1. Assessment of Sex Ratio (0-6 yrs.) & Perceptions on PCPNDT Akhilesh Bhargava Director-SIHFW, Jaipur

3. Sex Ratio CountrySex Ratio India933 China944 USA1029 Indonesia1004 Brazil1025 Pakistan938 Bangladesh951 Japan1041 Russian Fed.1140 Source:World Pop. Prospects, mid year estimates, 1998

4. Sex Ratio: India YearNo. of Females 1901972 1911964 1921955 1931950 1941945 1951946 1961941 1971930 1981934 1991927 2001933

5. Sex Ratio: India (1901-2001)

6. Child Sex Ratio(0-6), 2001, Rajasthan

8. Sex Ratio (Females per 1000 males) Total PopulationChild population in the age group 0-6 Population aged 7 and above 199120011991200119912001 India927933945927923935 Rajasthan910922916909908925

10. Study on Sex Ratio assessment & Awareness on PCPNDT Act Conducted by: SIHFW, Jaipur

11. District Selection criteria: Sex Ratio(2001) Best & Worst Sri Ganganagar (-42) Jhunjhujunu(-33) Alwar(-26) Pali(+31) Jaisalmer(+16)

12. Sample size: District CHCPHC SC Village PHC CHCPHC

13. Respondents Appropriate Authority Secy.-FW Dir. -RCH Collector CMHO BMHO Health PMO RCHO MO DPM BPM Health workers ASHA/ AWW Private Law & Order SP BDO DLR Advocates Community NGOS PRIs Individuals

14. Respondents:2850 Pvt. clinics : 26 District level:130 Health. Workers: 226 ANM: 40 ASHA: 58 AWW :78 LHV :7 Med. Officers: 78 Govt. :52 Private :26 PRI :43

15. Observations District Authorities Collector SP RCHO CMO PMO BDO BPM

16. Areas with low sex Ratio 26.3% unaware 26 % said ratio has increased 47.4 % affirmed increase

17. Reasons: Increase/ Decrease Increase Preference for Boys:68% Decrease Govt. schemes for Girls:33%

18. Knowledge of penalty on misuse of technique in PCPNDT Act N=130 Penalty For Providers :74 -88 % For Users:60-66 %

19. Misuse : Whose Responsibility 60 % of Dist. Authorities hold Medical Officers Pregnant woman + Motivator, and Husband / R elative Responsible for Misuse of Technique

20. Reasons for using USG Indications: Detection of Cong. Anomalies:82% H/o Multiple Abortions:53% Contraindications: Sex Determination:80%

21. Observations Health Workers(N-183) LHV ANM ASHA AWW

22. Understanding of referral Criteria:65-87% Bleeding Delay in Delivery Placenta expulsion delayed

23. Enquiry by Pregnant Woman on Sex determination centre »ANM:87% »ASHA:100% »LHV:67% Response to query Illegal »ANM:86% »ASHA:87% »AWW:87%

24. Awareness on Declining Sex Ratio: 81% ANM:90% ASHA:75% PRI:91% Responsibility Society:50% Woman :28%; 5-10% accuse Doctors Reasons: Extension :96% Economic: 80% Religious:63%

25. Consequences of declining Sex Ratio: Health workers feel Gender Imbalance: 96% Gender violence/ Crime: 82%

26. Reasons for female feticide Male :85 Dowry:70% Misuse of technique:60-80%

27. Awareness of Act Act-80% Aware (AWW-65%) Appropriate Authority- reasonable understanding Undergoing sex determination is punishable ANM-:95% ASHA:93% AWW:93% LHV:100% PRI:97% A healthy Reflection of awareness

28. Community perception

29. Distribution of Respondents by Sex

30. Age, sex and urban: Rural differential

31. % of 0-6yr. Children in area 2850 Houses, M-2432, F-2276, SR-935

32. Preference of pregnancy outcome Households:2850 Pregnant women :384 (14%) Preference:% 16.7 36.2 47

33. USG & Pregnancy Undergone USG:20.1% Who asked:Doctor (53.2%) Where:Govt. facility (52 %) :Private (20%) Why Abnormality:2.6 % Fetal position:15.6 % Age 35+: 6.5 % Sex Determination: 26 %

34. Sex and age of Urban/ Rural respondents

35. Societal perceptions and some healthy observations-male respondents

36. Societal perceptions and some healthy observations-Female respondents

37. Why are preferred

38. Desire to have Male child and efforts made Male »Rural:10.65 »Urban :8.9% Jhunjhunu tops with 16. 2 and 12.5% Female »Rural:11% »Urban:9.4% Who do they Contact »MaleUrban:Witchcraft/ Ledger man58% :RMP23% Rural75 & 25 »Female- Witch craft: Urban: 100% Rural- 62% RMP : Rural 12.5% 62

39. Some more Observations Rural /Urban, Male/ Female : Aware of Sex Detection – Illegal (R -81,U- 90%) Aware of PCPNDT - (R-50, U-60%) USG after 2/3 Girls Rural - Male/female15% Urban – Male-20% /Female-18.07% Gender imbalance leads to Sexual crimes M/F, R/U66-74%

40. Society to understand : Female Feticide illegal R/U, M/F 80% Boys and Girls are Equal 79-90%

41. Medical Officers on PCPNDT Awareness 100% Awareness of A/A85% Awareness on Penalty 84-90% Awareness on Committee Government 60% Private 85% Reasons for decreasing Sex ratio GovernmentSociety 69% Doctors 3.8% Private Society 54% Doctors 3.8%

42. PCPNDT Act : Some Punctuations Availability of Act at the Center Government 33% Private 89% Display Government57.7% Private 69.2% Filling of F Form Government –PW7.7% Private –PW92.3% Record (2 Yrs ) Government 3.8% Private 34.5%