Optimistic outlook

India was one of the few countries in the world to have elected a woman as prime minister, more than half a century ago. Currently, the head of the State is a woman. Women are excelling in every sphere of life — ranging from running in Olympics to leading the country. The status of women has been very high in Indian culture and tradition since ancient days. Anything holy and serene is equated to a female. Be it addressing India as 'Bharat Mata' or worshipping Ganges as 'Ganga Maiya'.

But in our society, generally, a male is widely viewed as an asset, a future breadwinner and old-age caregiver while raising a female is related to a huge cost in terms of dowry. Such roles and expectations are a product of the stereotypes woven around each gender. By gender stereotype, we mean attributes and qualities commonly associated with a gender. Thus, an idea on gender role differences that a child acquires is that of women of one's family marrying and leaving their homes to live with different groups of people.

As per the WHO, the biologically determined natural sex ratio at birth is 1.05 boy for every girl, which translates to 952 girls per 1000 boys. For India, this ratio is 1.82 (549 girls per 1000 boys) for first born boys and 1.65 (606 girls per 1000 boys) for last born boys. The recently released Sample Registration System Statistical Report, 2020, shows the sex ratio at birth for the country has gone up by three points to 907 in 2018-20 from 904 in 2017-19. Kerala has reported the highest Sex Ratio at Birth (974) while Uttarakhand, the lowest (844).

NFHS-5 further highlights, among all the states and Union Territories, men in Mizoram (37 per cent), Lakshadweep (34 per cent) and Manipur (33 per cent), and women in Bihar (31 per cent) show the strongest preference for more sons. Across all states and both genders, Meghalaya women are the only section in which a higher proportion prefers more daughters than sons. These findings indicate that before birth of a child, the son meta-preference is strong.

The good news is that after birth, this tendency shows a change. There has been a gradual drop in the female infant mortality rate — from 44 per 1000 live births in 2011 to 33 in 2017 and 28 in 2020, leveling with the male infant mortality rate. The state of Kerala (Overall-6, Male-10, Female-3) has the lowest IMR for both the genders while Madhya Pradesh (Overall-43, Male-44, Female-43) has the highest IMR in the country, yet female IMR is lower than male here.

In terms of rural areas, the states of Himachal Pradesh, Uttarakhand, Delhi, West Bengal, Telangana and Kerala outperform others in the dropping levels of IMR for female against male. Interestingly, in the urban areas, female IMR is lesser in the states like Chhattisgarh, Rajasthan, Gujarat, Uttar Pradesh, Odisha, Maharashtra, Tamil Nadu and Kerala. Though the overall rural-urban disparity (Rural IMR-31, Urban IMR-19) and variations across the states exist, the national average suggests an optimistic trend.

The findings of SRS suggest the percentage share of neonatal deaths to infant deaths is nearly 70 per cent, which indicates the first month after child's birth is very crucial. Once the child completes the early days, the chances of his/her survival improves and IMR gets lowered.

Neonatal mortality is defined as the probability of dying during the first 28 days of life, expressed per 1,000 live births. At the same time, the infant mortality rate is the probability of dying between birth and exactly one year of age, expressed per 1,000 live births.

UN Sustainable Development Goal 3.2 aims to end preventable deaths of new-borns and children under five years of age, with all countries aiming to reduce neonatal mortality and under 5 mortality. As per UNICEF, the target to reduce neonatal mortality is 12 deaths per 1000 live births while in case of under-5 mortality, the target is 25 deaths per 1000 live births. India has already surpassed the target in urban areas (NNM-12, Under 5-21).

We are already on the road to achieve SDG 3.2, with the government's efforts and missions like — Reproductive, Maternal, New-born, Child and Adolescent Health (RMNCH+A) framework; India Newborn Action Plan (INAP); Janani Suraksha Yojana (JSY); Janani Shishu Suraksha Karyakram (JSSK); Universal Immunization Programme (UIP); Beti Bachao Beti Padhao etc. — in place. The accomplishment will happen much ahead of time, 2030. Drop in IMR and matching of it across the two genders gives this hope.

To address the problem of meta-son preference as an old-age safety net, there is a need to realign the focus towards a quality old-age support system across all income groups, which may be government-led with active participation of the private sector. Nudging the psychological change and ensuring equal access to education, healthcare and opportunities to a woman at par with male counterparts can be a crucial step. All this may increase the pace of improvement in the sex ratio at birth, and gender equality at large in the country.

Sarvadanand Barnwal is Joint Director, Economic Advisory Council to the PM; and Himani Aggrawal is Young Professional (YP), Economic Advisory Council to the PM. Views expressed are personal