Nutritional status: Data from the S

darjang Hospital, New Delhi (IV,Mohan, personal communication, 19!show that more boys attend the out·,tients' department compared to girls,there is an overall higher incidencEsevere rfJalnutrition among girls, u~

\ the Gomez scale (Table 1).r--Sen-and Sengupta "{Ronomic .1 Political Weekly, vol. 18, Anr

. Number 855-864, 1983) provide silTdata on the nutritional status from

\ villages of West .8engal (Table 2).r .-Oifferences are more markedmKl

in spite of a better economic level ieating that boys have benefited f

better income levels. The authors 0

study also point out that the exterdiscrimination' sharpens in times atress as for instance was the ca

Visaria (Monograph No. 10, Office (the Registrar-General of India) attributethe current distortion in sex ratio in Indi,

to higher female mortality; the earlieKhanna Study (Wyon, J.B. and GordorJ.E., The Khanna Study, also HarvarUniversity Press, 1971) comes to thsame conclusion.

The life expectancy of females in Indis less than that of males (M 55.1

years, F 5431 years for 1981-1986

The projection for 1986-91 is 57.6 yea•• and 57.1 years for males and femah

respectively. It is interesting to note Itlife expectancy of females was highthan males up to 1911-21 and thereaf1the male life expectancy became high(

Table 1. Nutritional status of children attendingSafdarjang Hospital, New Delhi, 1986.

Age groupNumber'Normal'Degree of Malnutrition percent

percent

1st2nd3rd

0-5 yrs.

7636 M33.731.921.213.2

6056 F

23.930.725.919.5

Biological attributes: The sex ratioat the time of conception is normallybiased in favour of the males. A gradualdecline occurs during the period of ges­tation and many more male embryos areaborted compared to female embryos.This pattern of yreater foetal wastage ofmales is also reflected in the case ofstillborn babies. At the time of birth,males are in excess of females, thoughless dramatically.

FomCllos ,no considered to be the

biologically superior sex because of apair of X chromosomes which protectsthem against the chromosome-linked re­cessive disorders and makes them less

susceptible to infectious diseases (Wal­dron, I., in Lopez, A.D. and Ruzicka,L.T.:Sex Differentials in Mortality, AustralianNational University, Canberra, 1983).

Female infants weigh less at birthcompared to males, but the difference isonly about 100 g. In normal healthy chil­dren, the growth curve of the girls lagsbehind that of the boys except between10 and 12 years, when due to the earlieradolescence spurt in the girls, theirgrowth is faster. After that the boys takeover again.

Shanti Ghosh

The Female Child in IndiaA Struggle for Survival

. The declining ratio of females tomales in India over the last 100 years,

particularly since the beginning of thecurrent century, has been the subject ofmuch speculation and investigation. Atthe beginning of the century, the sexratio (females to 1,000 males) was 972;it showed a progressive decline till 1971,when it reached 930. In the census of1981, it was estimated to be 935 (HealthStatistics of India. 1983). However, lIinaSan (Economic and Politicn/ Wook/y.vol. 21, 497-500, 1986) has pointed outthat such marginal improvement as maybe inferred from this figure had mainlyoccurred in areas that were alreadyshowing indications of improvement in

previous years and that in many of thehard-core districts of adverse sex ratio,the situation was no better.

There are considerable variations with

respect to sex ratio between the Statesof the Indian Union. The only Sfate inwhich the sex ratio is above 1,000 isKeralawith a figure of 1,034. The Statesof Karnataka, Tamil Nadu, AndhraPradesh, Orissa, Jammu & Kashmir andHimachal Pradesh have a sex ratio be­tween 950 and 1,000, and in all the restthe ratios are below 950. In other words,in most of the northern and north-east­ern States, Haryana, Punjab, Uttar

• Pradesh, Assam, Nagaland, Sikkim andWest Bengal, males outnumber femalesby almost 10 percent, in AndhraPfadesh and Karnataka, four percentand in Tamil·Nadu and Orissa two per­cent (An analysis of the situation of chil­dren in India, UNICEF, 1984).

, .

Table 2. Severity of malnutrition in two West Bengal villages.

ShahjapurBoys

9471Girls

9273

Kuchli Boys7952

Girls9075

978 in rural Bengal after the floods.·imilar differences are reported from the

unjab where 74.8 percent girls hadormal nutrition ,compared to 84.9 per­ent boys. Severe malnutrition too was.igher among the girls (The Narangwal:xperiment, coordinated by Rasheedaruque and Carl Taylor, 1984. Theohns Hopkins University Press).

