Archive | November, 2007

Where have all the girls gone?

11 Nov

Namita Kohli, Hindustan Times
Email Author
Haryana/New Delhi, November 10, 2007

Faced with a crisis, even local elections have candidates promising brides in return for votes.

“My kismet brought me here,” says 14-year-old Heena, who’s come to ‘sasural’ in Malabnuhu — a sleepy village in Haryana’s Mewat region — from Kolkata. Originally from Bangladesh, the teenager can only blame destiny now. Last year, after a sum of Rs 6,000 changed hands, the ‘bahu’ found herself in an alien landscape: where Bengali is replaced by Haryanvi, rice by roti — and where cattle costs more than women like her, who are referred to as paros by the locals.

In the prosperous districts of Haryana and Punjab — where son preference has resulted in a skewed sex ratio — girls from economically weaker backgrounds in Bihar, Jharkhand, Orissa and West Bengal are being openly bought in droves for ‘marriages’ that are more often than not without the consent of the girl. The legal status of such wedlock, of course, remains questionable. According to data compiled by Shaktivahini, a Faridabad-based NGO that takes up anti-trafficking issues, there are up to 50,000 paros in Haryana alone, including a huge proportion of minors.

Census 2001 shows that the child sex ratio in Haryana and Punjab stands at 820 and 793 per 1,000 boys respectively. But according to the latest health survey by the Punjab government, villages like Sansarwal in Patiala have touched an alarming 438 girls per 1,000 boys.

Ergo, girls are fast turning into a vanishing tribe. A recent United Nations Population Fund (UNFPA) report warns that female deficit in the marriageable age (20-49) is set to touch 25 million by the year 2030.

The impact, however, is already being felt here. Says Dr Madhav Mohan Godbole, the director of Balgrah, a rehabilitation centre in Rai, Sonepat, “Villagers come to us and plead for brides. They say if we can’t fix them up, they will be forced to buy girls.” Faced with a crisis, even local elections have candidates promising brides in return for votes. Ram Prasad of Seoti village in Sonepat, concedes, “frequent trips are being made from all over Haryana to hunt for girls in Bengal, Orissa, Jharkhand and even Maharashtra.”

In a typical ‘buying’ scenario, someone with ‘contacts’ in source states facilitates such arrangements in return for kharcha-paani, explains Rishikant of Shativahini. The ‘going rate’ ranges from Rs 6,000 –10,000, depending on the age and virginity. Forced by poverty, many a time the paros also have to ‘accept’ polyandry.

Interestingly, parents of local girls are now spoilt for choice. No one wants a poor or unemployed groom, says Akbar Ahmed of Malabnuhu. Neither are they willing to send their girls to the land of paros.

Post-Marital Blues

Gradually, the cultural impact of these forced marriages is surfacing. Meena, 30, a paro from West Bengal bemoans, “Men here don’t know how to behave. Their language, attitude are very brash.” The women’s movements are kept under ‘close watch’ and they aren’t allowed to visit home for fear that they might escape. “But at least there’s food to eat here, else why would we come so far,” sighs Mamta, a ‘bride’ from Bihar.

Even so, there are ample stories of abuse. Ameena, 13, was sold to a 35-year-old widower Ashok in Seoti, who was desperate for a bride. It didn’t matter even if she was a minor. “Ashok would lock me up in a room, beat me up and sexually abuse me. He wouldn’t let me talk to my mother,” recalls Ameena, who tried to escape a couple of times, before being rescued by Delhi-based NGO Prayas just last month. “He was so much older, and there was a lot of communication problem. So I was just supposed to say yes to whatever he demanded.”

Ameena’s was the first case of trafficking registered in Haryana, as women seldom register complaints due to social pressures. “There’s no complainant, no accused,” laments Sibhash Kaviraj, SP of Mewat. A local police official in Seoti says, “How can we go about breaking homes? Unless villagers inform us of such incidents, our hands are tied… it is their personal matter.” While many like Chandigarh-based Professor Pam Rajput, vice president National Alliance for Women (NAWO), have been advocating frequent compiling of relevant statistics and sensitising both men and women, the administration has clearly, been slow to deal with the issue.

