Transcript Assessment o Sex Ratio (0

Assessment of Sex Ratio (0-6 yrs.)
&
Perceptions on PCPNDT
Akhilesh Bhargava
Director-SIHFW, Jaipur
Sex Ratio
Country
Sex Ratio
India
933
China
944
USA
1029
Indonesia
1004
Brazil
1025
Pakistan
938
Bangladesh
951
Japan
1041
Russian Fed.
1140
Source:World Pop. Prospects, mid year estimates, 1998
Sex Ratio: India
Year
No. of Females
1901
972
1911
964
1921
955
1931
1941
950
945
1951
1961
946
941
1971
930
1981
934
1991
2001
927
933
Sex Ratio: India (1901-2001)
1200
1000
800
No. of Females
600
400
200
0
1991 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001
Child Sex Ratio(0-6), 2001, Rajasthan
1000
980
960
940
920
900
880
Series1
860
840
820
800
780
1200
1000
951
933
954
916
909
800
600
Sex Ratio (Females per
1,000 Males)
400
200
0
1961
1971
1981
1991
2001
Sex Ratio (0-6 yrs. Females per 1000 males) Rajasthan
Sex Ratio (Females per 1000 males)
Total Population Child population in
the age group 0-6
Population aged 7
and above
1991
2001
1991
2001
1991
2001
India
927
933
945
927
923
935
Rajasthan
910
922
916
909
908
925
950
940
930
920
910
India
900
Rajasthan
890
880
1991
2001
Total Population
1991
2001
1991
2001
Child population in Population aged 7 and
the age group 0-6
above
Sex Ratio (Females per 1000 males)
Study on Sex Ratio assessment
& Awareness on PCPNDT Act
Conducted by:
SIHFW, Jaipur
• District Selection criteria: Sex Ratio(2001)
• Best & Worst
•
Sri Ganganagar (-42)
•
Jhunjhujunu
(-33)
•
Alwar
(-26)
•
•
Pali
(+31)
Jaisalmer (+16)
Sample size:
Village
SC
PHC
SC
CHC
PHC
PHC
District
PHC
CHC
PHC
PHC
Village
Village
Village
Respondents
Appropriate
Authority
• Secy.-FW
• Dir. -RCH
• Collector
• CMHO
• BMHO
Health
• PMO
• RCHO
• MO
• DPM
• BPM
• Health
workers
• ASHA/ AWW
• Private
Law & Order
• SP
• BDO
• DLR
• Advocates
Community
• NGOS
• PRIs
• Individuals
Respondents:2850
• Pvt. clinics
:
• District level :
• Health. Workers:
• ANM
:
• ASHA
:
• AWW
:
• LHV
:
• Med. Officers :
• Govt.
:
• Private :
• PRI
:
26
130
226
40
58
78
7
78
52
26
43
Observations
• District Authorities
• Collector
• SP
• RCHO
• CMO
• PMO
• BDO
• BPM
Areas with low sex Ratio
• 26.3% unaware
• 26 % said ratio has increased
• 47.4 % affirmed increase
Reasons: Increase/ Decrease
Increase
• Preference for Boys
Decrease
• Govt. schemes for Girls
:68%
:33%
Knowledge of penalty on misuse of
technique in PCPNDT Act
N=130
• Penalty
• For Providers
• For Users
:74 -88 %
:60-66 %
Misuse : Whose Responsibility
60 % of Dist. Authorities hold
• Medical Officers Pregnant woman +
• Motivator, and
• Husband / R elative
Responsible for Misuse of Technique
Reasons for using USG
Indications:
• Detection of Cong. Anomalies
• H/o Multiple Abortions
Contraindications:
• Sex Determination
:82%
:53%
:80%
Observations
Health Workers(N-183)
• LHV
• ANM
• ASHA
• AWW
• Understanding of referral Criteria:
• Bleeding
• Delay in Delivery
• Placenta expulsion delayed
65-87%
• Enquiry by Pregnant Woman on
• Sex determination centre
» ANM
:87%
» ASHA
:100%
» LHV
:67%
• Response to query
• Illegal
» ANM
» ASHA
» AWW
:86%
:87%
:87%
• Awareness on Declining Sex Ratio: 81%
• ANM
:90%
• ASHA
:75%
• PRI
:91%
• Responsibility
• Society :50%
• Woman :28%; 5-10% accuse Doctors
• Reasons:
• Extension
:96%
