How our betis are faring, 10 years on

As the Beti Bachao, Beti Padhao (BBBP) initiative becomes 10 years old, an evaluation of the programme leading to the ideal child sex ratio and promoting the empowerment and education of the girl child is fitting.

According to the government press note issued on the 10th anniversary of the BBBP, the sex ratio at birth (SRB) has improved from 918 in 2014-15 to 930 in 2023-24. Also, the girls' enrolment in secondary education has improved from 75.5 per cent to 78 per cent during the same period. Additionally, women have been empowered through skilling, economic initiatives and widespread community engagement.

While saluting these achievements, one must step beyond to understand how much women's lives have changed, for the better or worse. Comparisons need data and India relies on different surveys and data bases. They include the civil registration system, the sample registration system (annual) and the National Family Health Surveys (NFHS). The NFHS surveys (2015-16 and 2019-21) are the most reliable sources to compare and comment on wider issues as they provide a rich source of information. Because, after all the numbers are crunched and digested, ultimately, the true barometer of women's progress is their status in society.

While measuring this, some things matter more than the others. One of the important determinants is her age at the time of marriage. This is because it is her health and her understanding of both childbearing and child-rearing that has an impact on generational health.

The first questions that should stem from BBBP is whether the age of marriage of girls has gone up and whether teenage pregnancies have come down. This is because girls who marry young remain socially isolated and are denied the fruits of education.

Despite the Prohibition of Child Marriage Act (2006), the practice of child marriage remains widespread. Though the NFHS data reveals a decline in child marriages, their number remains high. Child marriages have reduced from 47 per cent (in 2005-06) to (26 per cent) in 10 years and in the next five years, to around 23 per cent. Given the size of our country, 23 per cent is still unacceptably high.

While more girls may have been saved from being aborted, the benefits of poshan (nutrition) and padhai (education) would have eluded most girls who were married before 18. Because, among other factors, it is in the teenage years that anaemia is at its peak and has cascading effects on the patient’s health.

The second important goal that BBBP has rightly focused on is curbing the practice of female foeticide. What is the status on that? The ideal child sex ratio, according to the WHO, is 950 girls to 1,000 boys. As per the latest NFHS-5 data, the ratio has gone up from 919 girls to 929 girls for every 1,000 boys born. This is good progress, but the data for many states remains far from satisfactory.

According to figures released by the Government of Haryana, the sex ratio was recorded at 905 girls for 1,000 boys in the first 10 months of 2024. The districts of Gurugram (859), Rewari (868), Charkhi Dadri (873), Rohtak (880), Panipat (890) and Mahendragarh (896) were the worst performers, all recording a below-900 sex ratio. Despite economic progress, many Haryanvis still want sons. Exhortations alone will not change the overall picture of saving the girl child.

A declining sex ratio means that female foetuses are being killed in the womb.

Several other states also have a child sex ratio less than 932, as per the NFHS-5. They include Rajasthan, Jharkhand, Punjab, Telangana, Maharashtra, Bihar, Goa, Himachal Pradesh, Odisha and Tamil Nadu. Delhi and Chandigarh, too, have adverse sex ratios.

It shows that education and wealth, if anything, exacerbate the demand for sex determination, underscoring the craving for sons.

At the same time, there has been a perceptible improvement in states like Andhra Pradesh, Uttar Pradesh, Gujarat, Madhya Pradesh and West Bengal. They are hovering nearer the WHO ideal. It indicates how much of the progress rests with the state leadership. A right-thinking chief minister can do wonders by giving primacy to BBBP and related health programmes.

It is a matter of comfort that the Health Ministry has extended the National Health Mission by five years. Started in 2005, the NHM has done more to improve the health indicators of women than any other programme.

Among the achievements relevant in the context of women's status is the decline of India's fertility rate to below the replacement level. Though it is cause for fresh worry about what will happen to the states that are aging, the plus side is that except for the identified districts — mainly in Uttar Pradesh and Bihar — the days of unwanted and repeated child births are over. It is a great blessing for women.

Side by side, institutional births, that is births under medical supervision, have increased phenomenally. An institutional birth benefits women hugely as it ensures that they undergo antenatal check-ups and are sensitised and skilled in spacing out children, which also staves off unwanted pregnancies. As a result, maternal and infant mortality have reduced substantially.

The increase in poorer households' access to clean drinking water, improved sanitation (toilets) and clean cooking fuel have also impacted women's lives for the better. Though they may not be directly related to BBBP, they give much reason for satisfaction.

Taking the important indicators into account and without making BBBB a separate vertical silo, it is apparent that women's status has improved. The question is how much and in what respect.

More attention needs to be paid to enforcing the legal age of marriage and incentivising births after 20 years. These two measures will greatly impact the health of both women and children and enable them to get educated and become economically independent.

The day that happens, India would have come into its own.