Meanwhile, the chain continues to grow. As the UNFPA report states, it is the poor and landless men who will be most affected by this bridal crisis. Evidently then, 35-year-old Anwari who was, many years ago, married to a man 20 years older than her in Malabnuhu, is worried for her four boys. “They don’t study. Maybe, I will have to buy brides for them also.” Already, across Haryana and Punjab, it’s a common refrain, “Who wants to give girls to poor men like us?” To which, one Ram Dulari of Seoti chides them: “Who will, when you foolish people kill your own girls?”

(Some names have been changed)


Sex selection in India

11 Nov


In ‘IT revolution and declining dowry practice’ (Open Page, October 28), Chandra Kommera has drawn an interesting analogy between the two. While it is extremely heartening to note this change in the bargaining power of women, such instances are still few and far between. For many, the birth of a girl child is still unwelcome. The sex ratio of India according to the 2001 census is a dismal 933 females per 1,000 males, up from 927 in 1991. These figures leave muc h to be desired.

A major concern is that economic and educational prosperity has not altered this long-held bias against the girl child. It is still a widely held theory that a male child will carry forward the family line. Another factor going against the girl child is the dowry which her family has to churn out at the time of her marriage.

In many areas, among the prosperous, dowry is viewed as a status symbol. Business families also feel the need for having a male heir. And with the trend of smaller families slowly creeping in, the girl child gets chucked out.

Armed with knowledge and money, access to methods of sex selection including female foeticide is easy. For instance, in relatively prosperous Punjab, the sex ratio is 874 whereas in so-called backward Bihar, it is 921 according to the 2001 census.

The mushrooming of illegal ultrasound clinics all over the country is testimony to the rampant sex-selective abortions.

And increasingly, for fear of being caught, these clinics seem to use symbolism to convey the results. They use blue or pink colour to convey whether the foetus is a boy or a girl. Or they make statements such as ‘Your child resembles a doll’ to convey a female foetus.
Hardly a deterrent

The Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act of 1994 banned sex determination tests. It provides for three years imprisonment for a first-time offender and a fine of Rs 10,000. This is hardly a deterrent given the huge profits the trade offers and the lax judiciary.

The rate of conviction under this law is one of the worst with the first conviction coming as late as 2006. This could be attributed to the difficulty in producing evidence in court and a powerful lobby which has virtually converted sex selection into a profitable trade. Of late, sting operations by women disguised as pregnant women have helped nail a few doctors.

This trend of sex selection is extremely unhealthy and can have disastrous consequences for society. Moreover, a society which denies the girl child even the basic right to existence cannot claim to be civilised. It is time the loopholes in the law were corrected. Strict implementation of the law can be the only deterrent to the practice, given that attitudes take time to change.

Tackling the problem of prostitution

11 Nov


Amendment to the Immoral Trafficking (Prevention) Act 1956 is in the making for over two years. Going by the modern standards of performance evaluation, it seems the voting public are getting too little work done by their representatives. The representatives are indecisive on what steps to take.

Prostitution per se is not illegal or criminalised in India but soliciting and trafficking is. The justification for such a dichotomy is as usual safely nestled in age-old beliefs, practices and religion. The law aims to protect the victim without punishing the perpetrators. Prostitution as a means of livelihood is exploitative, repressive and inhuman.

One amendment being heavily debated is whether the client — in effect the demand side — should be punished. Sweden has had some success in bringing down trafficking when it criminalised buying sex. Britain is also considering the move seriously. The argument advanced against this in India is that it would lead to more surreptitiousness and place the victims further at the mercy of police.

Sadly the poorer (weaker) argument is that it would affect livelihood of the sex workers. Does it mean that the government is there only to wring its hands and watch helplessly as people are traded like commodities, forced into a ‘profession’ which can hardly be called that?

Amnesty schemes for tax evaders or defaulters pave the way to legalise their illegal wealth. Why not a scheme to rehabilitate these workers to help them break the vicious cycle of poverty and coercion which condemns them to a life of disease and disrespect?

The entire approach is heavily tilted towards the effect and not the cause. Instead of catering to the ‘vote bank’ minorities, we should address this community which has little voice and a lot to complain about. This is a group which cannot organise itself, burn buses or issue threats to disrupt public life. A realistic solution would be alternative employment and focused provision of basic facilities.