Food intake: Various reports on the,uration of breast-feeding indicatedome preference for longer feeding for·oys (Kelly, N.O., Livinson, F.J., quotedy Miller loc. ciL). Halder and Bhat­

3charya (Fertility and sex sequence ofhildren of Indian couples: Sankhyaeries 6,31, 144, 1969) have shown byn analysis of the National Sample Sur­ey data that the interval between births

; shorter after the birth of a girl than '"fter the birth of a boy, indicating a shor-If period of breast-feeding for the!male child, resulting in an earlier onset

f ovulation and conception. Similar ob­

~rvations have been reported by Khan \lC.ciL).Kumar also noted that more boys ~ere being breast-fed at four monthsI)mpared to the girls (ICMR Ford Foun­3t;on Workshop on Child Health,

~83). Among certain groups, the cere­ony of giving the first solid food, An­

~pras.ha~a is earlier for girls than for'ys, indicating a shorter duration of:clusive breast-feeding. Miller has re­~wed the socia-cultural and historical'Iuences on sex differentials in North

jia in matters of nutrition, food intake,

:>rbidity and mortality and has referred

\ girls as the endangered sex (Miller,

~., The Endangered Sex, Cornell Uni­rrsity Press, Ithaca and London, 1981).Khan and colleagues (Health Prac-es in Uttar Pradesh, Operation Re­

'arch Group, Baroda, 1986) report afinite preference favouring boys withjard to access to milk, eggs, butter,:. in the family diet though there was

.\Isuch difference between children ofiiIll.two sexes with reQard to cereals and

Mortality: Several studies and reportshave highlighted the higher mortalityamong females, except in the first weekor month of life, contrary to developed

countries, where male mortality is higHerthroughout life, resulting in a lower lifeexpectancy for the male.

According to the Vital Statistics Divi­

sion, Office of the Registrar-General ofIndia, 1983, the infant mortality differen­

t tial between the sexes is as indicated in\ Table 5.~ EstlrTImes of infant mortality for 1982suggest that the gap between the male

and the female mortality rate is being

male children received care in the firsl

24 hours of their terminal illness (Kiel­mann, A. et al., Child and maternalhealth services in rural India: The

Narangwal Experiment, The Johns Hop­kins University Press 1983).

Chakraborty et al (lnd. J. Med. Res.68 (Suppl.) 1978) studied the health \

status of the rural population of Singur in ("1'1975. On a total population basis, total :sickness was 24.9 percent in females ascompared to 22.0 percent in males and ;

yet more male children attended the t.r

hospitals and clinics and male hospital ladmissions too were higher.

During an observation period of oneweek at a primary health centre, Khan(Ioc. ciL) observed that 43 boys at­tended as compared to 15 girls. Dis­crimination against girls increased withtheir number in the family. This was par­ticularly true of high caste Hindu familiesbecause of the prevalence of dowry. Be­sides, girls were taken to less qualifiedvillage "doctors". Cowan reported evi­dence of increase in discrimination

when there was more than one girl in thefamily (Cowan, B., personal communi- "

~...(

cation).

5355

39

55

69

7

8

Below Undernutrition

4th degree Index

39

44

1948

Below3rd degree

Table 3. Percentage distribution of ailing male and female non-adults.

1

234

M

FMFMFMF > -

.r

No treatment30.858.118.762.113.027.87.616.0

Table 4. Morbidity profile in boys and girls./

RuralUrban

M

FMF

Bel~1 yr.

53.052.053.555.51year

52.854.955.458.42 years.

57.258.354.8.57.6 .-~

greater access to fruits and vegetablesoutside the home and they usually hadesome pocket money for school. Girls,

being mostly at home, had less accessto these.

Sex differentials in morbidity andaccess to health care: There is consid­erable direct and indirect evidence of a

higher morbidity among girls eventhough hospital and clinic attendance re­cords show a preponderance of boys.This is even more marked for iMoor ad­

missions compared to outdoor patients.In Safdarjang Hospital at Delhi, for

example, male admissions are around65 percent and female around 35 per­cent of the total. In reports from differentparts of India, the ratio varies from 2.1: 110 1.3: 1, the latter being from the south.

Dandekar (quoted by Asok Mitra in

India's Population, 1978) in a survey inrural communities in 1957 found that the

percentage of children getting no medi­cal treatment was higher in females(Table 3)

In tffir' Registrar General's country­wide survey on Infant and Child Mortal­ity, 1979, the percentage of children sick

due to the top 10 causes was higher infemales as shown in able 4.

In Narangwal, Punjab, 8 percent of

female children relative to 64 percent

Below

2nd degree

Below

1stdegree