Gender Disparity in Child Care in India:



Gender Disparity in Child Care in India: Findings From Two National Family Health Surveys

Parveen Nangia* and T.K. Roy**

Abstract

This paper aims to assess gender discrimination in child-care practices in India and its states. It also investigates whether this discrimination is declining with time or not. For this purpose data are taken from first two national family health surveys (NFHS) conducted in 1992-93 and 1998-99. The indicators of child-care considered in this study are: immunization of children, duration of breastfeeding, health care of sick children, nutritional status, mortality of children in different ages, and their educational attainment. A gender disparity index is prepared for each indicator and states are ranked on the basis of this index. States are also ranked on the basis of other indicators of socio-economic development and relationship between gender disparity and socio-economic indicators is explained.

Results of the study show that gender disparity has declined in only some spheres of child-care. For example, at the national level, difference in the proportion of male and female children who did not receive any vaccination declined between first and second NFHS. The male-female difference in the median duration of breast-feeding remained at the same level. Differences in neonatal mortality have reduced, whereas differences in infant and under-five mortality are almost at the same level. The gap between proportion of male and female children age 6-14 attending school and literate children aged 10-14 has also declined between the two surveys.

Gender inequality exists in every country, but it varies in degree. According to the Human Development Report of 2006, the three top ranking countries in the gender-related development index (GDI)[1] are Norway Iceland and Australia. Norway tops with the GDI value of 0.962 in the list of 177 countries. A GDI value of 1.00 indicates a maximum achievement in basic capabilities without any gender bias. India ranks 126 in this list with the GDI value of 0.0.591, showing that women in the country suffer the double deprivation of gender disparity and low achievement (UNDP, 2006). From the successive census results, female disadvantage is evident in India from the constantly declining sex ratio, lower literacy rate of females than males and lower participation of women than men in the work force, e.g. the sex ratio (females per 1000 males) declined from 972 in 1901 to 933 in 2001. The male literacy rate for 2001 was 76 percent compared with 54 percent for females. In the same year the work participation rates for males and females were 52 and 26 percent, respectively.

In the absence of large scale male selective migration, excessive female mortality in any country is one of the important factors for determining low sex ratio. A number of studies have found higher female mortality than males in many of the developing countries. Coale and Banister (1994) have shown that the abnormal sex ratio of China's population is due to excess risk of female mortality at early ages. D'Souza and Chen (1980) found that in the Matlab project area of Bangladesh, females had 60 percent higher risk of mortality than males after the neonatal period. Hill and Upchurch (1995) studied data from a large number of countries and compared their sex differentials in mortality decline with North-West Europe. They concluded that girls in the developing countries have a higher risk of mortality than boys for a given level of mortality. Female disadvantage is maximum for girls age 1-4 years, where care is more important than genetic factors in determining mortality risks. According to the Sample Registration System of India, under-five mortality for males and females is 25.6 and 27.5, respectively for 1991. Das Gupta (1987) in her study of rural Punjab found that sex bias is not generalised, but focused on higher birth order girls.

Waldron (1987) postulates that higher female mortality in childhood may be either because of certain specific causes, which affect the fairer sex more or due to gender discrimination in nutrition and health care. Many studies have focused upon the existence of gender disparity in nutrition and health care of children (Wyon and Gorden, 1971; Chen et al., 1981; Sen and Sen Gupta, 1983; Das Gupta, 1987). According to Hill and Upchurch (1995) female mortality disadvantage is not related to nutritional status (anthropometric measures) and sickness rates, rather it shows a positive association with relative lack of immunization coverage for girls and a negative relationship with female disadvantage in treatment of diarrhoea. According to Das Gupta (1987), excess female mortality is a part of family building strategy, where girls are considered as burden and boys as resources.

In this paper an attempt is made to find out the existence of gender disparity in growth and developmental opportunities for children in India and changes in it during the 1990s. The disparity is assessed in child-care, nutritional status of children, child mortality and educational attainment at the state level. The correlates of gender disparity in developmental opportunities have been worked out with the social development, housing conditions, and female autonomy. The data have been procured from the all India and state level reports of the first and second National Family Health Survey (NFHS), conducted in 1992-93 and 1998-99, respectively.