The high profile campaign for the prevention of AIDS can at least in part be diverted to addressing the circumstances which force hapless people into sex trade.

Prostitution is still treated as some ‘foreign’ disease whereas it is, and must be recognised as, a ‘man made’ social evil. The policy and legal framework is to treat it and hardly to root it out. We never find any political leader or public figure taking a stand asking the youth to practise restraint or fidelity. If the ‘supply’ side is too dark and difficult to control, at least the demand can be attacked.

India is blessed with stability and order compared with countries torn by civil war, political instability and the like. It just requires the administration to be committed and interventionist. But given the approach of the establishment which rushes to ban bar dancers rather than bars, maybe it is too much to ask.

We have seen governments steamroll opposition from environmentalists, workers, coalition partners when it comes to economic and political agenda such as SEZs, privatisation or land acquisition but hardly are proactive when it comes to the unfinished social agenda. We have places categorised as ‘red light’ areas beyond the reach of the long arm of the state. Perhaps we can even have areas demarcated for fake currencies, drugs, arms, antiques and so on.

The absence of social anger and condemnation despite having full knowledge of its stigma and consequences remains an enigma. Why do we hesitate to say that, in the first place, it is wrong? Society needs values and they should not be contingent on convenience, laws and individual preference. Larger social interest cannot be held ransom to individual immorality.

The business of social responsibility

11 Nov

Any voluntary measure from the private sector will be fruitful only when there is a firm legal and policy regime

SANTANU SABHAPANDIT,The Hindu 11November 2007

Recent developments surrounding the operation of India’s largest foreign direct investor in the mineral sector, POSCO, in Orissa are indicative of the extreme conflict situation that exists on the ground. Incidents of violent protests and kidnapping of company officials can be seen as a manifestation of deep distrust and frustration that fills the general psyche of those living in one of the poorest parts of the country, bearing the brunt of development activities th at offer little to their needs.

Breaking the law cannot be justified, but it is indeed doubtful if criminal law alone can take care of a situation that the company is facing today. Clearly, social and economic interests are once again at loggerheads. Here is, however, an opportunity to recognise the finer linkages between business, governance and society.

What are the policy options that we have to respond to such a situation? It must be noted that we need private sector participation in the mining sector and the proposed new mining policy is trying to promote this. Beyond this, there seems to be a reliance on voluntary measures when the High Level Committee recommendations refer to the sustainable development framework, developed by industry association ICMM and the IUCN, in addressing social issues such as environment protection and meeting local needs.

Voluntary measures — e.g. the concept of corporate social responsibility (CSR) — are gaining ground in corporate strategy discussions or policy considerations in general.

There are a number of studies that show positive business outcomes of such measures, which in turn underwrite their reliability. However, the definition of CSR is still not free from controversy, as any prima facie drift from the profit-maximising objective by the corporations is believed to be unrealistic and seen with suspicion. From industry’s point of view, besides the economic, political or ethical underpinnings, CSR is increasingly becoming a necessary licence to operate within society.

Objectively, a company would be legitimate in carrying out its activities if it has received necessary approvals from the authorities to start operation and as long as it complies with the relevant laws during their operation. Also legitimate is their profit-maximising motive. There is perhaps no legal justification in the expectation that the company should carry out socially beneficial measures beyond what is required by law.

Any such measures undertaken would finally be led by individual business concerns of the company and would remain in the sphere of volunteerism. Yet if a company has to face a situation where it cannot initiate or carry out its ‘legitimate’ operation, it is doubtful whether a concept like CSR would at all be useful.

Voluntary measures cannot replace duties established by law or policy by the government. It is more so when the government needs to recover its credibility in public perception. Even from a responsibility point of view, the government, whether at the State or Central level, has much to undertake.

It cannot be denied that mining operations themselves are to be blamed for the distrust and suspicion that is pervading the general perception. Given that the public sector undertakings account for more than 80 per cent of the total value of mineral production of all minerals excluding atomic minerals, it must own responsibility for the externalities of its production process.

However, undertaking both regulatory and production activities simultaneously, the government subjects itself to a situation where likelihood of violation or dilution of statutory requirements is higher. This can, to a large extent, explain the public sector’s greater responsibility in nurturing the distrust among project-affected people in the mining sector.

