In India fewer girls than boys are born. In their study Prabhat Jha (St. Michael's Hospital, University of Toronto, Canada), Rajesh Kumar (Post Graduate Institute of Medical Education and Research, Chandigarh, India) and colleagues conclude that this may result from prenatal sex determination, followed by abortion of female fetuses.
The researchers looked at data on female fertility from an ongoing Indian national survey of 6 million people, living in 1.1 million households. The team analysed information from 133, 738 births. The investigators found that the sex of the previous child or children born affects the sex ratio of the current birth, with fewer females born as second or third children to families who are yet to have a boy. They also found that the deficit in the number of girls born as second children was more than twice as great in educated than illiterate mothers, but did not vary by religion.
Based on the natural sex ratio from other countries, the team estimated that around 13.6 to 13.8 million girls should have been born in 1997 in India. However, the actual number was 13.1 million--a deficit of 0.59 - 0.74 million female births.
Dr Jha states: "We conservatively estimate that prenatal sex determination and selective abortion accounts for 0.5 million missing girls yearly. If this practice has been common for most of the past two decades since access to ultrasound became widespread, then a figure of 10 million missing female births would not be unreasonable. He adds: "Women who have already had one or two female children are clearly at highest risk". (Quote by e-mail does not appear in published paper)
Professor Kumar comments: "Missing females is a growing problem. Our study emphasises the need for routine, reliable and long-term measurement of births and deaths. The ongoing Sample Registration System (covering over 1 million households) in India will help track missing female births and also gender differences in mortality." (Quote by e-mail does not appear in published paper)
In an accompanying Comment Shirish Sheth (Breach Candy Hospital, Mumbai, India) states: "In India, fetal sex determination and medical termination of pregnancy on the basis of fetal sex have been illegal since 1994…However, there is ample published evidence of rampant sex determination and female feticide."
Contact: Dr Prabhat Jha, Centre for Global Health Research, Department of Public Health Sciences, University of Toronto, Canada. Prabhat Jha (in India until Jan 27th at 91-981-006-1035; or in Toronto at 416-864-6042) prabhat.jha@utoronto.ca
Professor Rajesh Kumar, Professor and Head, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India. T) 91-931-613-9948) rajeshkum@sancharnet.in
Sharon Bala, St. Michael's Hospital, Public Relations Department T)+416-864-5047 balas@smh.toronto.on.ca
Comment: Professor Shirish Sheth, Breach Candy Hospital, Mumbai, India. T) 91-22-23084949 / 23098484.
Journal
The Lancet