DISPARITY IN CHILD CARE

The initial growth of a child depends upon the duration and frequency of breastfeeding it receives, since the breast milk provides important nutrients to infants and young children and protects them against certain infections. Although the practice of breastfeeding is universal in India, some studies have pointed out gender differences in duration of breastfeeding of children (Wyon and Gordon, 1971; World Bank, 1991). According to these studies female infants are breastfed less frequently and for shorter durations than male infants, their weaning also starts earlier and they are given lower quality foods. The results of the National Family Health Survey (NFHS) have also shown that the median duration of breastfeeding for male children is nearly two months longer than female children. It is longer by about a month for both males and females in NFHS-2 compared to NFHS-1 (Table 1). Gender difference in duration of breastfeeding is particularly high in the states of Assam, Punjab and Sikkim, where male children are breastfed for more than six months longer than female children. On the other hand, in the states of Madhya Pradesh, Jammu & Kashmir, and Karnataka female children are breastfed for a slightly longer duration. The least gender disparity is observed in Bihar, where median duration of breastfeeding is the same for both male and female children. For many of the states, median duration of breastfeeding in NFHS-2 is considerably different than NFHS-1 (state level data for NFHS-1 is not presented in this paper).

Children are required to be immunized against some of the childhood diseases, which can turn out to be fatal in the absence of timely vaccination. To reduce the incidence of morbidity and mortality, Government of India has made arrangements for free vaccination services of the required doses of BCG, DPT, polio and measles vaccines to protect children against tuberculosis (BCG); diphtheria, pertussis (whooping cough), tetanus (DPT); polio and measles respectively. Under the Universal Immunization Programme, Government targeted to cover at least 85 percent children against these vaccine preventable diseases (Ministry of Health and Family Welfare, 1991).

Table 1

Gender disparity in health care in India, 1998-99

| State |Percent of children (12-23 months) who |Median duration of |Percent of children under three years of age who |Child care |Rank |

| |received |breastfeeding |were |disparity index | |

| | | | |(CDI) | |

| |All vaccinations |No vaccination | |not taken to health |not treated for | | |

| | | | |facility when sick |diarrhoea | | |

| |Male |Female |Male |Female |Male |Female |Male |

|CDI |1.000 |-0.261 |-0.251 |-0.240 |0.236 |0.152 |0.120 |

| | | | | | | | |

|NDI | |1.0000 |0.110 |0.201 |-0.658** |-0.229 |-0.287 |

| | | | | | | | |

|MDI | | |1.0000 |0.156 |-0.210 |0.109 |-0.086 |

| | | | | | | | |

|EDI | | | |1.0000 |-0.560* |-0.447* |-0.779** |

| | | | | | | | |

|SDI | | | | |1.0000 |0.603** |0.616** |

| | | | | | | | |

|HDI | | | | | |1.0000 |0.661** |

| | | | | | | | |

|FAI | | | | | | |1.0000 |

Level of significance: * 0.05, ** 0.01

CDI - Disparity in child care NDI - Disparity in nutritional status

MDI - Disparity in under-five mortality EDI - Disparity in educational attainment

SDI - Level of social development HDI - Housing condition

FAI - Female autonomy

The nutritional disparity is strongly related to social development. Those states which have achieved a higher level of social development show a lower level of gender disparity in nutritional status of children. But nutritional disparity is not related to level of living or roughly speaking the economic status. Higher level of social development also reduces educational disparity. Educational disparity is also reduced with increasing level of living and growing women’s autonomy. The educational disparity is also likely to depend on the availability of schooling facilities, particularly for the girls, type of agricultural development requiring varying degrees of child labour, etc. Disparity in child care and child mortality does not show a strong correlation with any of the developmental indicators.

CONCLUSION

The study reveals that during 1992-93 and 1998-99 India experienced a positive change in social development and level of living. However, there exists a substantial difference in the development opportunity of male and female children. The disparity exists in the child care practices as well as in the opportunities for educational attainment. Though there is a slight decrease in child care disparity and educational disparity, nutritional disparity has increased in the country. The disparity exists in varying degrees in all the states and is noticeably high in the larger states of Bihar, Uttar Pradesh, Orissa and Rajasthan. Increasing social development may help in reducing gender disparity in nutritional status of children. Although educational disparity is strongly related to social development, level of living and female autonomy, it is related to government policies towards child education and implementation of these policies.

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* PT Faculty, Department of Sociology, Laurentian University, Sudbury, Canada.

** Ex-Director, International Institute for Population Sciences, Bombay 400 088

[1]GDI is constructed to show overall achievement of women and men in three dimensions of human development - life expectancy, educational attainment, adjusted real income - after taking note of inequalities between women and men.

[2]Scheduled caste (SC) and scheduled tribes (ST) are such castes, races or tribes which have been recognised by the Government of India as socially and economically backward. The Constitution of India has conferred upon them special protection against social injustice and all forms of exploitation.

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