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APHA Scientific Session and Event Listing

Recorded presentation

Mary E. Shepherd, MS (PhD), Department of Population & Family Health Sciences, Johns Hopkins University, 615 N Wolfe St W4510, Baltimore, MD 21205, (505) 982-4403, mshepher@jhsph.edu

The study objective was to determine if female feticide has been substituting for postnatal discrimination in India. If so, then eliminating sex-selective abortion could lead to an increase in excess female infant and child mortality. Using data from the National Family Health Survey, characteristics associated with a higher proportion of male births during the period 1977-1999 were identified by logistic regression. A propensity score for sex-selective abortion was calculated. Multi-level logistic regression analysis and propensity score methods were used to examine the effect of prenatal sex-selection on gender differentials in neonatal, postneonatal, and young child (ages 1-4) mortality, and in the use of preventive and curative care, and nutritional deficiency/infection co-morbidity. Among those with the highest propensity to selectively abort female fetuses, neonatal mortality was lower for girls than boys prior to the 1990s, but the rates converged over time; in the postneonatal period, female infants were 33% more likely to die than males, with no change over time. Among those aged 1-5 years, mortality was elevated for girls, and declined over time only among those with the lowest propensity scores. Girls were less likely to be vaccinated only in the highest propensity score group. Girls were 22% more likely to not receive curative care, and were 11% less likely to suffer from co-morbidity, neither of which varied by propensity score. No evidence was found that the diffusion of sex-selective abortion has led to a decrease in gender differentials in infant or child mortality, health care or morbidity.

Learning Objectives:

• Discuss the impact that female feticide in India has had upon excess female child mortality. Construct a propensity score to control for selection effects. Develop measures of disparities in health and survival. Cite factors at individual, family, and community levels which are associated with female feticide in India.

Keywords: Gender, India

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation