Correspondence Address:
Amitav Banerjee
Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra
India

Full Text

India has been experimenting with different models of population policies since independence. In 1952, it was the first country in the world to launch a national family planning program.[1] Kerala was the first state to conduct mobile family planning sterilization operations in 1971 – the forerunner of Sanjay Gandhi's aggressive sterilization campaign during the Emergency.

Although since launch of the family planning program political will tended to promote small family norm, the urgency was felt during the emergency. Sanjay Gandhi launched sterilization campaigns on a war footing with an unprecedented gusto. In April 1976, the Indian Cabinet approved a formal statement of national population policy outlining a number of measures to check population growth such as financial incentives for adoptees of terminal family planning methods or priority on house allotment.[2] States were encouraged to set sterilization targets and achieve them. Most states exceeded the decree-achieving targets much higher than what the center had proposed.

It is widely believed that Indira Gandhi's defeat in the 1977 elections was partly precipitated by the unpopularity of this coercive approach. Thrown into disrepute by this misadventure, family planning policies postemergency retreated into the background.[2] Such draconian measures generated misconceptions and myths among some segments of the lay population about other government programs for, example, the myth that pulse polio drops are intended to sterilize children.

Uncontrolled population growth adversely impacts the environment. Drinking water scarcity is another problem. Individual families deciding on the family size may miss this big picture. Population policies are therefore important. However, population policy planners need to know the sociocultural reasons why some people have more children. Neglect of the social and cultural factors has resulted in skewed sex ratio in an attempt to limit family size.

Issues of gender equality, or lack of, have important impact on family size. Decisions as to when and how many children to have are presumably made by a couple. Social and cultural norms play an important role. Women bear the brunt of pregnancy and childbirth. Their choice of family size is lower than that of men as brought out by surveys.[2]

Preference for a male child, deep rooted in the Indian psyche, drive couples to have additional children till a son is born.[2]

It is a sad commentary on gender perceptions that even today some women who give birth to female children face humiliation and have low self-esteem. Desperation and envy sometimes lead them to commit heinous crimes. News reports of close family members killing a child as a sacrifice to get a male child [3] or committing a similar deed out of jealousy and humiliation [4] captures the social pathology of gender discrimination in our country.

In this cultural environment of discrimination of the girl child, those who can afford opt for prenatal sex determination and abortion of the female fetus, sometimes traveling abroad to countries such as Dubai,[5] or Thailand,[6] to circumvent the Government of India's Preconception and Prenatal Diagnostics Act 1994. This is reflected in the 2011 census data on child sex ratio which shows the number of girls per 1000 boys between ages of 0–6 years. In rural areas, it was 923 girls per 1000 boys while in urban areas, it was just 905 hinting at misuse of technology for prenatal sex determination and selective abortion of the female fetus. Those who cannot afford neglect the girl child in infancy and childhood leading to higher mortality or short-statured future mothers.

In poor countries, the height of the mother is a surrogate measure of her nutritional status during her own growth and development during childhood.[7] Studies have shown that improved nutritional status of the girl child in the first 3 years of life influenced their own children's size at birth and height in childhood.[8],[9] In a social environment of discrimination against the girl child, nutritional deprivation of the female child vis-à-vis the male child in the first 3 years of life can adversely affect the girl child's growth and development. These females will grow into short-statured adults with skeletal structures not fully developed for mothering healthy children. Their offspring of both genders will get a slow start in the race of life. When these compromised children grow into adults, they are likely to have suboptimal physical and mental capacity.

More than any other sporting event, the Olympics indicates a country's progress or lack of it. The performance of Indian sportspersons in the 2016 Rio Olympics was dismal. The question needs to be asked as to why India, a nation of 1.2 billion, second only to China in population, could win only two medals.[10] Many answers have been given such as poor infrastructure, poor diet, and lack of sports culture. Our poor performance has also been attributed to the comparatively slight build of Indians and lack of stamina.

What perhaps have not been mentioned earlier is worth speculating on. Gender bias in India leads to neglect of the girl child in infancy and early childhood. The nutritionally compromised girl child grows into a small statured mother who cannot bear healthy offspring whether male or female. Getting a male child should not be enough. Getting a healthy male (or female) child should be the goal. Else these intergenerational influences on growth and development due to gender bias will prevent full attainment of physical and mental potential in the next generation of both men and women. Therefore, to beget future Olympic Medal winners, we should start with ensuring adequate growth of the girl child who is born today by providing good nutrition so that when she reaches motherhood, she has optimum skeletal build to bear robust children. Mentally and physically robust children will grow into future Olympic Medal winners. We still have to wait a generation or two for removing the intergenerational handicap due to the neglect of the girl child prevalent today. A long way to go for India provided, of course, we start eliminating gender bias with immediate effect. If we fail to address gender issues today, we are on a road which will lead nowhere.

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