Mainstream, VOL LI, No 15, March 30, 2013
Does the Girl-child Count? Census and Other Stories
Sunday 7 April 2013#socialtags
by Bijayalaxmi Nanda
Alarming reports in national and inter-national journals claim that over the last 30 years India has eliminated 30 million girls before their birth. These figures find their basis in the country’s decadal census reports. Approximately one million girls, who should have been born as per demographic calculations, are eliminated every year. In thirty years this figure stands at 30 million!
Census 2011 has recorded an all-time low in the child sex ratio (CSR) in India. The sex ratio, which stands at 914 girls for 1000 boys in the 0 to 6 age-group, shows a drop of about 13 points from the last census. The writing was already on the wall in the earlier two census reports, that is, 1991 and 2001. It is an extremely distressing trend signifying that the girl-child is being dispensed with and disposed off at an alarming rate by families across the country. In 27 States/UTs the ratio has declined from nominal to maximal levels. This includes Jammu and Kashmir, Madhya Pradesh, Jharkhand, Orissa, Manipur and Maharashtra. This decrease in the number of girls to boys is attributed to the rapid spread and easy availability of ultra-sonography for sex determination followed by sex-selective abortions. It reveals a complex interplay of medical consumerism, state with-drawal and male-child family planning.
This dismal picture about the status of the girl-child in India even before her birth is further exacerbated by the violence she faces after her birth which is exemplified in the now famous case of baby Falak. The story of Falak draws attention to the culture of violence which rears its ugly head when it is unleashed on the most vulnerable. The vulnerability of the girl-child to infanticide, her neglect in terms of nutrition and access to health-care and sexual abuse are clearly borne out by statistics and empirical research. This marginal status of the girl-child is maintained by adequate doses of violence or the threat of it all her life through adulthood and till her death. This marginali-sation does not only signify a denial of her rights but also indicates her powerlessness to confront and redress this denial.
Can we as a society and a country take pride in our development and growth in the light of such violations against the most marginalised and most vulnerable? As signatories to inter-national conventions and covenants like the Convention on the Rights of Children (CRC), have we done enough to protect and promote the rights of the girl-child? In simple terms, does the girl-child count for anything to any one of us? Is there somewhere a magic number that captures some form of redressal of this horrific and systematic elimination of the girl-child in India?
A glance at the trend in the CSR of Census 2011, reveals that the States where the CSR had dropped alarmingly in Census 2001 have now shown a slight improvement. The increase is substantial in Punjab (798 to 846—48 points), Haryana (819 to 830—11 points), Himachal Pradesh (896 to 906—10 points), Chandigarh (845 to 867—22 points), Gujarat (883 to 886—three points) and Tamil Nadu (942 to 946—four points). Does this turnaround reflect some positive interventions in support of the girl-child in those regions or is it a demographic plateauing after the lowest point has been reached?
Punjab provides an ideal scenario to evaluate such interventions. It has the dubious distinction of being the worst-off in the country as far as CSR is concerned. Although the 2011 statistics of CSR of 846 in Punjab is much below the national average, which stands at 914, the present improvement of 48 points cannot be wished away as a natural demographic plateauing. Are there some lessons to be learnt from the Punjab experience?
A plethora of activities both by the state, NGOs and other socio-cultural groups to counter the marginalisation of the girl-child before birth began in 2001 in Punjab. It was the Akal Takht1 which issued the hukamnama of kudi-mar (daughter-murderer) first on April 18, 2001, followed by the State’s strict monitoring and implementation of the law against sex-selective abortion. Today Punjab has the highest number of cases registered under the Pre-Conception and Pre-Natal Diagnostics Techniques Act (Prohibition of Sex Selection), 1994 (PC-PNDT Act) with 112 court cases and 23 convictions.2 The convicted include doctors and family members who were found indulging in sex determination and sex selective abortion in violation of the Act.
