Sex Differentials in Child Health and Nutritional Status in Punjab

1
Sex Differentials in Child Health and Nutritional
Status in Punjab

• Suresh Sharma
• Population Research Center
• Institute of Economic Growth
• University Enclave, Delhi-7

2
Punjab A Brief Profile

• Situated in the North West of India
• Area 50362 Sq. Kilometers.-1.57 of countrys
  area
• Population as per 2001 census 24.3 million 2.37
  of Indias population bigger than at least 150
  countries of the world
• Punjabs SR of 876 one of the lowest in country
• Its CSR OF 798 is perhaps lowest in the whole
  world
• One of the most prosperous states in India-only
  12 of population below poverty line as against
  36 for India. Has a very high per Capita Income
• The State played a major and critical role in the
  success of Green Revolution-still contributes
  64.1 of wheat and 42 of rice to the central
  pool.

3
Child Sex Ratio in Punjab and its Districts
1991-2001
4
(No Transcript)
5
Questions

• First, are boys more likely to have complete
  vaccination coverage than girls?
• Second, are girls more likely to suffer from
  Diarrhoea? Are boys more likely to receive care
  for episode of Diarrhoea, and are they more
  likely to receive better care than girls?
• Third, are girls more likely to be malnourished
  than boys? If so, does the extent of pro-male
  bias depend on various socioeconomic and
  demographic factors?

6
Methods of Analysis

• First part of the analysis, all indicators of
  gender difference are measured either as
  Percentages or ratio
• Second level of analysis, we estimate the effect
  of the sex of the child on various outcomes of
  gender difference, controlling for the
  demographic and socioeconomic characteristics of
  women
• Nature of the dependent variable (0, 1) ,
• using binary logistic regression

7
Areas of female Discrimination

• Nutrition and food
• Medical and health care
• Education Opportunities
• Feeding practices
• Household chores
• Distribution of family resources
• Outright Neglect of girls
• Female Infanticide
• Sex selective abortions

8
Sex Differences on these Dimensions

• School Attendance
• Immunization
• Prevalence of Diarrhoea and Treatment
• Treatment Seeking for Illness
• Nutritional Status

9
(No Transcript)
10
Percentage of Children Aged 12-35 Months, by
source of Information and Specific Vaccination,
According to the Sex of the Child
11
(No Transcript)
12
(No Transcript)
13
of Children under Age 3 Years Classified as
Undernourished on three Anthropometric Indices of
Nutritional Status by Sex of the Child
14
Anaemia among Children
Children age 6-59 months who are anaemic ()
15
(No Transcript)
16
Reason for Son Preference and Daughter Neglect

• Economic Utility of Sons
• Sons are more likely than daughters to provide
  family labor on the farm or in the family
  business, earn wages, and support the parents
  during old age
• Upon marriage, a son brings a daughter-in low
  into his family, and she provides additional help
  around the house as well as economic rewards in
  the from of dowry payments
• Although a daughter provides help in household
  work before marriage, she is considered to be an
  economic liability by her parents because of the
  dowry payment demanded by the grooms family, as
  well as the high cost of wedding which is
  generally the responsibility of the brides
  family to bear
• Sons plays an important role in local power
  struggles
• Socio-Cultural Utility of Sons
• For Continuation of the family line
• Historical Reasons

17
Second level of analysis

• For the analysis of the undernourished children,
  the dependent variable was equal to 1 if the
  childs z-score below 2 standard deviation units
  (under-nourished child) and equal to 0 if a
  z-score falls above 2 standard deviation (well
  nourished child).
• Due to the small number of cases the effect of
  the sex of the child on the choice of a treatment
  alternative is not assessed in a regression
  model.
• Coefficients are estimated using the maximum
  likelihood method (MLM) of estimation.
• The independent variables are recoded into
  categorical indicator variables. One value of
  each variable is chosen to be the reference
  category.The reference category was the first
  category of the variable
• For case of interpretation, the results are
  discussed in terms of the odds ratios. The odds
  ratio is a measure that approximates how much
  more likely,(or unlikely) it is for the outcome,
  in this case,
• A variable was considered significantly
  associated with mortality when its p value was
  below 0.5.

18
Logistic Regression Analysis of the Low
Weight-for Age as a function of selected
Explanatory Variables
Note p
19
Logistic Regression Analysis of the Low
Height-for Age as a function of selected
Explanatory Variables.
Note p
20
Results (Both Models )

• The Odds ratios indicate that in Punjab girls are
  more likely to be underweight (OR1.41 pand stunted (OR1.32 p
• In both model, preceding birth interval of more
  than 24 months are associated with lower odds of
  being underweight and stunted.
• Fathers education, young age of mother at the
  time of child birth (20-29 years) and rural
  residence is also associated with lower odds of
  being underweight.
• In both models, higher age of child (12-23 and
  24-35) is associated with underweight and
  stunting.
• This may be due to positive effect of
  breastfeeding on the nutritional status of
  children.

21
CONCLUDING POINTS

• Analyses shows gender bias in treatment for
  immunization and giving nutrition health to boys
  specifically.
• Discrimination for girls and favors to boys is
  inheritably taught to the parents.
• Studies reflect that the people living in both
  rural and urban parts of Punjab prefer sons than
  a daughter also nutritionally girls have lower
  value than boys.
• Parents of a girl child give less time and
  inferior care in terms of food allocation to
  girls where as on the contrary boys are given
  more extra nutritional value food and care.
• Even the living status of a family does not
  matter in giving preference to a boy child,
  whether the family is rich or poor the low
  nutrition food is confined to a girl child only.
• The sense of greater concern and responsibility
  can be seen among the parents of a boy child, on
  the other hand girls child is uninterested and
  managed.

22
Thank You
23
Any Reason for Daughter Preference?

• According to Hindu tradition parents can earn
  religious merits by selflessly giving away their
  daughter in marriage According to scriptures,
  Kanya Dan or the gift of a virgin in marriage,
  is one route salvation
• Provide more emotional satisfaction to parents
  than sons
• Daughters needs to cry at the death of their
  parents?

24
Implication of Low and Falling Sex Ratio in Punjab

• Have the living conditions of the females of the
  females in general and young girls in particular
  deteriorated overtime?
• Has there been a greater undercount of females or
  an over count of males in the census?
• Has the decline in death rate continued to be
  favorable to males?
• Has the SRB become more favorable to males in
  recent rears?
• Is the practice of female infanticide and
  foeticide in Punjab substantially Responsible for
  the shortage of girls?