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Enforcement measures to control female foeticide, Punjab
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Subject Area="Public / private partnership (including NGOs)." Objective="To promote birth of female baby and improve sex ratio."
Details for Reform Option "Enforcement measures to control female foeticide, Punjab"
Summary

Background: As revealed in census 2001 that all the 17 districts of Punjab were among the lowest 34 districts of the country where sex ration was poorest. In district Nawashahr sex ratio in 2001 was 808 per 1000. In another survey conducted by department of Child Development revealed 33 point decline in the child sex ratio in four year span (2004). Though government machinery in the department of Health and Child Development were taking measures against medical centres, which were indulged in the sex determination of the unborn child and pregnancy termination after sex determination. But these measures were proved to be inadequate to control the menace. Therefore, to control the social evil measures were introduced in a campaign mode in district Nawashahr in May 2005. Action: (1)Involvement of Non Government Organisation (NGO): All NGOs of the district were brought under a registered society named UPKAR Cordination Society (UCS). Ex officio chief patron of the society was appointed to Deputy Commissioner (DC). 35 NGOs were member of the society and each member was assigned an area of their choice. With the help of NGOs, UCS has developed committee at the block and village level. Block and village committees were the operational units, whereas district UCS has main role as facilitator for all the activities. Personal letters were sent to the lady Sarpanch and wives of the male Sarpanch by DC and UCS for their active involvement. With the special drive, community, especially young couple and adults group, was encouraged to become the member of the society. At present 4000 have already registered with the society as its member. Base line survey was conducted in all the villages under the supervision of all district officers. DC had actively monitored the whole survey process. (2)Monitoring of the pregnant women: Realising the fact that pregnant women need to be monitored continuously and sincerely for outcome of pregnancy, a computerised data base was prepared based on initial survey conducted in the area. Database has information like number of previous live children, age of the women, date of visit paid by Auxillary Nurse Midwife (ANM) and complete postal address including her telephone number. In case women does not have telephone, telephone number of the Sarpanch was noted. With the computerised database, a list of pregnant women was generated whose pregnancy was in the third to fifth month of gestational period, because this period is considered most vulnerable period for sex determination of foetus and followed by abortion. The main objective to take out the list was to monitor them telephonically by a lady telephone operator in the DC office. She used to ask about the health condition of the pregnant women and the foetus, thus leaving a invisible impact on the mind of lady as well as her family that they are watched and followed by somebody. Second list was generated for the pregnant ladies whose Expected Date of Delivery (EDD) had crossed. Telephonic enquiry was also made to them for the outcome of the pregnancy. In case there was none, further enquiry was also made for loss of foetus. (3) Monitoring of the Sonography centre: With time it was realised that one of the obstacle in the monitoring of the medical centre was to get complete details of sonography conducted during gestational period. In order to make monitoring effective, new software was developed at Suwidha Centre, Nawashahr. All data collected from the scanning centre was feeded in the software by 5th of every month and subsequently medical audit reports were generated for monitoring. These medical audits helped to cross check the social audit conducted telephonically. Disciplinary action was taken against the medical centre that does not comply with the rules. (4) Focused monitoring: During the baseline survey it was revealed that one fourth villages were worst affected by the sex ratio. It was as low as 411 point as compared to 900 point in the adjoining villages. Focused monitoring was launched in these affected villages to identify the associated reasons for low sex ratio. Careful analysis of the information revealed the fact that a nexus was operating between the ANM / nurses and medical practitioners for their financial gain.In order to break this nexus, all ANMs Nursus and Anganwadi Workers (AWW) working in the village were identified with their complete postal address and telephone number. A separate seminar was organised for these workers to discontinue their unprofessional act and strong warning was also issued to all of them to restrain from such activities or else case would be registered against them. Midwives of the area were given a toll free number (555501) to provide information for all such couples that come to them for abortion after sex determination. (5) Involvement of youth: It was observed that without involving youths below the age group 25 years, that is largely to be affected segment by the social evil, enforcement measures against female foeticide can not be made fully successful and sustainable. Therefore, all college students were invited to DC office for a direct meeting with DC. Single Window System (SWS) was also introduced in the DC office to facilitate other related administrative work like driving licence, arm licence, birth certificate, depositing electricity and telephone bills etc. SWS encouraged the youth to visit DC office. Keeping the objective of SWS as secondary, half hour direct interaction was organised with DC to introduce the problem of female foeticide and drug addiction among youth. As a surprise to note that many youths were not aware about present trend of sex ratio as well as its associated impact. Students were appealed to identify pregnant women in their neighbour and inform in the DC office for the purpose of their registration. To encourage their active participation students were offered INR 100. Among the students, girls took active participation in the enforcement measures. They also submitted memorandum in the hospitals and clinics to stop against the menace of sex determination and female foeticide. (6) Adoption of villages by government officials: Government officials 5 contagious villages. Simultaneouly they were given other related responsibilities in the villages like inspection of school education, veterinary hospitals, drinking water supply, power supply etc. (7) Mourning of baby girl: In order to sensitise the villagers for female foeticide, UCS used to do mourning of the baby girl in case where abortion took place after sex determination. (where at clinic or in front of house where abortion occurred for female baby). (8)Involvement of public personality:Recorded messages of popular personalities were displayed on vehicle and literature were distributed. (9) Identical names to baby girls: To promote birth of baby girl, function was organised at district head quarter every month, where all the baby girls born in a particular months were honoured and given one identical name like ‘Navjot’.’Harsimran’ and ‘Jaspreet’. Results: The sex ratio in 77 villages out of 475 have crossed 900 points (in 2006) in some cases has reached 1000 points. All these villages panchayats were honored on 8th March, 2006 on the International Women Day by Mrs. Anjali Bhawra , IAS, Commissioner, Patiala Division, Patiala. (See reference section for further details).

Cost Information not available.
Place District Nawashahr, Punjab in 2005.
Time Frame Approximately one year.
Advantages

Involvement of community: Activities were designed as community based with their active involvement. Youth participation: Youth were encouraged to come forward to take ownership of the programme. Strict social and medical audit: To monitor the ongoing activities and current pregnant women strict computerised audit were devised.

Challanges

Insensitive attitude of medical professional: Incorporation can be perceived from the medical fraternity for their personal benefit. Deep rooted social norm: Social norms and gender based societal culture puts a obstacle to turn the knowledge into the behaviour.

Prerequisites

For organised efforts to bring the entire field NGOs under one umbrella.

Who needs to be consulted

Community District officials NGOs

Risks

Sustainability

Sustainability component need to be judged according to the awareness generated among youth and their active involvement in the measures against female foeticide, as it is the large segment, which would be affected by the deep-rooted social evil.

Chances of Replication

Good, but need modification based on local constraints.

Comments

Down with the sex ratio is growing as a social menace. Making a law and providing a guideline to follow would not solve the problem unless it would be enforced in the society to get implemented.

Contact

Submitted By

Dr. Anuradha Davey, Research Consultant, National Institute of Medical Statistics, ICMR, September 2006.

Status Active
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