Campaigns highlighting the value of the girl-child were also encouraged. These interventions gained momentum during the period 2002-2005 and thereafter they started waning. Incidentally 2005 was the year the National Rural Health Mission (NRHM) was launched. The package deal provided in the NRHM was seen as a panacea for all problems. The Janani Suraksha Yojana (JSY) to promote institutional deliveries, women accredited social health activists (ASHAs) in each village, and other promotional schemes for the girl-child under the Mission were considered superior to the existing initiatives. However, it led to the undermining of vibrant local-level campaigns which may not have secured automatic accountability to girl-child concerns but nevertheless were consis-tently pushing the envelope for change. The present census report has brought in a further complacency on the part of the state as well as a withdrawal of donor driven community based campaigns. The state is no longer seen to be actively implementing the Act. Its support for local level campaigns seems to be non-existent now. This clearly reveals that the earlier state initiatives were not motivated by any concern or commitment to the girl-child rights but by a technical pressure to correct numbers. Once that has been seen as achieved, the girl-child issue is presently no one’s baby. What are being paraded today as initiatives for countering the problem may actually be contributing to it.
Present Initiatives: Perils and Paradoxes
The State Government claims that strict tracking of pregnancies has led to the prevention of sex selective abortion. Pregnant women who have already given birth to two daughters are kept under active surveillance. This tracking has a triple objective of killing three birds with one stone. They include the encouragement of institutional delivery under the Janani Suraksha Yojana to arrest maternal mortality, linking up with the renewed target-oriented sterilisation programmes to control numbers and incidental watch and monitoring of sex-selective abortion. The eligibility criteria of conditional cash transfer Balri Rakshak Yojana, meant to enhance the worth of the girl-child, are also linked to the size of the family as well as permanent sterilisation. While the criteria do not specify female sterilisation, it mostly translates into that since male involvement in fertility control continues to be marginal due to patriarchal norms. This kind of approach sits uncomfortably with the notion of women’s reproductive rights, their right over their bodies, their fertility, their choices and their privacy. Ironically, this obsession in controlling population continues even though Punjab’s Total Fertility Rate at 1.9 is below the replacement level of fertility which is 2.1.3
The modern norm of small families has now translated to mean just about one son per family. A 2011 study by Voluntary Health Association of Punjab (VHAP) reveals that 75 per cent of families in eight villages in Fatehgarh Sahib have only one son.4 This phenomenon reveals that the tracking of pregnancies has not been able to monitor sex selective abortion. Other contributing factors like fragmentation of land, shrinking water resources, etc. have influenced the fertility choices of families in Punjab in favour of sons. This paradox of family planning has led to perils for the girl-child and women intersecting at the point of denial of three basic rights—the right to be born, the right to give birth and the right of control over one’s body.
The country’s insistent efforts to reduce births through targeted sterilisation is on the rise today. Almost all cash transfers supposedly meant for enhancing the worth of the girl-child are linked to extremely coercive population control criteria and inflexible, arbitrary and unimaginative guidelines. When the guidelines framed by policy-makers are in themselves biased against the woman and girl-child, their implementers in the field further distort the scheme with their patriarchal dispensation. The criteria for accessing the Balri Rakshak Yojana, for instance, include: “Couples within the age group up to 45 years for Male and 40 years for Female are covered under the scheme irrespective of their date of marriage. The benefit will be available to the child/ children of those couples who have adopted terminal method and the age of the youngest child is less than 5 years at the time of the commencement of this scheme…. The payment of the incentive shall be made from the date of adoption of terminal method and after due verification by the Civil Sur-geon…. Birth of another child for whatever reason, after the adoption of terminal method of family planning, shall result in immediate stoppage of monthly incentive.”5
The inflexible and unimaginative approach was clear in the field when a 38-year old woman was being denied the scheme irres-pective of having a single daughter and being menopausal because she or her husband did not have a sterilisation certificate.6 Understandably, this is not the only case. Rajinder Kumar of the same district had to approach the Punjab and Haryana High Court to access the scheme as his wife had undergone the sterilisation procedure before the date of the commencement of the scheme on March 3, 2005.7 Bhushan Kumar, a tea vendor of Bhatinda district, on the other hand, met all the criteria but the tubectomy of his wife Sunita was ‘unfortunately’ performed in a private hospital and not in a government facility in January 2009. In June 2010 Sunita was advised to go for hysterosalpingogram (HSG)8 to prove that she actually underwent a tubectomy.9 Interestingly, she was advised to get this test done from a private facility. These cases exemplify the unreasonableness of the conditionalities and the unsympathetic and irrational interpretation by government functio-naries making a mockery of such welfare schemes. The difficulty of accessing the scheme is also clearly evident from the fact that the scheme has been in existence since March 2005 and only around 300 beneficiaries10 in the whole of Punjab have been able to access it, with districts like Mohali not having even a single beneficiary.