The policy options in the hands of the government to address the situation are by and large obvious. Efforts are being made to address concerns of land acquisition and consequent rehabilitation policy for project-affected people. What needs to be emphasised is that such efforts deserve the additional thrust from business considerations that the policy is trying to promote.

What should promote a more proactive stance from the government is the fact that social responsibility is fast becoming a sine qua non for business operations and consequently for private sector investment. And only the government can provide the minimum standards through appropriate policy measures. Any voluntary measure from the private sector would be feasible and fruitful only when there is a firm legal and policy regime that ensures the basic minimum to society.

Tribals no strangers to female foeticide

11 Nov

With better education, villagers adopt city lifestyles

Where technology is not accessible, quacks are approached

NEW DELHI: Even as education and technology reach the far-off tribal belts of the country, the practice of female foeticide is also fast making inroads there.

Tribal youth are now going to cities or making use of portable ultrasound machines that provide sex determination ‘services’ at a nominal price.

The practice of sex determination and female foeticide was alien to these communities till recently.
Elders’ fear

Now elders in tribal villages fear that urbanisation will hit tribal villages as youngsters will fall prey to this “style” very soon, says a study conducted by the Pune-based Centre for Youth Development and Activities (CYDA), with support from the United Nations Population Fund.

This fear was expressed by villagers of Badi in Rajasthan, who said that as the educational level went up among their youngsters they tended to adopt certain lifestyles followed by city dwellers.

Quoting a social worker intervening in this area, the study says: “It is being increasingly felt that the issue of female foeticide is entering into the village settings dominated by tribals. Although in the programme area where we work there exist no ultrasound labs, our tribal youth are seen indulging in sex selective practices by going to the cities.”

There are also indications that in rural and tribal areas, where the sex determination technology is not locally accessible, people seek the help of quacks and dais (midwives) who prescribe herbs/medicines claiming that these will change the sex of the child.

Quoting another social worker in the area, the CYDA study says, “People also use traditional herbs and other medicine to have a male child or to change the sex of the foetus from female to male.”

Performing districts

India’s 10 best performing districts, where the ratio of girls is higher than boys, are mostly dominated by tribal communities, while the 10 worst performing districts are in Punjab and Haryana.

The best performing districts are South Sikkim, Upper Siang and East Kameng in Arunachal Pradesh; Bastar and Dantewada in Chhattisgarh; Pulwama, Kupwara and Budgam in Jammu and Kashmir; Senapati in Manipur and Mokukchung in Nagaland.

The access to information, means and technology, and the impact of the pro-sex determination perspective of the urban educated economically well-off sections have influenced some migrant populations of rural India also, a chunk of which are tribal. Technology inroads into semi-urban/rural areas have resulted in an increasing number of people there going in for sex selection.

In Maharashtra’s Akluj gram panchayat, a well developed semi-urban area with a population of 40,000, many unqualified people are using portable machines and travelling to interior villages to offer sex determination services on the doorstep for a nominal fee. According to a Tamil Nadu organisation, Rural Rehabilitation Centre, access to technology has led certain communities such as the Kallars in Madurai district, who were traditionally practising female infanticide, to gradually shift to sex determination tests and sex-selective abortions.

Her story: Fourteen girls, yet no son

11 Nov

Namita Kohli, Hindustan Times
Rohtak (Haryana), November 11, 2007

At 70, Krishna Devi is impassive about life — save a desire for a son, for which she ended up having 14 daughters. Her youngest daughter was born when she was 55, making her one of the ‘oldest mothers’ in the world.

“Yahan toh sab chhora hi chahte hain (Everyone here wants a son),” she says. In Bhalli Anandpur village in Rohtak district, Krishna is ‘famous’ for the sheer size of her all-girls family. “There were no machines (ultrasonography machines) to check, so I kept having girls till I was 55.”

Krishna, who had her first daughter at 15, is in sync with the social fabric of a region where the worth of a family is dictated by a son. In the third National Family Health Survey released recently, 90 per cent of women with two sons said they didn’t want to have any more children, while only 61 per cent with two girl children said they wanted to stop the family.

Unlike Krishna, villagers here resort to sex determination tests clandestinely: “If the doctor writes in red it’s a girl, if blue, it’s a boy.”

