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Sex Ratio

11th December, 2021

RSTV Perspective: Sex Ratio


  • 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.
  • 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.
  • These statistics are a significant moment in India’s socio-economic and demographic transformation story and other findings of NFHS also convey a similar message.


More on the news:

  • India’s overall sex ratio — women per thousand men — is now at a level seen in developed countries.
  • Sex ratio is better in rural areas compared to urban centres.
  • However, analysis also shows that 13 states and union territories still have more males than females.
  • It has been observed that in backward states and districts, the female-male ratio is better as medical facilities are yet to become easily available. In districts where these are available, sex determination goes up and sex ratio declines.
  • The union territory of Dadra and Nagar Haveli and Daman and Diu had the worst urban sex ratio: 775 women per 1,000 men. And Delhi had the worst rural sex ratio (859) among all states.
  • Sex ratio at birth and overall sex ratio differ by virtue of migration streams. It cannot be directly drawn from a declining sex ratio at birth that the overall sex ratio will also remain skewed moving forward.
  • Himachal Pradesh, Jammu and Kashmir, Chandigarh, Chhattisgarh and Ladakh witnessed a decline in sex ratios compared to 2015-16, while Lakshadweep saw it improve to 1,187 from 1,022.
  • The sex ratio at birth for the country was still 929 females per males — an improvement from 919 in 2015-16, but still lower than the natural standard of 952 female births per 1,000 male births.
  • Analysis indicates that 19 states/UTs had a lower sex ratio than the natural standard, and the sex ratio at birth was more skewed in urban areas than rural centres.


Summary of NFHS-5:

  • NFHS-5, the most comprehensive survey on socio-economic and health indicatorsin the country, shows some surprising demographic transitions.
  • The previous four rounds of the NFHS were conducted in 1992-93, 1998-99, 2005-06 and 2015-16.
  • Births in institutional facilities: Such as a hospital, improved by nearly eight percentage points.
  • Stunting and wasting:
  • Children who were either stunted or displayed signs of wasting only dropped by a maximum of three percentage points, shows a comparison of National Family Health Survey-5 (NFHS-5) and NFHS-4.
  • Slow and steady progress is seen on stunting, which seems to be coming from change happening in big States such as Uttar Pradesh and others.
  • Total fertility rate (TFR):
  • India has also officially hit a total fertility rate (TFR) of 2.0that indicates a decrease from the 2.2 in the NFHS-4.
  • The urban TFR is 1.6and the rural TFR is 2.1.
  • Only six States:Bihar, Meghalaya, Manipur, Jharkhand and Uttar Pradesh have a TFR above 2.0.
  • Use of contraceptives: An overall survey of the major differences between the NFHS-5 and NFHS-4 suggests that the use of contraceptives has improved from 53.5% to 66.7% in the latest NFHS-5 and institutional births increased from 78.9% to 88.6%
  • Vaccination of children: The proportion of children (12-23 months) who were fully vaccinated improved from 62%-76% and children under 6 months who were exclusively breastfed also showed a sharp improvement from 54.9 to 63.7%.
  • Nutrition concerns: Though the gains in childhood nutrition were minimal, women and men (15-49) who had a below normal body mass index (BMI) each dropped roughly four percentage points. Those overweight increased by around 4 percentage points.
  • Anaemia: India's battle with anaemia also appears to have faltered. The proportion of anaemic children (5-59 months) increased from 58% to 67%. Women aged 15-49 who were anaemic increased from 53% to 57% and men of the same age increased from 29% to 31% between both editions of the NFHS.
  • Obesity: 7% women and 47.7% men have a high-risk waist-to-hip ratio.
  • Most populous country in the world: India is still poised to be the most populous country in the world with the current projection by the United Nations population division forecasting that India's population will peak around 1.6 to 1.8 billion from 2040-2050.


What are the concerns associated with the NFHS-5 report?

  • Demography experts say the NFHS figures do not give an accurate picture of India’s sex ratio. They believe that the census figures were more reliable than NFHS. This is because:
  • Smaller sample sizes in district when compared to Census.
  • The survey derived sex ratio based on the number of males and females present in the household on the last night of the survey
  • NFHS counts only certain women, who belong to specific demographic categories
  • Phase 2 of NFHS 5 happened during the Covid Pandemic, so migrant workers from Uttar Pradesh, Odisha, Rajasthan and Madhya Pradesh had returned to their home villages.


Challenges Involved:

  • Regressive Mindset: There is considerable son preference in all states, except possibly in Kerala and Chhattisgarh. This son’s preference is derived from a regressive mindset. E.g.: People associate girls with dowry.
  • Misuse of Technology: Cheaper technology like ultrasound helps in sex selection. Failure in Implementation of Law: The Prenatal Conception and Prenatal Determination Act (PC-PNDT), 1994 which punishes healthcare professionals for telling expectant parents the sex of a child with imprisonment and hefty fines, has failed to control the sex selection.
  • Illiteracy: Illiterate women in the reproductive age group of 15-49 years have higher fertility than literate women.
  • Gender Bias: According to information from the UNPFA, reasons for female infanticide include anti-female bias, as women are often seen as subservient to men, who often employ positions of power.
  • Social Practices: Parents of girls are usually expected to pay a dowry, which could be a massive expense, avoided by raising males.
  • Counter Effect of Rise in Income: Contrary to popular perception, in India’s sex ratio at birth declined even as per capita income increased nearly 10 times over the last 65 years, according to an IndiaSpend analysis of government data.
  • Gender-imbalance:
  • Amartya Kumar Sen, in his world famous article “Missing Women‟ has statistically proved that during the last century, 100 million women have been missing in south Asia.
  • This is due to discrimination leading to death, experienced by them from womb to tomb in their life cycles.
  • An adverse child sex ratio is also reflected in the distorted gender makeup of the entire population.
  • Distortion in the Marriage System:
  • Adverse ratio results in a gross imbalance in the number of men and women and its inevitable impact on marriage systems as well as other harms to women.
  • In India, some villages in Haryana and Punjab have such poor sex ratios that men “import” brides from other States. This is often accompanied by the exploitation of these brides.
  • There are concerns that skewed sex ratios lead to more violence against both men and women, as well as human-trafficking.


Government Initiative- Beti Bachao Beti Padhao Scheme:

The sharp decline in sex ratio as pointed by Census 2011 data called for urgent action. Beti Bachao Beti Padhao Scheme was launched in 2015 in Panipat, Haryana to address the issue of decline in child sex ratio and related issues of empowerment of girls and women over a life cycle continuum. It is a tri-ministerial effort of the ministries of Women and Child Development, Health & Family Welfare and Ministry of Education




Way Forward:

  • Increasing female education and economic prosperity will help to improve the ratio.
  • Rollout campaigns on sensitisation towards women and children, making women safety cells, ensuring the safety of women on public transport systems, making cyber-crime cells are some other initiatives that need to be taken.
  • In view of the complexity of son preference resulting in gender-biased sex selection, government actions need to be supplemented by improving women’s status in the society.
  • Reaching out to young people could reduce the effect of population momentum and accelerate progress towards reaching a more normal sex-ratio at birth.
  • Effective implementation of the existing women- and children-related policies, including women's property ownership, are required to empower women, to ensure girl child's survival, and to reduce gender gap in access to healthcare.
  • Regarding the services of Accredited Social Health Activist (ASHA) can be leveraged, especially in rural areas.
  • India must implement the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 more stringently and dedicate more resources to fighting the preference for boys.