In February this year in the Balaghat district of Madhya Pradesh, a 35-year old woman bled to death when government doctors were conducting a sterilisation procedure on her as part of the government’s sterilisation pro-gramme.11 Inci-dentally, the woman was carrying twin female foetuses in her womb. While it would be simplistic to put the blame squarely on the family planning programmes of the country, it is important to note the way it works against the interest of the girl-child and women. This tragic death brings to light the nexus between rejection of the girl-child and targeted family planning procedures.
In Maharashtra, which is claiming to show the way when it comes to countering this gender bias at birth, there has been upping of efforts in terms of raiding clinics and sealing sonography centres. While the importance of law implementation cannot be underestimated, earlier this year the State launched a tracking device to be attached to ultrasound machines. The purpose of the machine is to ‘silently’ keep an account of all ultrasounds and thereby aid the state to monitor sex determination. Studies have not been done to find out the efficacy of the machines, yet the State has procured them in large numbers. Today the tracking device, called the silent observer, is being touted as the next big thing! This is unfortunate since the tracking device, apart from its doubtful efficacy, has all the limitations of the tracking of pregnancy strategy and finally may compound problems for the girl-child and woman in similar ways.
The tracking of pregnancies and coercive population policies work mostly against the women and girls of poor and marginalised communities. The Auxiliary Nurse Midwife (ANM) in Punjab who proudly furnished to me the tracking of pregnancy form, admitted that they have difficulties to reach out to the rich and powerful which means it is only the poor who fall into their net.12 The framework of the NRHM is inadequate to deal with the nuances of such an intersectionality especially since it not the poor who are the worst culprits when it comes to the discrimination of the girl-child.
There are many powerful forces that would like the present strategies to continue since it agrees with the predilections of a lucrative private market, a coercive and patriarchal state and family. Of course, the law against sex determination and sex selective abortion needs to be more carefully implemented with quick delivery of justice along with gender-enabling judgements. Apart from that, a strong regulatory framework needs to be insisted upon to get rid of adhocism and build in more accountability of state institutions and bodies. For example, when the Central Supervisory Board, the apex monitoring and reviewing authority of Government of India under the PCPNDT Act, which is mandated to meet at least once in six months, had not met even once in the past three years (mid-2008 to mid-2011),13 the state should itself be liable for punishment.14
Building on a framework of non-discrimination on the basis of the intersectionality of class, caste and gender would mean the rejection of strategies like tracking of pregnancies or coercive sterilisation programmes. Sensitivity to the issue requires tracking the girl-child’s development since birth by examining her access to the 3 Es—empathy, education and employment. Empathy to ensure that the girl-child is placed at the centre of equity-based programme formulation and implementation with equal access to healthcare and nutrition in a violence- free environment. A gender-sensitive framework of education, which emphasises and increases the girl-child’s power of bargaining and negotiation and plays a crucial role in breaking gender stereotypes and myths. Finally a reasonable guarantee of gainful employment linked to the choices of women should be available which allows them the opportunity to live in dignity and enhances their self esteem. This form of tracking is not to be confused with conditional cash transfers with their disparate criteria and inadequate financial resource base. In conclusion, a critical space needs to be kept open, where women’s movements, youth groups and other social movements should engage with and where essential, resist and challenge the inherent tendency of the state, family, community and market to reinforce patriarchy.
