Differential female mortality and health care in South Asia

J Soc Stud. 1989 Apr:(44):1-123.

Abstract

PIP: This report examines differential female mortality in South Asia--India, Sri Lanka, Bangladesh, and Pakistan. Under conditions of mortality decline and an aggregate trend toward convergence of life expectancy, disequilibria which are comparatively unusual, persist. The converging life expectancies are a product of changes unique to each sex. Female mortality gains after the reproductive period conceal excess female mortality from the post-neonatal period to 5 years and in most regions of South Asia during the reproductive years as well. These imbalances appear to be most exaggerated on the upper Gangetic plain and among communities such as the Jats and Rajputs. The most marked imbalances do not bear a consistent relationship to economic conditions. They may, however, be declining over time. In certain regions of India, most notably in the peripheral south, discrimination against women is not seen in demographic data and has not been for several decades. Male life expectancy is being affected by only slow improvement in male mortality from age 35. Major social changes are accompanying these changes in gender differences in vital statistics, including changes in the technology of agricultural production, falling female participation rates, the education of girls, the increasing practice of dowry, and fertility decision making changes. It is not clear whether child mortality or maternal mortality is the key to the political economy of Indian demography, whether maldistribution of food or health care is the prime determinant of excess female child mortality, whether excess female mortality is the result of being neglect or conscious selection, whether regional contrasts result from differences in the religious roles of sons between north and south India, whether the female sex is culturally inferior and the male sex superior, whether food scarcity is more important than food availability in the determination of sex bias, whether poverty results in greater discrimination, whether class position determines reproductive strategy, whether major contrasts in demographic regime exist between north and south India, or whether material conditions or cultural practices determine demographic regimes. The workshop papers contributed data for the decision process, advocacy for the agenda, and details on the results of implementation, and the realities of access.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors*
  • Asia
  • Bangladesh
  • Congresses as Topic*
  • Culture*
  • Delivery of Health Care
  • Demography
  • Developing Countries
  • Disease
  • Health
  • Health Services Accessibility*
  • Health Services*
  • India
  • Infant Mortality*
  • Mortality*
  • Nutrition Disorders*
  • Organization and Administration
  • Pakistan
  • Population
  • Population Characteristics
  • Population Dynamics
  • Program Evaluation
  • Research
  • Sex Factors*
  • Social Change*
  • Sri Lanka