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Published: 2013-10-08

Abortion of female fetuses and more death among girls result in poor girl child survival in India

NEWS Modern ultrasound technology and economic pressure leads to female fetuses in the Ballabgarh area of northern India being aborted more often than male fetuses. Additionally, girls up to the age of five die more frequently than boys, which results in a gender imbalance in the area, according to Anand Krishnan, MD and doctoral candidate at Umeå University, who defends his thesis on 11 October.

Anand Krishnan has completed work on the dissertation in an area called Ballabgarh Health and Demographic Surveillance System Site in northern India, about 40 kilometers from the capital of New Delhi. In the project researchers have collected data from all the people living in the area's 28 villages since 1992. Anand Krishnan has examined the issue sex ratio at birth and survival of children up to age five in the study.

The thesis shows that girls under the age of five in the Ballabgarh area die at higher levels than boys, a difference that lasts up to five years of age. That compares with global figures where mortality among boys is higher. Based on the sex ratio at birth in Ballabgarh and comparing with international norms, it was estimated that on average, 58 abortions of female fetuses per 1,000 births are conducted, which results in a gender imbalance.

Anand Krishnan demonstrates in the thesis that the differences in the sex ratio at birth and infant mortality can be linked to socioeconomic groups in the area. These include the parents' education, caste, economic conditions, and more.

“The results show that families in the richest and most educated group perform most abortions based on gender,” says Anand Krishnan. “In addition, newborn girls born in these families have a greater risk of dying during the first month of life, compared to girls who are born into families with lower socioeconomic status.”

Additional factors that have been discussed as explanations for the gender imbalance in the area are vaccines and their effect on the immune system, in addition to the desired ones. The thesis shows that the vaccine against diphtheria, tetanus and whooping cough appear to be linked to an increased mortality among girls compared with boys, and it may contribute to the excess mortality among girls.

According to Anand Krishnan, Indian authorities are working to rectify the gender imbalance, including control of access to technology for sex determination of fetuses. The Indian Government also has a system that provides monetary compensation to the families at birth of girls. This seems to reinforce the impression that girls constitute a financial burden on the family. In addition, the system has caused an increase in the registration of female births, primarily because they want to access state funds. In the research results Anand Krishnan cannot see any change for the better when it comes to societal attitudes towards girls because of this system.

“The fundamental problem in Indian society is that girls constitute a "debt" because they do not contribute to the household financially,” says Anand Krishnan. “Girls are rather a burden because they take a dowry that drains family finances when they get married. There are also religious and cultural factors that reinforce this perception.”

He says that the years 2001-2010 were the worst period so far concerning selective abortions and mortality in girls under five. The pressure to reduce the sizes of families, mainly for economic reasons, was supported by increased opportunities for sex determination of fetuses. At the same time, it was more desirable to have baby boys.
“As international experiences show, it takes time for the change in thinking to occur by development,” continues Anand Krishnan. “With government pushing its schemes, it is hoped that the tide will turn sooner rather than later.”

Anand Krishnan is working as a medical doctor and public health expert at the Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, and is a doctoral candidate in the Department of Public Health and Clinical Medicine, Division of Epidemiology and Global Health, Umeå University.

Contact information:Phone: +91981150 06 67
E-mail: kanandiyer@yahoo.com

CNN InterviewTake a look at this interview with Anand Krishnan on CNN - Indian father accused of killing baby 'for being a girl'.

On October 11, Anand Krishnan, Department of Public Health and Clinical Medicine, defends his thesis entitled: Gender inequity in child survival: Travails of a girl child in rural north India.Opponent: Per Ashorn, Professor, Tampere Center for Child Health Research, University of Tampere, Finland.
Supervisor: Nawi Ng.

The defense will take place at 9:00 a.m. in Umeå University Hospital, Building 9A, level 1, Room 135.

The thesis is published electronically, see link:

Editor: Mattias Grundström Mitz