Sex differential trends in Infant Mortality
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[Leena Mehendale]
It is a biologically recognised fact in all scientific communities that male child is more vulnerable to illnesses than female child. Hence out of any given population of 1000, more male children would die than the female children. Nature has her own methods of checks and balances. She allows more male children to be born to begin with.
Thus at birth there should always be more boys than girls. Then more male children would die so that finally the FMR would come to a favourable figure of around 1010. This is called favourable becasue it has been observed sociologically that any society having an FMR of 1010 or more is less crime prone, more peaceful and more advancing than the others.
While we celebrate our reaching the One Billion Mark there is already an alarm that our FMR is already as low as 927 and is declining further which is a sure sign of great social malice. If we want to think of policy interventions, it helps to know where the desease is more acute, and how much more than the rest.
An analytical report released by the Registrar General and Census Commissioner of india, which studies death rates from Sample Registration System (SRS) tell us about the undercurrents in our existing demographic pattern.
The overall death rate in India has decreased steadily which means that,now less number of people are dying per year, only 9.8 out of thousand people in 1993. This death pattern, however, is not uniform for people of all ages. Infants, that is children below one year age are most vulnerable and so also older people above the age of 70. Highest vitality is among the children in the agegroup of 10 to 14. A typical study of 1984 pattern showed that the death rate was 110.4 per thousand for children below 1 year, it came down to 15.9 for 1-4 age group and further down to 1.6 for 10-14 age group. Then it slowly moved upto only 4.1 for 35-39 age group. After the age of forty, the vulnerability was again higher, it was 8.0 for 45-49 and 44.1 for 65-59 age group. Death rate for 70+age group was 95.9.
This demonstrates the natural phenomenon that infants are much more prone to die than any other age group, while children in the age group 10-14 are least prone.
It is here that male-female death rate differential study becomes important. By nature’s design the male infant mortality should be more than the female infant mortality. However, this is not true of many Indian states. It is not very difficult to guess that the reason is rampant female infanticide. But the trends reveal more than that.
The analysis of the Male Female death rate differential shows that the culprits are Haryana, Punjab, Rajasthan, UP, Bihar, Tamil Nadu and very surprisingly Himachal Pradesh and Gujarat. Here is a very significant aspect. If we are trying to achieve better justice for the girl child, then we have to talk not only of BIMARU states, but also the so called affluent states like Punjab, Haryana, Gujarat and Tamil Nadu.
For infants, the All India death rate decreased from 113 to 84 during 1983-93, and the male female differential remained nerarly 2 per thousand during the decade. In 1983, while 114.84 male infants dired per thousand the female infants dying were 112.94. For 1993 the figures were 85.84 and respectively . In that Kerala has far superior record than any other state, both in having low infant mortality rate and the male-female mortality differential rate. Barring Kerala, the three states of Karnataka, Maharashtra and Assam top the list of being very fair to the infant girls. The male female infant death differential in these states was above 9 throught the 1983-93 decade. Most cruel was Haryana whose differential was negative and remained around MINUS 10 throughout the decade of report. When only 73.14 infant boys were dying per 1000, as high as 83.39 infant girls were dying.
If we take Karnataka, Maharashtra and Assam as the ideal situation with 10 more infant girls surviving than the infant boys then we find that Haryana record is just the reverse, where ten more infant girls die. Comparatively Punjab picture is much less bleak; only about 3 more infant girls dying than the boys throughout 1983-93. Himachal Pradesh shows a sudden alarm. It started with 3 more infant girls surviving in 1983, and went to as bad as 10 more girls dying upto 1991. The trend thereafter seems reversing again in favour of girl infants, with only 4 more girls dying than the boys. But it still remains alarming .
Uttar Pradesh comes next to Haryana where the study shows a steady trend of nearly 8 more infant girls dying while the Bihar report throws a surprise. Earlier 4 more infant girls were dying but the differential came down close to zero in 1993. Knowing the otherwise worsening pictures in Bihar, someone may undertake a deeper study there.
In three states, MP, Orissa and Andhra Pradesh which have a large tribal population, the trend is going against the girl infants. Andhra had a high record of favourable atmosphere to girl infants. Their death rate was less by 14.87 compared to male infant death rate in 1984. This differential has come down to 7.24 in 1993. Madhya Pradesh having the MF differential of 11.91 in 1983, has MF differential of only 2 in 1993. Orissa differential fluctuates between 9 and 4 but fortunately does not show a steadily declining trend. What could this mean? These states have a high tribal population who traditionally do not have a bias against girl child. Does the alarming trend of higher female infant mortality mean that the rate have become far worse in non-tribals or does it mean that the not has started setting in tribal culture also. One has to carefully watch and analyse the data for tribals.
During the decade of 1983-93, the Tamil Nadu differential remains between - 2 and + 2 while Rajasthan remains within 0 to - 4. West Bengal has remained within 5 to 10.
If we are worrying about a “faster than the normal” elimination of female infants, we have to look more closely in the social attitudes of Haryana, followed by Uttar Pradesh.
Next to them more specific studies need to be undertaken to understand why Himachal Pradesh recorded an unfavourable trend of -10 differential, and is continuing to record -4 and why Gujarat recorded -9 differential before coming to the present +1 differential. What social and attitudinal changes have led to this reversal of trend in favour of girl infants in Gujarat and Himachal Pradesh. Even Bihar shows a favourable trend. How has the social psyche changed in just a decade?
Next worrisome reports are from Tamil Nadu, Punjab and Rajasthan who all remain in the category of steady unfavourable conditions for girl infants.
Orissa, West Bengal, Kerala show a steadily favourable trend. Maharashtra and Assam show an even better trend and Karnataka holds the best record for not eliminating the infant girls.
In passing, it is useful to look at the overall infant mortality also. By 1993, the all India IMR has come down to 84. States showing higher IMRs are Madhya Pradesh (130), Orissa (119), Uttar Pradesh (105), Rajasthan (100), and Assam (95). All other states including Bihar have smaller IMR than All India figures. Maharashtra and Tamilnadu IMRs are around 55 while Kerala has the best record of only 17 IMRs.
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