNJ ABCHILD SEX RATIO IN AGE GROUP 0 - 6

(DISTRICT)

Panchkula

Ambala Yamuna-nagar

Kurukshetra

KaithalKarnal

Sirsa

Jind

Fatehabad

HisarPanipat

Sonipat

Rohtak

Bhiwani

Jhajjar

GurgaonFarida-

bad

RewariMahen-dragarh

Sirsa

Hisar

Bhiwani

Karnal

Gurgaon

Kaithal

Sonipat

Jhajjar

Fatehabad

Rohtak

RewariFarida-

bad

Ambala

Panipat

Kurukshetra

Mahen-dragarh

Yamuna-nagar

Panchkula

Jind

HaryanaChild sex ratio

(District)

1991 2001

CHILD SEX RATIO800 AND BELOW801 - 850851 - 900901 - 950951 - 10001001 AND ABOVE

CHILD SEX RATIO800 AND BELOW801 - 850851 - 900901 - 950951 - 10001001 AND ABOVEDATA NOT AVAILABLE

Child Sex Ratio 2001Gujarat by Tahsils

CHILD SEX RATIO800 AND BELOW801 - 850851 - 900901 - 950951 - 10001001 AND ABOVE

Child Sex Ratio 2001

Tamil Nadu by Tahsils

Sex ratio at birth

98

100

102

104

106

108

110

112

114

116

Sex

ratio

(1981-90)

SRS Estimates-Registrar General, India

Figure 4

INDIASEX RATIO AT BIRTH

1982

19991991

NO. OF MALES PER 100 FEMALES105 AND BELOW106 - 110111 - 115116 AND ABOVE

SOURCE:SAMPLE RAGISTRATION SYSTEM

INDIASEX RATIO AT BIRTH

1991

NO. OF MALES PER 100 FEMALES105 AND BELOW105 - 110110 - 115115 - 120120 AND ABOVE

Source: Census of India

Reported sex ratio at birth – Punjab District level 2000

5060708090

100110120130140150

Am

rits

ar

Bat

hind

a

Far

idko

t

Fat

ehga

rh S

ahib

Fir

ozpu

r

Gur

dasp

ur

Hos

hirp

ur

Jala

ndha

r

Kap

urth

ala

Lud

hian

a

Man

sa

Mog

a

Muk

thas

ar

Naw

ansh

ahar

Pat

iala

Roo

pnag

ar

San

grur

Tot

al

Rural Urban

SOURCE: CIVIL REGISTRATION SYSTEM

HARYANASEX RATIO AT BIRTH

1998

NO. OF MALES PER 100 FEMALES110 AND BELOW111 - 115 (S.A.-113)116 - 120121 AND ABOVE

SOURCE : CIVIL REGISTRATION SYSTEM

PUNJ ABSEX RATIO AT BIRTH

1998

NO. OF MALES PER 100 FEMALES123 AND BELOW124 - 128 (S.A.-126)129 - 133134 AND ABOVE

GanganagarHanumangarh

BikanerChuru

J hunjhunun

J aisalmer

SikarAlwar

J aipurJ odhpurBharatpurNagaur

Dausa

Ajmer

DhaulpurKarauli

Barmer

Sawai MadhopurTonk

Pali

Rajsamand

Bhilwara

J alor

Ajmer

Bundi

KotaSirohi

Baran

ChittaurgarhUdaipur

Chittaurgarh

J halawar

Dungarpur

Banswara

GanganagarHanumangarh

BikanerChuru

J hunjhunun

J aisalmer

SikarAlwar

J aipurJ odhpurBharatpurNagaur

Dausa

Ajmer

DhaulpurKarauli

Barmer

Sawai MadhopurTonk

Pali

Rajsamand

BhilwaraJ alor

Ajmer

Bundi

KotaSirohi

Baran

ChittaurgarhUdaipur

Chittaurgarh

J halawar

Dungarpur

BanswaraNO. OF MALES PER 100 FEMALES

120 AND BELOW121 - 125126 - 130131 AND ABOVE

2000 2001

Sex Ratio at Birth : Rajasthan

Ongoing Interventions

PNDT Act

Female infanticide is a cognizable offence

Universal registration of all pregnant women

Antenatal care and Counseling

Advocacy for institutional delivery

Universal registration of births and deaths to identify problem areas for focussed intervention

