In India, improvement in
the relative conditions faced by women has been among the explicit goals
of
government policy, along
with growth, reduction of poverty and inequality and improved human
development indicators. Indeed, in the 1990s, the publicity given to the
need for gender equality and women’s empowerment meant that there was a
proliferation of government schemes specifically for women.
Nevertheless, some of the data on
conditions of women indicate that things may not have got much better for
the bulk of India women over the past decade. This is reflected even in
demographic indicators, which tend to sum up health and living conditions
at the most basic level of survival.
One of the basic measures
traditionally used as a proxy for capturing the relative position of women
in terms of conditions of survival, is life expectancy. The other is the
sex ratio (number of females per number of males). The recent Indian
experience with both of these indicators is described in Charts 1 and 2,
and it is apparent that they suggest slightly contradictory conclusions.
It will be seen from Chart 1 that the life expectancy of women has
improved at a faster rate than that of men, so that by the mid-1990s,
women in India had greater expectation of longevity than men, along the
standard international lines and as predicted by biology. However, the
life expectancy differential between women and men is still below the
international norm.
Chart 1 >>
Chart 2 >>
Chart 2 presents a
somewhat different, and more depressing, picture. While the aggregate sex
ratio for all ages improved between 1991 and 2001, at the later period it
was still lower than the level of 1981, showing thereby a long-term
decline. And the sex ratio for the 0-6 years age cohort has declined
continuously and quite substantially.
This is startling given
that the spread of access to modern medical techniques is supposed to
ensure birth and survival of children to a greater extent. It points to
the likely role played by the combination of greater neglect of girl
children and wider practice of female foeticide based on modern medical
techniques to determine the sex of the foetus.
Chart 3 presents evidence on sex ratios for
the total population by state for 2001, and Chart 4 for the sex ratios for
children in the age group 0-6 years. It is clear that there is very
substantial variation across states – but more significantly, that such
variation has virtually nothing to do with per capita income or degree of
development. The lowest sex ratio is to be found in Delhi, which has the
highest per capita income of all states, and is the most urbanised, and
among the most developed of all states. The agriculturally developed and
high per capita income states of Punjab and Haryana are next in terms of
low sex ratio; in fact, in Punjab, the figure drops to an appalling 793
girls per 100 boys in the age group 0-6 years.
Chart 3 >>
Chart 4 >>
By contrast, Kerala, which has much lower per capita income, shows the
best sex ratio at 1058 women per 1000 men, close to international norms.
However, even in Kerala the 0-6 years sex ratio is unsatisfactory, while
it is higher than the national average. In general, several of the states
that are economically less developed (such as Andhra Pradesh, West Bengal
and Tamil Nadu), perform better than the national average by these
indicators. The complex relationship between economic growth and the
status of women, becomes very evident here.
While infant mortality
rates have declined over time, evidence from the Registrar General’s
Sample Registration Surveys (SRS) suggests that the rate of decline has
decelerated over the 1990s. This is also evident from Charts 5 and 6 which
give aggregate IMRs for rural and urban areas respectively.
Chart 5 >>
Chart 6 >>
The aggregate infant
mortality rate for males fell by 26 per cent between 1981 and 1991 (from
110 per thousand to 81 per thousand) but only by 12 per cent over the
subsequent decade, to 71 per thousand. The deceleration in infant
mortality among girls over the two decades was even sharper, from 27 per
cent to 10 per cent, such that the female IMR was 72 per thousand in 2001.
Of course this conceals the extent of female foeticide, which is likely
(if anything) to have brought down female IMRs.
Some states have very high
female IMRs, ranging from 96.9 per thousand in Orissa to 81.4 per thousand
in Haryana in 1998-99. The female IMR in Madhya Pradesh in that year was
as high as 101.5 per thousand. What is even more disturbing is that in the
recent past, there is evidence of rising IMRs in several states,
which reverses the long run trend of decline evident across India since
Independence.
Death rates during the
first five years of life also show very significant gender differentials.
In 1998-99, the national average child mortality rate (CMR) was 29.3 per
thousand. However, the CMR for rural boys was 27.9, while that for rural
girls was one and a half times higher at 41.7. The urban gender
differential was somewhat less: the urban CMR for boys was 14.6 while that
for girls was 19.7. For all these variables there are significant
variations across states, and in addition, within states as between
different sub-regions, ethnic and social groups such as certain castes and
tribes and minority groups.
Maternal
mortality rates reflect health infrastructure conditions as well as other
factors such as maternal nutrition levels. It is disturbing to observe
that the rate of decline of maternal mortality has been very slow in
India. Maternal mortality for the country as a whole was estimated at 580
per 100,000 live births in the early 1990s. (P.N.
Bhat, Mari K Navaneetham and S. Irudaya Rajan "Maternal mortality in
India: Estimates from a regression model", in Studies in Family Planning,
1995)
Once again, there are
significant rural-urban differentials (the rural rate at 638 is nearly
double the urban rate of 389 per 100,000 live births). Similarly, there
are wide variations across states, as evident from Chart 7. The extent of
variation is quite dramatic, varying (according to UNICEF estimates) from
738 in Orissa to only 87 in Kerala. These may be underestimates. Thus Bhat
et al. (1995, op.cit.) estimate MMR in Assam to be as high as 1068, with
MMR in Uttar Pradesh at 920 and in Bihar at 813
Chart 7 >>
Indeed, the low MMR in
Kerala indicates how much can be achieved through the greater spread of
improved public health facilities and provision of basic nutrition through
the Public Distribution System. It has been estimated that 40 per cent of
all maternal deaths in rural areas are due to bleeding of pregnancy and
puerperium, and anaemia. The former is a directly obstetric cause, which
can be mitigated through medical attention, while the latter is directly
affected by nutrition.
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