1. Akal Takht is the principal centre of Sikh temporal authority. For further details, see W.H. McLeod, Sikhs and Sikhism, Oxford University Press, New Delhi, 1999.
2. As communicated by Dr V. K. Goyal, former State Nodal Officer, PCPNDT Cell, Department of Health and Family Welfare, Government of Punjab.
3. “Time Series Data on CBR, CDR, IMR and TFR” at Ministry of Health and Family Welfare website, (It gives TFR as in the year 2009), viewed on March 27, 2012 (http://nrhm-mis.nic.in/Public Periodic Reports. aspx).
4. Findings shared by VHAP in a seminar on Issue of Declining Sex Ratio in Punjab at Chandigarh on November 25, 2011.
5. See further for detailed guidelines, “New Strategies: Balri Rakshak Yojana”, Department of Health and Family Welfare, Government of Punjab, viewed on March 20, 2012 (http://www.pbhealth.gov.in/sch1.htm) and “Balri Rakshak Yojana / Janani Suraksha Yojana”, District Administration, Fatehgarh Sahib, viewed on March 20, 2012 (http://fatehgarhsahib.nic.in/balri_janani.htm).
6. Information gathered in an interaction in the field in Mohali District.
7. See further, “HC asks Punjab Govt. to relax rules under girl-child scheme”, March 14, 2008, viewed on March 21, 2012 (http://www.expressindia.com/latest-news/hc-asks-punjab\-govt-to-relax-rules-under-girl-child-scheme/284312/).
8. Hysterosalpingogram is an invasive procedure to confirm infertility. It is ironic that to access a girl-child protection scheme Sunita had to undergo such a test to prove her infertility. As a ‘safeguard’ the guidelines already prescribe that “birth of another child for whatever reason, after the adoption of terminal method of family planning, shall result in immediate stoppage of monthly incentive”.
9. See further, “Seeking govt benefits, tea vendor caught in the web of procedures”, The Indian Express, June 7, 2010, viewed on March 22, 2012 (http:// www.indianexpress.com/news/seeking-govt-benefits-tea-vendor-caught-in-the-web-of-procedures/630690/0).
11. “MP sterilisation drive killed pregnant woman”, The Times of India, New Delhi, February 26, 2012, p. 15.
12. Information shared during a focused group discussion in the district of Mohali in the course of the author’s field work in December 2011.
13. Rajalakshmi, T K (2011): “Worrisome Trend”, Frontline, Vol.28, Issue May 10, 7-20.
14. The Central Super-visory Board was reconstituted in April 2011 in the wake of the release of the provisional census data. Since then the Board has met twice.
1. John, Mary E, Ravinder Kaur, Rajni Palriwala, Saraswati Raju and Alpana Sagar (2008): Planning Families, Planning Gender: The Adverse Child Sex Ratio in Selected Districts of Madhya Pradesh, Rajasthan, Himachal Pradesh, Haryana and Punjab (New Delhi: Action Aid and International Development Research Centre).
2. Patel, Tulsi (ed.), (2007): Sex-Selective Abortion in India: Gender, Society and New Reproductive Technologies (New Delhi: Sage Publications).
3. Registrar General and Census Commissioner of India Census of India (2011): Provisional Population Totals, Paper 1 of 2011, India Series 1 (New Delhi: Office of Registrar General and Census Commissioner).
Bijayalaxmi Nanda (email@example.com) teaches Political Science at Miranda House, University of Delhi. She is an Associate Professor at the Department of Political Science there.