Incentives for the girl child don’t work, with only about 5 per cent registering for them. Says Krishna’s husband, Dayanand Lohaar: “I had to take loans for their marriages.” His eldest daughter Satwanti, 55, is a mother of two sons. Ask her if she’d got the ‘test’ done, and her silence says it all.

‘Get a truckload of girls for the boys here’

11 Nov

November 11, 2007
Namita Kohli, Hindustan Times

Just over 100 kms from the Capital, a curious waiting game is on at the nondescript village of Bamla. Men here have gotten used to waiting for a bride — sometimes, for years on end. With at least 70 per cent of the ‘eligible’ bachelors unable to find a girl, it could well be a scene straight out of Manish Jha’s 2003 film Matrubhoomi: A Nation Without Women.

Azad Singh, 40, a shopowner at Bamla, says, “Fot the last ten years, the problem has been acute. Earlier boys here used to get married at 18-20. Now even at 30, many are unable to find a girl.” At least 500 boys are desperately looking. There are even families with four or five unmarried sons. “This is leading to great tension within the village,” adds Singh. With age, the single men become the subject of ridicule amongst friends who have “settled down”.

Curiously, while bride buying is de rigueur all over the state, in this village ‘single’ men are still living in denial. “Get a truckload of girls here and you will see a queue of boys in no time. But we don’t want to badmouth the village. We will try to hide the fault till we can for our honour,” says ex-sarpanch Sudhir Pehelwan. Sudhir says that after the local media reported this trend sometime back, the then sarpanch was forced to take his statement back, due to local pressure.

Ajay Grewal, who’s in his late 20s, has almost given up on getting himself a bride — even though he owns a sizeable portion of land and is a “state-level” wrestling player. Ditto for Sanjay Kumar Grewal, 28, a local farmer.

With a low female population and consequently more ‘single’ males, the fallout has been a rise in sexual violence against women. Says Ram Chander, a schoolteacher from the neighbouring village of Bhalli Anandpur, “Earlier, we could send our women to the fields alone, but now men around can’t be trusted. Rapes and violence are rising due to their desperation. It will take a lot of time for the situation to change.”

While Bamla village takes great pride in its male wrestlers, women here are still supposed to cover their heads and faces completely. “We don’t allow girls to roam freely outside, nor do we send them to work. That’s why you can’t see them around. They stay indoors mostly,” says Pradeep Kumar Grewal, a resident. Women, he says, are a “liability” for the middle class families like him and perhaps, that’s the reason behind the scarcity of brides.

Many like Pradeep have no qualms in accepting that female foeticide is happening on the sly, and that no one registers for government incentives for the girl child. “Schemes don’t work. The procedures to avail the benefits are too tedious. Sex determination is easy. Families decide on their own about their children.”

But with a scarcity of women, how do they intend to have ‘families’? “That’s the way our society is. We can’t really help it,” says father Anil Kumar Grewal.

Focussing on children in need of care and protection

6 Nov

The handbook is useful for people working in the area of child rights

BANGALORE: There is still a long way to go for all children in India to dream of living a healthy, happy childhood free from abuse and exploitation. The protection and promotion of child rights in India vis-À-vis the juvenile justice system is an issue that needs to be addressed with much seriousness and concern.

“Justice for Children,” – a Handbook on Implementing The Juvenile Justice (Care and Protection of Children) Act 2000 and the Juvenile Justice Care and Protection of Children) Amendment Act 2006, is an attempt to guide the statutory body under the Juvenile justice system, the child welfare committees while dealing with the web of legal maze of procedural and substantive laws.

Representatives of non-governmental organisations got a sneak preview of the handbook co-authored by Nina P. Nayak and Anuradha Saibaba Rajesh at an informal programme here recently. The venture is supported by Child Fund India and Karnataka State Council for Child Welfare.

According to the authors, the handbook focuses on children in need of care and protection, that is, children who are exploited or abused and abandoned. It is largely based on the provisions of the Juvenile Justice (Care and Protection of Children) Act 2000 and the Juvenile Justice (Care and Protection of Children) Amendment Act 2006 and the Karnataka Juvenile Justice (Care and Protection of Children) Rules 2002. The Constitution of India, other laws relating to children and the international human rights instrument, the Convention on the Rights of the Children are also appropriately referred to.

