Jhunjhunu and Sikar had the worst child sex ratio of Rajasthan’s 33 districts as per Census 2011. But policy intervention has significantly helped the cause since.
Jhunjhunu/Sikar: It’s an usual scene inside one of the two maternity wards at the Bhagwan Das Khetan government hospital in Jhunjhunu. Of the 13 women, all of whom delivered in the last 72 hours, some are feeding their newborn while the men are trying to pacify their crying babies.
In this part of Rajasthan, what’s unusual, though, is that all the women in the ward have given birth to girls.
Such a scene was a rarity earlier here in the state, notorious for its abysmal child sex ratio of 888 girls born per 1,000 boys, as against the national average of 943 girls born per 1,000 boys, according to Census 2011 data.
“Not anymore. There are many days in a month that all new born in the ward are girls,” says Dr Mahesh Karwasra, Information Education and Communication coordinator at Jhunjhunu’s Medical and Health department.
Changing attitude
As per Census 2011, of the 33 districts in Rajasthan, the child sex ratio (CSR) — counted in the 0-6 age group — was the worst in Jhunjhunu and Sikar, a neighbouring district.
In Jhunjhunu, 837 girls were born per 1,000 boys, while the figure stood at 848 girls per 1,000 boys in Sikar.
The sex ratio at birth (SRB), however, has been on the rise every year since 2013, according to Dr Jagdish Prasad, coordinator, Rajasthan State Resource Centre for Women.
As of March 2018, the SRB increased to 949 girls per 1,000 boys in Jhunjhunu while in Sikar its 947 per 1000 boys.
CSR reflects after six years in the Census, whereas SRB is evaluated annually.
“If the sex ratio at birth keeps increasing every year and the trend is maintained, it will result in an overall increase in child sex ratio also,” says Prasad, who attributes the growth to a slew of measures.
“Intense awareness drive by the state government, strengthening institutional delivery and frequent monitoring has slowly resulted in changing the attitude of families towards girl child,” he says.
‘Daughters are like Laxmi’
Surekha Devi, a frail 25-year-old housewife, breaks into a shy smile when asked if she has any children.
“Ek hi hain. Ladki hain. Kavita (I have one. A girl. Kavita),” she says, outside her small one room house in Katrathal village in Sikar.
Surekha says both she and her husband, a farm labourer, had wanted their first born to be a girl. Their prayer was answered this August. “Daughters are like Laxmi (the Hindu goddess). I want to make her a doctor,” says Surekha.
Till a few years back, Surekha’s confident reply would have raised eyebrows in her village. Not anymore. A few metres away from Surekha’s house, 60-year-old Barji Devi is playing with her one-and-a-half-year-old granddaughter, the youngest of her five granddaughters and two grandsons.
“Without the girls, who will tie Rakhi to my grandsons,” she asks.
A skewed demography might not be an electoral issue in the state, which goes to poll on 7 December, but the joint effort by the Centre and state government is showing results on the ground.
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The turnaround story
After the 2011 Census, which placed Rajasthan among one of the worst performing states in CSR, there was a lot of scepticism, says Prasad, who is also the director of the state Women and Child Development Department.
A robust data of deliveries in government as well as private hospitals and clinics was also not available.
“In the absence of record, it was difficult to keep track. Then there was the issue of nomadic tribes present in the state,” says Prasad.
“How do we keep a tab on them? But we slowly addressed these issues and brought them under our monitoring system.”
The state government widened their awareness and outreach campaign. A host of incentives introduced by the state and Central government also played a big role in changing the narrative.
This included the Rajshree scheme, introduced by the Vasundhara Raje government in 2016, under which the family of a girl born in a government hospital gets Rs 50,000 in six installments till she is 18.
The Centre’s Janani Suraksha Yojana, under which pregnant women from poor families are given cash of Rs 1,400 for delivery and post natal care, and the Beti Bachao Beti Padhao programme also played a part in the turnaround. Under the latter programme, state governments are allocated funds for creating awareness about educating girls.
School-going girls are also given a cycle by the state government.
In Jhunjhunu, government representatives now personally visit and congratulate a family where a girl child is born.
“These are small measures but have an impact,” said Karwasra.
Stringent enforcement
Campaigns and schemes aren’t enough, though. In Rajasthan, like in neighbouring Haryana, running an ultrasound clinic for sex determination was a profitable business till just a couple of years back.
“The strengthening of the PCPNDT Act and its strict enforcement broke the back of this profitable business. It prescribes a three-year jail term for anybody caught conducting or prescribing sex determination test, besides a fine of Rs 10,000,” said Karwasra.
The PCPNDT Act was enacted in 1994 to prohibit pre-natal diagnostic techniques for determination of sex of the foetus. The law was amended in 2003 to make it more stringent. Violation of the law is punishable with three-years jail term and a fine of Rs 10,000.
The enforcement wing of the state’s medical department also started decoy operations in 2012 under which Rs 1 lakh is given to those providing information about clinics running sex determination test. Another Rs 1 lakh is given to pregnant women who act as decoy.
Rajasthan was the first state to set up the PCPNDT Bureau to investigate violation of the law.
In many instances, decoy customers helped the enforcement agency by giving information on an errant clinic or doctor.
“We have come across cases where a woman who went to the clinic to find out the gender of the foetus was given incorrect information. Because of strict enforcement, the clinics did not conduct test but took money and gave wrong information,” says Dinesh Kumar, PCPNDT coordinator at Jhunjhunu.
“In villages, people are not educated and believe what they are told. Later, these people gave information to the enforcement agencies and also acted as decoy customers,” adds Kumar.
Sabu George, an independent researcher who has campaigned against pre-natal sex determination, says that unlike other states Rajasthan’s turnaround has been made possible mainly by strict enforcement of the PCPNDT laws.
“If people don’t have any means of finding out the sex of the child, things will automatically change on the ground. It’s the doctor’s who were promoting clinics doing sex determination tests,” says George.
“When the noose was tightened around them, they backed away.”
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‘Sustain work on the ground’
The researcher who had filed a PIL in Supreme Court to review the PCPNDT Act way back in 2000, says things have improved in Rajasthan after the Census 2011 data highlighted the drastic drop in CSR.
“But we have to see if the authorities sustain the work on the ground. The focus of this government was to improve Rajasthan’s CSR and many measures were taken to ensure that the situation improves,” says George.
“If, however, the new government that comes does not give the same importance to the programme, the result will reverse,” he adds.
The real success for Rajasthan will be a continuous upward trend in SRB that positively impacts the CSR when the new Census data comes in 2021, says George.
Prasad agrees that the present tempo has to continue for a long term impact. “If that does not happen, the gains that we have made so far won’t reflect in the next Census.”