GS-2 – Government policies and interventions for development in various sectors and issues arising out of their design and implementation.
GS-2 – Issues relating to development and management of Social Sector/Services relating to Health and Human Resources.
Sex Ratio
In News: The latest National Family and Health Survey (NFHS-5), facts sheets of which were released recently, has indicated positive growth in the sex ratio of India. The National Family Health Surveys (NFHS) is brought out by the International Institute for Population Sciences (IIPS), and provide some of the most critical information on demographic, health, nutrition and socio-economic status of people in the country.
The Numbers
The numbers indicate that India can no longer be called a country of “missing women”, a phrase first used by Nobel Prize winning economist Amartya Sen in a 1990 essay in the New York Review of Books.
As seen from the NHFS-5 data, for the first time since Independence, the number of women in India have surpassed the number of men, which is unprecedented.
India now has 1,020 women for every 1000 men.
During NFHS-3, conducted in 2005-06, the sex ratio was 1000:1000 and in NFHS-4 done in 2015-16 it declined to 991:1000.
The NFHS-5 figures have also shown that the sex ratio at birth improved from 919 in 2015-16 to 929 in 2019-20.
78.6 percent of women have their own bank account compared to 53 percent five years ago.
The percentage of women who said they had a say in making decisions relating to healthcare and major purchases for the family increased from 73.8 percent in 2015-16 to 92 percent in 2020-21.
Contraceptives: Use of contraceptives improved from 53.5% to 66.7%
Sterilisation: An increase in female sterilisation. Continued stagnation in male sterilisation uptake. It shows that the onus of family planning still lies with women.
NFHS-5 reveals that institutional births have increased substantially from 79 percent to 89 percent nationwide. Institutional births mean that pregnant women and newborns get proper medical attention and this is visible in improving maternal and child health in the country. In addition, more women are opting for C-section deliveries.
NFHS-5 shows that the percentage of married women in the 18-49-year age group that have suffered spousal violence has more than doubled from 20.6 percent in 2014-15 to 44.5 percent per NFHS-5. Distressingly, 30 percent of women surveyed said their husband was justified in beating them.
India’s low SRB can be attributed to the deep prejudice that girls face. Unlike girls, who are seen as an economic burden on parents because of the practice of dowry, sons are preferred. Families celebrate the birth of a boy, a girl child’s arrival is reason for mourning. If in earlier decades, people chose to kill new-born girls, the availability of technology to identify the sex of the fetus has resulted in women committing sex selective abortions to prevent a girl from being born. Pre-natal sex screening is banned in the country. Yet female feticide continues as reflected in India’s low SRB.
Criticism for the Report
Demography experts are saying it is not the time to rejoice yet as the figures do not give an accurate picture of India’s sex ratio. The overestimation of sex ratio (number of women per 1,000 men) in NFHS-5 was due to two major reasons.
First, the sex ratio mentioned in the factsheet was based on de facto enumeration, meaning the number of males and females who were present in the household on the last night of the survey.
The second reason was a significant improvement in the sex ratio in India during the last 30 years.
There are now 1,037 women per 1,000 men in India’s rural areas according to NFHS-5, which is a new record. But according to experts, the possibility of migrant rural men and women being away from their homes on the last night of the de facto enumeration cannot be ruled out.
The Way Forward
While the statistics quoted above are a watershed moment in India’s socio-economic and demographic transformation story, other findings of NFHS also convey a similar message. Socio-economic challenges facing India, going forward, will need to be dealt with more nuance and some of the stereotypes and political beliefs (such as the political obsession with population control laws) which dominate the public discourse will need to be shelved.
The fact that we are now an aging population suggests that our approach to women’s health needs a more holistic life cycle view rather than one that prioritises reproductive health only
More women have completed ten years of schooling in 2019-20 than previously, coincides with a drop in female labour force participation points to significant structural challenges in India’s labour market. These need to be urgently addressed if India is to make progress
The findings on fertility decline are good news for maternal and child health and nutrition outcomes. However, the high fertility-high undernutrition states of Uttar Pradesh, Bihar, and Jharkhand still need to see more progress on fertility reductions – improvements in those high burden states are essential to move the all-India average for all outcomes
NOTE:
What is National Health Family Survey (NHFS)?
NFHS is a large-scale nationwide survey of representative households. The data is collected over multiple rounds.
Implementation Agencies: The MoHFW has designated International Institute for Population Sciences in Mumbai as the nodal agency and the survey is a collaborative effort of IIPS; ORC Macro, Maryland (US); and the East-West Center, Hawaii (US).
Funding: The survey is funded by the United States Agency for International Development (USAID) with supplementary support from UNICEF.
Previous Surveys: The first four NHFS were conducted in 1992-93, 1998-99, 2005-06 and 2015-16, respectively.
What data does it collect?
The initial factsheet for NFHS-5 provides state-wise data on 131 parameters.
These parameters include questions such as how many households get drinking water, electricity and improved sanitation; what is sex ratio at birth, what are infant and child mortality metrics, what is the status of maternal and child health, how many have high blood sugar or high blood pressure etc.
Each round of NFHS has also expanded the scope of inquiry.
In the fifth iteration, for instance, there are new questions on preschool education, disability, access to a toilet facility, death registration, bathing practices during menstruation, and methods and reasons for abortion.
Why are NFHS results important?
Evidence Based Policy making: The NFHS database is possibly the most important one because it not only feeds into the research needs and informs advocacy but also is central to both central and state-level policymaking.
International Comparison: NFHS survey results also provide internationally comparable results. That’s because the questions and the methodology is internationally valid. Thus, it places the results of say child malnutrition trends in Bihar in the global context.
Can you answer the following question?
NFHS-5 survey results show that population growth has stabilized but misogyny remains strong. Discuss.
