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Infant girls in India more likely to die

In India, female infants are more likely than male infants to die of easily treatable conditions, according to a recent report.

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In India, female infants are more likely than male infants to die of easily treatable conditions, according to a recent report.Social scientists and health professionals are expressing grave concern about the adverse sex ratio in India. According to the 2001 Indian census there are only 933 females per 1000 males. Ordinarily women outnumber men, possibly because the extra X chromosome they carry makes them less susceptible to infectious diseases and protects them against sex linked recessive disorders. In India, where there are more men than women, the role of sex discrimination is of wide concern; both antenatal sex determination and female feticide are incriminated.According to researchers at the St. Stephen's Hospital in Delhi, gender discrimination is a major health hazard. Between 1997 and 2001, the average death rate for girls under the age of 1 year was 72 per 1000, compared with 55 per 1000 among boys. In a study carried out by health workers in three Delhi slums, of 442 infant deaths reported by nurse midwives, twice as many girls died as a result of diarrhoea (63 versus 32). In contrast, the number of deaths due to lack of oxygen at birth, prematurity, infection and birth defects did not differ significantly between the sexes. Eleven male and 33 female deaths were categorised as unexplained. Among the 22 suspicious deaths that occurred in the first month of life, 19 were female.The researchers attribute the higher rate of death in infant girls to discrimination and neglect. The excess number of unexplained deaths and deaths due to treatable conditions such as diarrhoeal disease in girls might be because girls are regarded and treated less favourably in India. The bias against females is a "complex problem", the solution for which requires a multidimensional approach. While physicians and other healthcare professional can play a role in preventing infanticide, governments will ultimately have to step forward. East Asia, West Asia, Southern Asia, and North Africa can be described as "female deficit areas," where men significantly outnumber women. The government is a major stakeholder in health matters such as this, and it is more so in developing countries. The short-term interventions include 'strong girl-child centered educational programmes' focusing on nutrition and health care. Medium-term interventions would include empowerment, awareness and self-esteem enhancement programmes targeted at adolescent girls.

BMJ, July 2003; Vol. 327 (7407)

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