Gender bias caused ‘excess’ deaths of girls under 5: Lancet study

Problem most pronounced in Uttar Pradesh, Bihar, Rajasthan and Madhya Pradesh

There have been 2,39,000 “excess deaths” per year of girls under the age of five in India, and 29 out of 35 States contributed to this mortality, according to a study in the online, open access, peer-reviewed journal Lancet Global Health . That works out to about 2.4 million deaths in a decade, and the additional deaths were found in 90% of districts in the country.

“Around 22% of the overall mortality burden of under-five females is therefore due to gender bias,” said lead author Nandita Saikia, at the International Institute for Applied Systems Analysis, Austria, in a statement.

Excess mortality is the difference between observed and expected mortality rates in both genders.

46 countries

To arrive at this number for India, the researchers calculated the difference between these two numbers in 46 countries that consistently did not have a problem with gender discrimination. They then used that to define an equation and arrive at numbers for India.

Most studies of India’s skewed sex ratios have focussed on pre-natal mortality.

The National Family Health Survey in 2017 said that India’s sex ratio at birth has increased to 919 in 2015-16 from 914 in 2004-05. This study, however, focuses on mortality after birth and says that the problem is most pronounced in northern India, where the four largest States in the region, Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh, accounted for two thirds of the total excess deaths of females under five. In Uttar Pradesh, excess female mortality was calculated at 30.5. In Bihar, the rate was 28.5, in Rajasthan it was 25.4, and in Madhya Pradesh, it was 22.1.

Consistent data

The average level of excess mortality in girls aged 0-4 in the study period of 2000-2005 was 18.5 per 1,000 live births, compared to the expected mortality of girl children aged under five in areas of the world without known gender discrimination. This study period was chosen, said Dr. Saikia, because it had the most consistent district-level data.

The worst affected areas were all rural, agricultural areas with lower levels of education, high population densities, low socio-economic development and high levels of fertility.

Many deaths of females under five are partly due to unwanted child bearing and subsequent neglect. “The sustained fertility decline currently observed in north India is likely to lead to a reduction in postnatal discrimination. Unless son preference diminishes, lower fertility, however, might bring about a rise in gender-biased sex selection as was observed 20 years ago in western India,” Dr. Saikia added.