Indian Journal of Public Health

COMMENTARY
Year
: 2020  |  Volume : 64  |  Issue : 2  |  Page : 204--206

Son preference, security concerns and crime against women: Expanding the public health discourse in India


Bijayalaxmi Nanda1, Nupur Ray2, Ritwika Mukherjee3,  
1 Acting Principal, Miranda House and Associate Professor, Department of Political Science, Miranda House, University of Delhi, Delhi, India
2 Assistant Professor, Department of Political Science, Kamala Nehru College, University of Delhi, Delhi, India
3 Research Associate, Indian Council of Social Science (ICSSR) Supported On-going Research Project by the Authors, titled ‘Declining Child-Sex Ratio and Violence Against Women: Examining Girl-child Discrimination in India', Commissioned by the ICSSR on March 27, 2018

Correspondence Address:
Bijayalaxmi Nanda
Department of Political Science, Miranda House, University of Delhi, Delhi - 110 007
India

Abstract

The phenomenon of son preference in India and the declining number of girls due to such a mindset has been an area of concern. While the Preconception and Prenatal Diagnostic Techniques Act and the Beti Bachao and Beti Padhao scheme have been the mainstay of the government's initiative to counter this reproductive injustice, recognizing son preference and crime against women as public health concern opens up a new vista to counter this injustice. This study has identified that the public health system needs to engage with the following aspects to counter the problem: counseling services to women and men around fertility choices; access/availability to contraceptive choices; engaging men and boys in developing a response against violence; gender-sensitive training and capacity building; access to sexual and reproductive rights awareness amongst girls, women, boys, and men; and health insurance for senior citizens.



How to cite this article:
Nanda B, Ray N, Mukherjee R. Son preference, security concerns and crime against women: Expanding the public health discourse in India.Indian J Public Health 2020;64:204-206


How to cite this URL:
Nanda B, Ray N, Mukherjee R. Son preference, security concerns and crime against women: Expanding the public health discourse in India. Indian J Public Health [serial online] 2020 [cited 2020 Aug 11 ];64:204-206
Available from: http://www.ijph.in/text.asp?2020/64/2/204/286819


Full Text



 Introduction



The culture of son preference in India has led to the masculinization of child sex ratio in the society motivated by parents to consciously plan the desired number and sex of their children. In the quest of attaining the complete family size, aspiring families ensure to have at least one son as health insurance for parents in old ages and protective guarantee in the context of rising crimes against women and girls in the society. In this context, reproductive decisions around childbearing have evolved around misusing access to prenatal care technologies initially designed to empower women through access to prenatal health services. Several scanning centers have flourished in different parts of the country, to bank upon the growing needs of son preference. Many families, having resources and access to the new reproductive technologies, selectively discriminate the 'unwanted' female gender by resorting to sex-selective abortion. In this way, they have achieved the desired sex composition without having too many children that are characteristic of modern families for whom access and decisions to childbearing are centered on meeting the economic needs of the family.[1] The demography of unwanted daughters arises where the continuum of public health does not connect with the lack of awareness and access to public health facilities. The “unwanted daughters” then become subject to increasing violence arising due to the millions of girls who are missing from the population and who could otherwise have had a moderating impact on the rising violence against women.

Public health discourse in India has not been sufficiently expanded to examine this critical linkage of reproduction and safety and security concerns related to women and girls. Gender-based violence has been globally recognized as a public health concern as it impacts women and girls in several ways. Women face all forms of physical, sexual, and mental violence that have implications on the public health system in the country. It is a violation of rights for women and girls and also has its impact on men and boys who can be in the role of “perpetrators,” “spectators” or “protectors.” However, engaging with the crime against women as a public health concern requires us to examine the linkages between the two.

The United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”[2] Intimate partner violence is the most touted forms of violence in private spaces, in which one of every three women in the world have been the victim of physical or sexual violence.[3] In the United States, the rise of homicide during the 1980s and the acceptance of behavioral etiology and prevention of diseases made violence as a larger public health initiative.[4] Violence against women has been recognized as an impediment for women's liberation and well-being as it jeopardizes the fundamental rights for a peaceful and dignified life. Increasing violence against women is epitomized as a major public health concern and operates through multifaceted contextual, sociocultural, and political processes.[5],[6]

In all societies, the understanding of crime influences and is influenced by concerns of public health. Patriarchal societies are often characterized by crime against women, which is pervasive both in the public and private domains. One of the concerns is that most of these forms of violence have been normalized. Another emerging concern regarding growing crime is the declining number of girls in the family. According to the Census of India data, for every 1000 boys (in the 0–6 age group) there are 919 girls in the year 2011, a decline from 927 in 2001.[7] Tracking gaps in reproductive rights and choices, it has clearly come to the forefront that crime against girls and women leads to insecurities among families regarding giving birth to daughters. This mindset has proven to be one of the most challenging ones to overcome. Although no direct linkage can be proved between crime against women and son preference, the implications one has on the other cannot be completely ignored.

