Sex ratio in India
2006; Elsevier BV; Volume: 367; Issue: 9524 Linguagem: Inglês
10.1016/s0140-6736(06)68758-8
ISSN1474-547X
Autores Tópico(s)Migration, Health and Trauma
ResumoI am surprised to see a paper as flawed as that of Prabhat Jha and colleagues in The Lancet (Jan 21, p 211).1Jha P Kumar R Vasa P Dhingra N Thiruchelvan D Moineddin R Low male-to-female sex ratio of children born in India: national survey of 1·1 million households.Lancet. 2006; 367: 211-218Summary Full Text Full Text PDF PubMed Scopus (295) Google Scholar Their claim that 10 million female feticides have been committed in India is highly unlikely because the quality of the data is suspect and the interpretation incorrect. I have spent 20 years working on issues such as girl neglect, female infanticide, and sex selection.2George SM Dahiya RS Female feticide in rural Haryana.Econ Political Wkly. 1998; 33: 2191-2198Google Scholar, 3George SM The Government response to female infanticide in Tamil Nadu: from recognition back to denial?.Reprod Health Matters. 1997; 10: 124-132Summary Full Text PDF Google Scholar I have been involved with research, community intervention, public advocacy, litigation in the Supreme Court, and have lobbied successfully for legislation to improve girls' rights. If there was evidence that 10 million girls have been eliminated before birth, it would fuel public outrage against mass medical crimes. The study's findings are implausible. The birth order distribution of sex ratios at birth is contrary to the published research. No large study, in countries where fetal sexing has been extensive, such as China, South Korea, Taiwan, and Hong Kong, has reported similar figures.4Park CB Cho NH Consequences of son preference in a low fertility society: imbalance of the sex ratio at birth in Korea.Popul Dev Rev. 1995; 21: 59-84Crossref Google Scholar Sex ratio at birth (ie, boys per 100 girls) increases with increasing birth order or from the second birth onwards. The first-order sex ratio at birth is close to normal in published studies except Jha and colleagues'. In India, both National Family Health Surveys (NFHS-1 and NFHS-2) have reported nearly normal sex ratios at birth for the first born. Furthermore, data in Jha and colleagues' table 1 also suggest that 200 000 male feticides should have taken place in India annually (to those who had previous male children). I have travelled to many parts of the country over the past 12 years in search of sex-selection practices and nowhere was selective male feticide reported even anecdotally. The only plausible reason for Jha and colleagues' unusual birth order distribution is systematic undercounting of liveborn girls. Observers of the Sample Registration System data do recognise that it has a long history of undercounting girls up to the 1990s. Jha and colleagues' study seems to suffer from the same bias. The number of ultrasound machines manufactured in India according to government data increased 33 times between 1988 and 2003.5Murthy L, Bal V, Sharma D et al: The business of sex selection: the ultrasonography boom. Presented at the Nehru Memorial Museum & Library Workshop on declining child sex ratio, Jan 23–24, 2006, New Delhi, India.Google Scholar However, it was only after the economic liberalisation of the early 1990s that the annual production increased strikingly from a few hundreds to thousands, starting from 1994 (1314 during 1988–91, 5651 during 1992–95, 11 290 during 1996–99, and 19 581 during 2000–03). Multinationals such as General Electric started to manufacture in India after this policy change. Therefore, given the relatively recent proliferation of ultrasound machines, Jha and colleagues' inference from half a million fetuses from the 1997 cohort to 10 million over two decades is absurd! Jha and colleagues do not cite work on child sex ratios from any serious Indian demographers (Mari Bhat, Monica Dasgupta, Irudayarajan, etc), and not a single reference from the respected Economic and Political Weekly has been considered. For the past 25 years, a vigorous debate on sex selection took place in this journal and if the numbers during 1988–97 had been as bad as implied by Jha and colleagues, it would have been documented and published. We are happy that Jha and colleagues have highlighted female feticide, but their sensational claim will undermine the recently activated Indian campaign against sex selection. The unethical medical professionals who still carry out this practice will be happy to divert the issue away from stopping the genocide to an intellectual discussion of numbers. I declare that I have no conflict of interest. Department of ErrorJha P, Kumar R, Vasa P, Dhingra N, Thiruchelvam D, Moineddin R. Low male-to-female sex ratio of children born in India: national survey of 1·1 million households. Lancet 2006; 367: 211–18—The title of this Article (Jan 21) should be: Low female-to-male sex ratio of children born in India: national survey of 1·1 million households. Full-Text PDF Sex ratio in India – Authors' replyOur estimate of 0·5 million selective abortions is for 1997, and the estimate of 10 million refers to 1985–2005, not to the two decades before 1997. Overall sex ratios (female births per 1000 male births) have dropped further since 1997 according to the Sample Registration System (SRS). Sabu George highlights a striking increase in ultrasound machines since 1997. Thus, it is reasonable to use the 1997 annual estimate as an annual average for 1985–2005. Full-Text PDF
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