The predominant aim of “Justice for Children” is to serve as a reference tool primarily for the Child Welfare Committee members in Karnataka and functionaries of the Department of Women and Child Development and itself draws from the experiences of the five-member committee here. Additionally as child protection issues gain increasing awareness amongst the public, the handbook can be useful for anyone working in the area of child rights and protection — be it academicians, activists, voluntary organisations, students, childlines and so on.

Disclosing rape victim’s identity is punishable

6 Nov

6 Nov 2007, 0008 hrs IST,Dhananjay Mahapatra,TNN

NEW DELHI: The Supreme Court has named a rape victim 11 times in a recent judgment, forgetting the self-imposed code put in place through its rulings in 2003 and 2006. Reversing a Rajasthan HC order acquitting a rape accused, the SC ordered the convict to undergo seven years’ rigorous imprisonment instead of 10 years awarded by the trial court.

Both the 2003 and 2006 judgments, written on behalf of the benches by Justice Arijit Pasayat, had an identical paragraph exhorting trial courts, HCs and the Supreme Court not to mention names of rape victims in their judgments, given the ignominy they face in a conservative society like India.

Section 228-A of the Indian Penal Code makes disclosure of identity of a victim in sexual assault cases a punishable offence, which deters the media from making public the name of the rape victim.

However, Justice Pasayat recognised that the restriction did not bar the media from publishing names of the victims while publishing the judgments of high courts or the apex court. So, in both the judgments, he had said, “Keeping in view the objective of preventing social victimisation or ostracism of the victim of a sexual offence for which section 228-A has been enacted, it would be appropriate that in the judgments, be it of this court, high courts or lower courts, the name of the victim should not be indicated.”

Section 228-A of Indian Penal Code is in sync with laws abroad, such as UK’s Sexual Offences (Amendment) Act, 1976 which guarantees anonymity to women who complain of rape. These enactments are meant to encourage rape victims to complain against assaulters without having to facing public glare and the resulting humiliation.

The US, however, is an exception. The Supreme Court there has consistently struck down state laws which prohibit the media from revealing the name of the victim of sexual abuse. However, media organisations there have scrupulously observed a self-imposed code of not publishing the name of the rape victim.

Miles to go

6 Nov

The third National Family Health Survey has immense significance for policymaking in health, nutrition and gender issues.


The report of the third National Family Health Survey (NFHS-3), released in the second week of October, has immense significance for policymakers in health, nutrition, education and gender issues. The NFHS-3 (2005-06) is significant in that it has gone beyond the parameters set by the two preceding surveys, in 1998-99 and 1992-93. And for the first time, the survey interviewed all women (ever-married and never-married) in the 15-49 age group and all men in the 15-54 age group. In earlier surveys, only ever-married women were chosen for individual interviews. The NFHS-3 sample covered 109,041 households, 124,385 women and 74,369 men in the 29 States. According to G.C. Chaturvedi, Director of the National Rural Health Mission (NRHM), the findings of the NFHS-3 are an important benchmark for the NRHM.

The NFHS-3 included testing of the adult population in a community-based survey, the first of its kind, to estimate HIV (human immunodeficiency virus) prevalence in the general population. Surprisingly, the figures dipped sharply, forcing the government to revise its national figures.

The NFHS-3 essentially throws light on the state of India’s health, behavioural attitudes, fertility and mortality. In another first, it provides information on perinatal mortality (stillbirths and early infant deaths), male involvement in the use of health and family welfare services, adolescent reproductive health, family life, education, high-risk sexual behaviour and awareness of tuberculosis.

The shocking parts of the report contain implications for the girl child. India continues to be in the stranglehold of a very strong son preference; the presence or absence of a male child in the family dictates family planning. “Many women prefer not to use contraception and to continue childbearing until they have at least one son,” says the report.

The survey drew out responses of women to domestic violence. More than one-third of the women in the 15-49 age group had undergone physical violence; and 9 per cent of the women in the same age group, some form of sexual violence. Only 6 per cent of women were subjected to domestic violence in Himachal Pradesh, but the figure was 40 per cent or more in Rajasthan and Madhya Pradesh and 56 per cent in Bihar.