 Public Health and Gender Concerns



Public health and gender concerns have been well established through various policies and programs in India and globally. Public health systems in the 1960s were mainly concerned with providing basic health care to all, including ending the scourge of maternal and child mortality when it came to achieving demographic targets without any gendered understanding of the family health programs. It led to compromises on the quality of reproductive health services. It was in 1994, with the International Conference on Population and Development (ICPD) in Cairo, that a global consensus emerged around women making informed fertility choices.[8]

The unfinished agenda of the ICPD is to bring about 'empowered and informed choices' for women. Universal quality health services are based on women making free and equal choices. However, vulnerability to crime inhibits and forms barriers to public health, information, and services for women and girls. It also results in discrimination right down to fertility choices about whether it is a rational choice to give birth to girls in an insecure environment.

Every crime against girls and women, especially sexual violence, leads to a perception that giving birth to girls is a liability for parents in terms of protection and constant supervision linked to cultural connotations of honor, purity, and virginity. The existence and even threat of crime against women create an environment where women and girls are seen as “passive,” potential victims' and subjugated with denial of agency further aggravating fertility choices leading to greater son preference.

 The Continuum of Son Preference, Violence Against Women and Security Concerns: a Public Health Discourse



While sons are preferred for various reasons in India, including inheritance, dowry, caring for parents in old age, increasing crime against girls and women is also now an established cause. In a study supported by the Indian Council of Social Science Research Declining Child-Sex Ratio and Violence Against Women: Examining Girl-child Discrimination in India in which we are examining the linkages between violence against women and decline in child sex ratio, the preliminary research findings from both Uttar Pradesh and Haryana, have provided evidence that perceptions about crime play a pivotal role in increasing son preference.[9] Experiences from field visits in the two states focused on the rising overall crimes for which women are pushed to the margins of development in terms of restrictions for work and mobility. The larger concern of wanting a son in the family has revolved around providing security to the families as well as maintaining the chastity of the daughters in the context of rising sexual violence in the public spaces.

The impacts of son preference were evident in the rise in the number of males within the household, which curtailed women's freedom to freely access public spaces. The public spaces were corroborated even by the male members as 'unsafe spaces' due to rising unemployment and alcoholism among men. In households where men outnumbered women, 32.1% of women reported that the husband or any other family member did not trust women, especially in monetary matters. Three out of every ten women who had more daughters than sons reported that the husband/any other family member expressed dissatisfaction with the birth of the girl-child.[10]

While violence against women is a public health concern, what is necessary is to recognize is that discrimination at birth is also a public health concern. The other important finding of son preference, which is linked to public health is the fact that births of daughters are not only avoided due to insecurity about them being liabilities, sons are preferred because they are culturally perceived as protectors and providers during old age. Perceptions about the support needed in old age are also linked to public health.

In traditional societies, sons are essentially looked at as caregivers to parents, unlike daughters who “leave the natal home” after marriage. Patrilocal marriages disincentivize parents to hope for care from girls. South Korea's improvement in Sex Ratio at Birth is a lesson for Asian countries who are suffering from the problem of the declining number of girls and women in society. The country's well-developed protection for senior citizens with old-age insurance systems acts as a preventive mechanism to tackle son preference which needs to be taken into account.[11] With positive feedback from health insurance systems, State policies in China have initiated uxorilocal marriage to benefit from daughters during old ages.[12]

Public health concerns

Crime against women and girls → son preference ← old age care of parents

While sex-selective abortion has been seen as one of the main manifestations, Preconception and Prenatal Diagnostic Techniques Act and the overarching scheme of Beti Bachao-Beti Padhao campaign have made stellar efforts to curb son preference, However, recognizing son preference and crime against women as public health concerns provides an opportunity to make important interventions to bring about reproductive justice for women and girls as well as establish it as one of the major goals of the public health system in India. Access to public health services, therefore, needs to engage with:

Counseling services to women and men around fertility choices like the right age to conceive, the gap between the birth of children, prenatal and postnatal care of womenwith gender sensitive behavior by health service providersAccess/availability to contraceptive choices with an emphasis that the onus to not conceive is a shared responsibility of both men and womenEngaging men and boys in developing a response against violence both as potential perpetrators and victimsGender-sensitive training and capacity building of facilitators and public health officialsAccess to sexual and reproductive rights awareness among girls, women, boys, and men through group discussion, campaigns, and engagementFinally, health insurance for senior citizens can be an alternative response to tackle the decline of the girl-child population. So far, family planning policies have focussed on cracking down the illegalities of sex selection and providing financial incentives to motivate parents for the birth of girl child. Efforts have been appreciative in some states, but the latest Sample Registration System statistical report (2017) show a further decline in the Sex Ratio at Birth, reaching an all-time low in the period 2015–2017. The economic burden of raising a girl child, therefore, assumes equal significance as the loss of old age security and health care of the elderly, more so in the context of the maturing demographic transition of particular states in India that is witnessing a rise in the elderly population. Concerted efforts are needed through the National Health Policy to recognize the value of the girl child and connect it to social security schemes for senior citizens in its implementation.

The way forward is, therefore, a holistic approach keeping in mind the above recommendations provided here. The intense son preference in India, leading to a declining number of girls and women in society, requires urgent attention as public health concern since reproductive justice and choices are linked to the overall health of the society.

Financial support and sponsorship

Research grant has been provided by the Indian Council of Social Science Research (ICSSR), Ministry of Human Resource Development, Government of India, for the on-going research project being carried out by authors, titled “Declining Child-Sex Ratio and Violence Against Women: Examining Girl-child Discrimination in India”, commissioned by the ICSSR on March 27, 2018.

Conflicts of interest

There are no conflicts of interest.

References

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