Amniocentesis – No longer commonly used

Ultrasonography – Diagnosis of sex possible in II trimester by visualising the genitalia

Chorion Villous – Diagnosis in I trimester biopsy expensive, has risks

spontaneous abortionPre-conceptional – Developing technology sex selection individual’s choice

PNDT Act can therefore be an enabling tool for achieving social transformation. It can be used as an educational tool to build up awareness among the population. The deterrent punitive measures may reduce abuse of the technology by the clinics for sex selective abortion. However only when the population mind set is changed can manifestations of the gender bias, like female infanticide and sex selective abortions, be eliminated.

Sex Differentials in Infant & Child Mortality

0

20

40

60

80

100

120

NeonatalMortality

Postneonatalmortality

Infant Mortality Under FiveMortality

Male Female Source :NFHS 2

Gender based differentials in IMR & Under 5 MR

108.3146.2

45.5 54.4

110.1

163.9

42.4 54.1

0

50

100

150

200

IMR Under 5 MR

Male Quintiles Poorest Male Quintiles Richest

Female Quintiles Poorest Female Quintiles Richest

Gender Differentials in Immunization Coverage

020

4060

80100

Measles DPT 3 All None

Male Quintiles Poorest Male Quintiles RichestFemale Quintiles Poorest Female Quintiles Richest

Gender Differentials in Treatment of ARI (%)

7.9

68.7

4.7 6

56.8

3.7

77.191.7

0

20

40

60

80

100

Prevalance Seen Medically

Male Quintiles Poorest Male Quintiles RichestFemale Quintiles Poorest Female Quintiles Richest

Mean Energy Consumption- Children / Adolescents and Adults

Age Group

Males Females

Kcals RDI % RDI Kcals RDI % RDI

Pre-school 889 1357 65.5 897 1351 66.4

School Age 1464 1929 75.9 1409 1876 75.1

Adolescents 2065 2441 84.6 1670 1823 91.6

Adults 2226 2425 91.8 1923 1874 102.6

Source NNMB

Time Trends in Nutritional Status of 1-5 years Children

0

10

20

30

40

50

Normal Mild Moderate Severe

perc

ent

1975-79 1988-901996-97 2000-01

Source: NNMB Technical Report No.21

0

10

20

30

40

50

60

%< -2SD %<-3SD

GIRLS

BOYS

Gender difference in Undernutrition (DLHS2003)

Nutritional Status of Children by Income

0

5

10

15

20

25

30

35

Kerala TamilNadu

Punjab O rissa Uttar Pr. Gujarat

Per

cen

t

Low Medium HighSource: NFHS-II

Anaemia among Adolescents girls age 10-19 years in INDIA

MILD MODERATE

SEVERE NO ANAEMIA

43 Percent

28 Percent24 Percent

5 Percent

Anaemia among pregnant women in Major States

585554

46

404040393636

34343431

27262524

4 2345

13234

20121

8

1 13 3

MHHRPJCHHGJUPMPRJBHINDIAORAPHPJHUTKATNWBKE

Moderate

Severe

Percent

Nutritional status (BMI) of women- (NNMB 1999)

6.04.13.4

46.346.644.847.749.351.8

0.0

10.0

20.0

30.0

40.0

50.0

60.0

1975-79

1988-90

1996-97

1975-79

1988-90

1996-97

1975-79

1988-90

1996-97

< 18.5 18.5-25.0 >=25.0

%

EFFECT OF INCREASE IN LONGEVITY

women live longer more women than men in over 65 years mostly housewives; no assured income poor family support poor health care unneeded; not looked after.

Current Need: Better care for these women who cared for others as long as they could