As much as 37 per cent of ever-married women had experienced violence at the hands of their spouses and 16 per cent, emotional violence. The survey found that 1 per cent of the women had initiated violence against their husbands; evidently, that was in reaction to violence perpetrated on them earlier.

Slapping was the most common form of violence from husbands; 62 per cent of the women reported physical or sexual violence in the first two years of their marriage. Only one out of four abused women sought help to end the violence. A large majority of them chose to bear it in silence. Alarmingly, the report said that more than half the women in India believed that it was justifiable for a husband to beat his wife. The acceptance of wife-beating was found to be high in Manipur and low in Himachal Pradesh and Uttarakhand.

The good news in the survey is that women waited longer to marry and fertility was on the decline. As a telling example, a domestic worker based in Delhi said she was married off at 15 in her village in Allahabad, conceived at the age of 16 and bore seven children in 14 years. But she was determined that none of her daughters were going to be married before 22. She got her eldest daughter married at 24 and ensured that at least one of her daughters completed college. Such instances are common in urban centres, particularly the metros.

But the bad news is that more than half the women were getting married off before the minimum age of 18. Urban women waited two years longer than their rural counterparts for marriage; the median age at marriage among urban women aged between 20 and 29 was 18.8 years while that of rural women in the same age group was 16.4 years. This, in turn, had an impact on maternal mortality as well as infant and perinatal mortality.

The survey has other revealing facts. For instance, the fertility rate has come down from 2.9 per woman in the NFHS-2 to 2.7 per woman. However, this is seldom appreciated by policymakers, who often speak of a population boom in the country.

Recently, the Supreme Court suggested that women with more than two children should be excluded from the Janani Suraksha Yojana (JSY), or scheme for safe motherhood, which now covers all Below Poverty Line (BPL) mothers. Health Ministry sources told Frontline that they were yet to respond to the suggestion. Initially, the JSY was confined to families with only two children; but when sections among the Left and other health activists pointed out the inherent injustice in the scheme, it was made accessible to all BPL mothers.

Though the fertility rate has come down, replacement levels (two children for two parents) are yet to be reached. The NFHS-3 brings out the fact that the desire to stop childbearing has increased rapidly with the number of living children. Only 3 per cent of women with no living children said they did not want any more children, compared with 83 per cent of women with two children and 90 per cent of women with three children.

The desire to stop childbearing increased with education. The fertility rate decreased sharply by the household’s wealth index as well, from 3.9 children for women living in households in the lowest wealth quintile to 1.8 children for those living in households in the highest wealth quintile. Ninety per cent of women, the survey found, wanted to stop childbearing if both their children were sons, 87 per cent wanted to stop if they had one son and one daughter.

The proportion of women with two daughters and no sons and who wanted no additional children increased from 37 per cent in the NFHS-2 to 61 per cent in the NFHS-3. But this does not indicate that son preference has gone down or that the women themselves are in a position to decide the ideal family size or the number of sons or daughters they would like to have. The motivating reason for wanting a daughter is more religious – fulfilling of the obligation of kanyadaan (giving a daughter away in marriage), which is supposed to enable parents to acquire the highest level of merit or punya.

Knowledge of contraception was found to be almost universal, but more women and men knew about female sterilisation than male sterilisation though the latter is considered to be safer among the terminal methods of contraception. Ninety-three per cent of the men knew about condoms as opposed to 74 per cent of women.

Significantly, even the choice of contraception was influenced by son preference. At 67 per cent, the adoption rate of female sterilisation was the highest among women with two sons. Also, women who had more sons were found to be more likely to be persuaded to go in for contraception. Wealth also influenced contraceptive prevalence; it was almost 68 per cent among women in the highest wealth quintile and 42 per cent in the lowest wealth quintile.

For health activists and women’s organisations who have been crying hoarse regarding informed choices, the survey has dismal news. Only one-third of the women contraceptive users said they were aware of the side effects while only one quarter were informed about what to do in case of any side effects. It was only in Tamil Nadu and Delhi that more than half the women knew what to do in case of side effects.