• Economic : 80%
• Religious :63%
Consequences of declining Sex Ratio:
Health workers feel
• Gender Imbalance
• Gender violence/ Crime
: 96%
: 82%
Reasons for female feticide
• Male
:85
• Dowry
:70%
• Misuse of technique:60-80%
Awareness of Act
• Act-80% Aware (AWW-65%)
• Appropriate Authority- reasonable understanding
• Undergoing sex determination is punishable
• ANM:95%
• ASHA
:93%
• AWW
:93%
• LHV
:100%
• PRI
:97%
A healthy Reflection of awareness
• Community perception
Distribution of Respondents by Sex
1133 1115
1200
1000
800
600
400
200
0
Male
228 222 225 224 229 220 224 226 227 223
Female
Age, sex and urban: Rural differential
60
50
51
49.7
49.2
44.7
40.8
40
36.5
18-25
30
24.5
24.3
22.5
24
24.3
26-32
33-40
20
11.9
10
3.7
2.1
1.5
0.6
0
Male
Female
Rural
Male
Female
Urban
41+
% of 0-6yr. Children in area
2850 Houses, M-2432, F-2276, SR-935
25
20
22.4
20.07
22.4
21.6
20.6
18.7
19
16.8
20
18.3
15
10
Male
Female
5
0
Preference of pregnancy outcome
• Households
• Pregnant women
• Preference:
•
:2850
:384 (14%)
%
16.7
•
36.2
•
47
USG & Pregnancy
• Undergone USG
• Who asked
• Where
• Why
• Abnormality
• Fetal position
• Age 35+
• Sex Determination
:20.1%
:Doctor (53.2%)
:Govt. facility (52 %)
:Private (20%)
:2.6 %
:15.6 %
: 6.5 %
: 26 %
Sex and age of Urban/ Rural respondents
60
50
51
49.7
49.2
44.7
40.8
40
36.5
18-25
30
24.5
24.3
22.5
24
24.3
26-32
33-40
20
11.9
10
3.7
2.1
1.5
0.6
0
Male
Female
Rural
Male
Female
Urban
41+
Societal perceptions and some healthy
observations-male respondents
50
45
40
35
30
25
20
15
10
5
0
Respondents
Alwar
Girl
Jaisalmer
Boy
Jhunjhunu
Both
Pali
Ganganagar
Societal perceptions and some healthy
observations-Female respondents
60
50
48.4
46.3
42
40
30
41
36
25.6
20
3635.8
31
28
27
32
28.1
27
15.4
10
0
Alwar
Jaisalmer
Jhunjhunu
girl
Boy
Both
Pali
Ganganagar
Why are preferred
1
89%
0.9
0.8
72.30%
0.7
58%
0.6
71.20%
68%
62.50%
70.90%
72.60%
58%
0.5
0.4
0.3
0.2
0.1
0
0
60.40%
Alwar
55.40% 0
Jaisalmer Jhunjhunu
Family extension
64.20%
Pali
68.40%
57.90%
Ganganagar
Economic reasons
Rituals
Desire to have Male child and efforts made
• Male
» Rural
» Urban
:10.65
:8.9% Jhunjhunu tops with 16. 2
and 12.5%
• Female
» Rural
:11%
» Urban
:9.4%
• Who do they Contact
» MaleUrban :Witchcraft/ Ledger man 58%
:RMP
23%
Rural
75 & 25
» Female- Witch craft: Urban: 100% Rural- 62%
RMP
: Rural 12.5% 62
Some more Observations
• Rural /Urban, Male/ Female :
• Aware of Sex Detection – Illegal (R -81,U90%)
• Aware of PCPNDT (R-50, U-60%)
• USG after 2/3 Girls
• Rural - Male/female
15%
• Urban – Male-20% /Female-18.07%
• Gender imbalance leads to Sexual crimes
• M/F, R/U
66-74%
• Society to understand : Female Feticide
illegal
• R/U, M/F
80%
• Boys and Girls are Equal 79-90%
Medical Officers on PCPNDT
•
•
•
•
Awareness
100%
Awareness of A/A
85%
Awareness on Penalty
84-90%
Awareness on Committee
• Government
60%
• Private
85%
• Reasons for decreasing Sex ratio
• Government
Society 69%
Doctors 3.8%
• Private
Society 54%
Doctors 3.8%
PCPNDT Act : Some Punctuations
• Availability of Act at the Center
• Government
33%
• Private
89%
• Display
• Government
57.7%
• Private
69.2%
• Filling of F Form
• Government –PW
7.7%
• Private –PW
92.3%
• Record (2 Yrs )
• Government
3.8%
• Private
34.5%