Demography and health researchers alike reject the reports that the sex ratio among children in Kerala is alarming. Several media houses reported the ‘reverse trend’ in sex ratio in the state. It even triggered debates in the state Assembly. Congress leader P Chidambaram wrote an article criticising governments for their ‘inaction’.
All these were caused by the Union Health Ministry’s fifth edition of the National Family Health Survey (NFHS). The results were released on November 24. NFHS is a ‘large-scale, multi-round survey conducted in a representative sample of households throughout India’ to ‘provide essential data on health and family welfare.’
As per NFHS-5, the sex ratio at birth for children born in the last five years in Kerala drastically came down compared to NFHS-4 (2015-16) data. In the latter, the ratio was 1,047 girls to 1,000 boys. It has gone down to 951 girls to 1,000 boys in the NFHS-5. This is despite an increase in the overall sex ratio to 1,121 females for 1,000 males (1049 in 2015-16).
Thrissur recorded the lowest number- 763. Idukki, Kannur, Kottayam and Malappuram are below 900. Meanwhile, Kollam saw a record increase compared to the previous survey. This is the average of the sex ratios at birth in the last five years. It does not include the children who died in these years.
Kerala is known for its high sex ratio of the population compared to the rest of India. Its numbers are equivalent to the developed nations. The conundrum of high social development indicators with low GDP has been studied by researchers aplenty. So it is natural to ring the alarm bells when someone sees a number like 951 girls for 1,000 boys.
However, researchers say that the NFHS-5 data does not show any alarming trend. Speaking to mathrubhumi.com, Dr KS James, Director of International Institute for Population Sciences, said: ‘While looking into the data of sex ratio at birth, we always check if it is within a limit. Not whether it is increasing or decreasing. The numbers in Kerala are within the preferred range.’ IIPS is the nodal agency that conducts NFHS.
‘We cannot compare the numbers with the previous survey as it is a sample survey,’ said Prof Anil Chandran S, Assistant Professor and Head of the Department of Demography, Kerala University. ‘In a normal condition, 105 boys are born to 100 girls. Hence 951 girls to 1,000 boys at birth is a normal rate. In other parts of India, it is 920 or even below that,’ he added. Dr Sankara Sarma P, head of Achutha Menon Centre for Health Science Studies of Sree Chitra Tirunal Institute of Medical Sciences and Technology, Thiruvananthapuram, reiterated the opinion of Prof Anil. ‘This is a global trend. Due to biological reasons, more boys are born everywhere in the world,’ he said.
Some researchers attribute this as an impact of evolution. However, there is no concrete evidence to prove it and the scientists are not on the same page. Dr Jayasree AK, Associate Professor and Head of the Department of Community Medicine at the Academy of Medical Sciences, Pariyaram, added that boys are more prone to death after birth. Child Mortality Rate (death before reaching the fifth birthday) is higher among boys (they are at higher risk of birth complications, and infectious disease, popularly called ‘the male disadvantage’) across the world.
Data from around the globe show that more males die at all stages of life than females. This is why the overall sex ratio of many countries show more women than men. Dr S Irudaya Rajan, Founder Chairman of the International Institute of Migration and Development, said that India bucked this trend. ‘In India, more girls die than boys. This is due to gender biases,’ he said. Besides India, only in Tonga (Oceania region), more girls die than boys in the world.
However, NFHS-5, for the first time in India, recorded more women in the country than men. It said 1,020 women are there in India to 1,000 men. It was 991 in the last survey. Interestingly, the sex ratio is better in rural India than urban, shows survey data. Dr Rajan also said that the sample size of the surveys has to be increased, especially in Kerala as the birth rate in the state is very low. The NFHS-5 was conducted from 20 July 2019 to 2 December 2019 in Kerala by Society for Promotion of Youth and Masses (SPYM). ‘Information was gathered from 12,330 households, 10,969 women, and 1,473 men.’ Dr James said the sample size is good enough.
Dr B Ekbal, public health activist and Kerala State Planning Board member, said that there is no evidence whatsoever to claim sex-selective abortions are taking place in Kerala. ‘Interestingly, more girls are preferred by prospective adopters in Kerala. It clearly shows there is no gender bias at birth.’ Ekbal said that the state witnesses other types of biases. ‘A couple with two girls may try for another kid hoping it would be a boy. While, if the same couple has two boys, they may not try for a girl,’ he said. However, this too is very rare as the fertility rate of Kerala is 1.8 (a slight improvement from 1.6 last time). It means most of the families do not have more than two children in Kerala.
Dr Mohanachandran Nair, a former director of Population Research Centre, University of Kerala, said that since the NFHS is a sample survey, it is better to avoid referring the survey for the sex ratio of the population. ‘We have a census which gives the data of the entire population,’ he said. However, Dr James reminded us that the sex ratio at birth cannot be obtained from Census.
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