The survey has also confirmed the worst suspicions of health activists regarding the safety of injectable contraceptives. The NFHS-3 found that among the spacing methods, the discontinuation rates were the highest for injectables (53 per cent), followed by pills and male condoms. For pills, intrauterine devices (IUDs) and injectables, the most common reason for discontinuation were concerns about side effects or health problems.

Another important aspect of the survey relates to child sex ratio, which has dipped since Census 2001. Though the NFHS does not do a head count unlike the Registrar General’s office, its findings regarding the child sex ratio from the sample population are not likely to be very different from the child sex ratio figures that will emerge in the Census 2011.

In the NFHS-3, the sex ratio of the population in the 0-6 age group is 918 girls for every 1,000 boys; this was 927 girls per 1,000 boys according to Census 2001. The under-seven sex ratio in urban areas is the same as in Census 2001, but a decline was seen in rural areas.

On nutritional, maternal and child health indicators, there has not been much improvement. Perinatal mortality, which was explored for the first time, turned out to be rather high at 49 deaths for every 1,000 pregnancies. Such mortality was very high for young mothers and in first pregnancies. It is highest for the rural poor uneducated mother.

While the infant mortality rate (IMR) has gone down from 68 deaths to 57 per 1,000 live births, it is still very high. It is estimated that one in 18 children dies within the first year of birth and more than one in 13 dies before the age of five.

Children of the Scheduled Castes and the Scheduled Tribes are at a greater risk. Even here, there is a gender bias: 79 girls under five die before the fifth birthday compared with 70 boys per 1,000 births. Uttar Pradesh has the highest IMR in the country while Kerala and Goa fall in the category of States with the lowest IMR.

As for maternal health, only 44 per cent of women started antenatal care in the first trimester of pregnancy. The percentage of women getting more than three antenatal visits by the auxiliary nurse midwife (ANM) ranged from 17 per cent in Bihar and Uttar Pradesh to 90 per cent in Kerala, Goa and Tamil Nadu.

The quality of antenatal care is also a major issue. The iron and folic acid coverage for expectant mothers was lower than the national average in Nagaland, Bihar, Arunachal Pradesh, Jharkhand, Uttar Pradesh and Meghalaya. The percentage of women who received two or more tetanus toxoid injections ranged from 40 per cent in these States to 90 per cent or higher in Delhi, West Bengal and Tamil Nadu.

“The thrust of the NRHM is on the mother and child. The southern States are almost on the threshold of replacement level fertility while the northern States have still a long way to go. Our attempt is to get the IMR levels to 30 per 1,000 live births. There is a lot of demand for institutional deliveries but the supply side is weak,” said Chaturvedi. Of the 22,000 sub-centres in Uttar Pradesh, he said, only 7,000 had buildings.

Manpower is another concern. Between 1947 and 1997, there were only 47,000 doctors in Uttar Pradesh, in the private and public sectors taken together. The number of nurses was 30,000 less than what was recommended by the Bhore Committee. Chaturvedi felt that more than money, the motivating factor for the efficient functioning of the accredited social health activist (ASHA) was “recognition”. On the other hand, health activists argue that accredited social health activists need to be given a decent remuneration as most of them hail from poor families, and that there is need for more than just social appreciation.

The findings of the NFHS-3 underscore the need for more convergence among Ministries as it cannot be left to the Health Ministry alone to deal with what is primarily an economic issue. The survey brings out clearly which section of the population is desperately in need of health care. Health issues are not maternal health issues alone. The most commonly reported problem faced by women in terms of accessing health care was the distance to the health facility; 44 per cent of the Scheduled Tribe women reported “distance” to be a major problem.

The percentage of women who have at least one big problem in gaining access to health care declined rapidly with increasing wealth. On the other hand, the dependence on the private health sector continues to be quite high. According to the survey: “The private medical sector remains the primary source of health care for the majority of households in both urban areas (70 per cent) and rural areas (63 per cent) … overall, the private medical sector dominates health care delivery in the country and the use of private doctors and private clinics is the primary source of health care among the rich and poor alike.”

If the “Health for All” declaration, to which India was a signatory nearly 30 years ago at Alma Ata, must have any meaning, it cannot be with the majority of the population depending on the private sector, where health care is affordable to only a few. It cannot also be realisable in a situation of a declining child sex ratio, high IMR and rampant son preference.

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