Hindustan Times (Patiala)

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%.

- Sanchita Sharma sanchita.sharma@htlive.com

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.

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 ₹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.

In a family that already has a daughter, the chances of the second child being a girl drops by 38%. 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 firstand 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 birthdefec­t 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.

Smaller percentage of girls is significan­t as SNCUs are referral units, with most babies being treated either being referred... from other hospitals in the vicinity DR SATISH MARAVI, Paediatric­ian India newborn action plan 2014 has a goal of attaining singledigi­t neonatal mortality and stillbirth rates by 2030 with efforts like starting birthdefec­t surveillan­ce in medical colleges HEALTH AND WELFARE MINISTRY OFFICIAL

 ?? SANCHITA SHARMA/HT ?? 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 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.

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