Numbers can lie and that is why it is too early to celebrate Haryana’s improving child sex ratio

Sonam Ahlawat from Barhana village in Haryana’s Jhajjar district delivered her second daughter in late December 2016. The 21-year-old mother is now waiting for the government to organise a kuan pujan for the newborn baby. A kuan pujan is a ritual in which a family worships the well that is their source of water in celebration of the birth of a baby boy. The Haryana ministry of women and child development started organising kuan pujans for births of girl children across the state as one of many activities under the Beti Bachao Beti Padhao yojna, Prime Minister Narendra Modi’s pet project aimed at ending sex-selective abortions and infanticide and at advancing education for girls.

“Extending kuan pujan to girl child creates awareness among people that girls are as important as boys in the society,” said a government official in charge of women and child development in Jhajjar, who did not wish to be identified. “This, combined with other awareness activities, has helped in increasing sex-ratio at birth in the district.”

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At 774, Jhajjar had the lowest child sex ratios among all districts in India in the census of 2011, which put it on the list of 100 focus districts where the Beti Bachao Beti Padhao yojna is being implemented.

But none of these schemes have reached new mothers in Barhana like Ahlawat.

The Haryana government has been claiming tremendous success through Beti Bacho Beti Padhao in improving the sex ratio in districts like Jhajjar and across the state. On January 6, Chief Minister Manohar Lal Khattar said that the sex ratio at birth in the state had crossed 900 in 2016 – that is, 900 girl children had been born for every 1,000 boys. Similarly, in January last year, he said that the sex ratio at birth in 2015 was 903. Both times, the chief minister compared the numbers to the child sex ratio recorded in the 2011 census of 834.

There are two counts on which Khattar’s statements are misleading. The first is that he compared data from civil registrations of birth to census data.

“Data from the census rounds cannot be compared with the civil registration system,” said Arbinda Acharya, consultant demographer with the United Nations Population Fund. “The methodology of collection of data is entirely different.”

As Acharya elaborated, a census is carried out once in 10 years by collecting data through door-to-door surveys. Civil registration, however, is a record of annual data of births and deaths.

“Scientifically, we cannot compare the two,” Acharya emphasised.

Data disparity

The data elements of the two systems are also different. Data of from the 2011 census that Khattar cited is the child sex ratio – the number of girls per 1,000 boys between ages of zero and six. The numbers for 2015 and 2016 that he cited are the sex ratios at birth – the number of girls born per 1,000 boys. Sex ratio at birth does not account for discrimination of girl children in nutrition and healthcare, and therefore their mortality by the age of six.

Secondly, comparing sex ratios at birth over just two consecutive years – 903 in 2015 and 900 in 2016 – cannot provide any indication that it has improved and stabilised.

“It requires a few years to see if the population trend has indeed changed,” said Acharya. “Haryana has shown improvement, but we have to see if this is sustained.”

Of all the methods to determine sex ratio, the most definitive is a census.

“Sex ratio at birth and child sex ratio are both important to know the trend in the society and an annual estimate can be made through birth registries,” said Amulya R Nanda, former Registrar General and Census Commissioner of India. “However, every child is not registered. Usually 60-70% of the deliveries are registered. Therefore census is the most reliable method because it is most rigorous.”

Nanda, who also served as secretary at the union health ministry, said that birth registries can be considered as reliable as a census only if when 90-95% of births are registered.

“To know if Haryana has definitely moved to a better sex ratio, we have to wait for Census 2021,” he said.

The Haryana government has also been issuing notices to Auxiliary Nurses and Midwives or ANMs and to Accredited Social Health Activists or ASHAs of areas with low sex ratios at birth. Scared of being pulled up, the health workers are now insisting that families with newborn girl children register their births but have not applied the same rigour in getting boy babies registered. This skewed registration also contributes to the improvement in the sex ratio at birth in recent months.

There are various sources for the data at village level which ultimately feed into district and state level data. Besides the civil registration system, ANMs also collect data and are supposed to record every birth in their respective areas. In Jhajjar, the civil registration system for 2015 was showed that sex ratio at birth was 850 in the district while the ANMs’ data for the same year was 834. The disparity exists because of the difference in methodology – ­people have to register the birth of their children in the civil registration system while ANMs’ track childbirth from the pre-natal stage through to deliveries. Nanda said reliability of the two sets of data differs because in some areas the civil registration system is more robust and others the ANMs are more efficient.

If Jhajjar has one of the poorest child sex ratio track records, then Barhana where Ahlawat lives has one of the worst records among its villages. In 2011 census recorded the sex ratio in Barhana at only 378. Preference for a male child is apparent among the residents of this village where the promised Beti Bachao Beti Padhao initiatives like kuan pujans are yet to begin.

“We do not have a problem that our second child is also a girl,” said Ahlawat’s mother-in-law. “But now we will have to try for the third child because there has to be at least one son for every couple. I hope the next child is not a daughter. It is too costly to bring up children these days.”

Health officials say that they have been organising education and counseling across Jhajjar. “We conducted several seminars in Jhajjar in the past two years,” said Ramesh Dhankhar, chief medical officer of the district. “Through them, we counseled people regarding importance of girls and women. These seminars included ASHAs and ANMs, women in reproductive age-group and their families. These have been successful and have brought down preference for male child in the district.”

While health department data shows that the government organized 25 such seminars, few people have been to one. Neither Ahlawat not the nine ASHAs and 12 ANMs in Jhajjar have been part of any seminar or counseling. “I have never been told about any awareness activity,” said an ASHA worker who did not want to be identified. ”We have heard about kuan pujan ceremony when the second girl child is born in a family. But if Ahlawat’s ceremony happens, it will be the first in my area.”

Inherent biases

Savita, secretary of the Haryana chapter of the All India Democratic Women’s Association, said that the government displays inherent bias against women even in its Beti Bachao Beti Padhao campaign material. She describes an advertisement aimed at preventing sex selective abortion that was a song in which an unborn girl appealed to her mother to not kill her. “The tone of the ad suggested that the mothers kill their girl child and only they can stop it,” said Savita. “This was totally anti-women. Mothers have to abort under pressure from husbands and in-laws. Our interactions with women show that they want to give birth to their children irrespective of gender.”

Health officials also say they have been strictly implementing the Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994. In 2015, the government conducted the first ever raid on an ultrasound clinic in Jhajjar for determining the sex of foetuses illegally. In 2016, officials raided 12 such clinics. “We have raided 13 clinics under PCPNDT,” said a health official. “Out of them, five were in Delhi and one in Uttar Pradesh where residents of Jhajjar went to get tested. The rest were in the district only.”

However, there have been no convictions yet in any of the cases filed as a result of these raids and all the accused are out on bail.

“We also found same people running the show in different areas,” said the health official. “Once out on bail, the accused start to operate from somewhere else. In two instances, we saw the same technician involved in sex selection, who we had caught earlier. Without stronger implementation of laws and convictions, such incidents cannot be handled.”

Women activists say that without a long-term strategy, improvement in sex ratio of the state will remain a dream. “We appreciate efforts of the government under the PCPNDT Act,” said Jagmati Sangwan of All India Democratic Women’s Association. “But this is a small part of the big picture. Until the mindset of people is changed, women become economically independent, and safety and security for them is ensured, these gains will not sustain. Haryana government is making big claims too early.”

This reporting project has been made possible partly by funding from New Venture Fund for Communications.