Know the Issue

About Declining Child Sex Ratio

Calculated as the number of girls per 1000 boys in the age group 0-6 years, the ratio has declined steeply in India from 976 girls per 1000 boys in 1961, to 918 girls in 2011. Global trends indicate that the normal child sex ratio should be above 950 girls for every 1000 boys.

Declining Child Sex Ratio (CSR) lies at the heart of the national civil society coalition Girls Count. A direct result of deeply entrenched discrimination against women and girls, declining CSR reflects a strong preference for sons and un-wantedness of daughters. Declining CSR stems from both pre-birth discriminatory practices such as gender biased sex selection, and post- birth practices such as neglect, poor nutrition and poor access to health care, leading to adverse survival rates for girls. It is estimated that on an average, 4.56 lakh girls were missing at birth every year during the period 2001-12.

An immediate direct impact of the decline in CSR is visible in terms of a significant imbalance in the number of males and females in the population thereby changing the demographic landscape. Over a period of time, such imbalance is expected to have severe implications for the survival and rights of women and girls. Evidence indicates that women and girls in regions with a history of adverse child sex ratios are witnessing increased rates of violence and higher degree of control over their lives.

Apart from the impact that is immediately experienced by women and girls, the overall impact on the nation is also likely to be severe. A country that does not recognize, accept and value the presence and contribution of its women and girls, curtails its ability to grow and develop its full potential.

Urgent need to act now

Census 2011 has shown that India’s CSR has not only declined further over the last decade but the problem of declining CSR is now fast spreading from urban towns to rural locations and tribal regions. This calls for the need for urgent concerted action to stem further decline in CSR.

Change is possible

Census 2011 data indicates that some states and districts have experienced an increase in CSR in the last decade. This has been made possible through action on multiple fronts- effective implementation of the law, alongside efforts to invest in girls.

The specifics of what drives decline in CSR and therefore what works to address the drivers is different in each region- there is no ‘one-size fit all’ solution.

Collective voice and accountability- role for Girls Count

Girls Count represents the commitment of a national movement to stop sex selection and enhance the value of girls. By collectivizing the voice and efforts of civil society organisations around the country we aim to amplify the advocacy against sex selection and seek accountability for upholding the rights of women and girls.

Where is it Taking Place?

The Child Sex Ratio (CSR) has been on decline since 1981 Census, indicating a continued discrimination against the girls. In 2001 Census, the child sex ratio stood at 927 girls for every 1000 boys in the country, which dropped to 918 girls by 2011. It is clear from the maps that the epicenter of the problem is northwestern region in the country. Jammu & Kashmir (862), Rajasthan (888), Uttarakhand (890), Maharashtra (894), Uttar Pradesh (902) and Madhya Pradesh (918) witnessed 14 to 79 points of decline in its CSR and they were ranked as states below the national average (918).

To see the state wise comparative data on CSR please click on the link

Causes: Why does it happen?

Son preference- greater ‘value’ assigned to sons over daughters

Declining CSR is fuelled by a system that attaches a higher value for sons over daughters. Dowry, patrilineal descent- carrying on of family name and lineage through men, patrilineal patterns of inheritance with the property passing on from father to sons, perception of the necessity of sons for completing religious functions especially last rites, and the perception of sons as the only source of support during old age, all create a strong disincentive to raising daughters.

Declining fertility

The desire for smaller families accompanied with a strong desire to have sons also determines how individuals plan their families. More and more families want to opt for smaller families, with sons.

Misuse of technology

The misuse of medical technology such as ultrasound for the purpose of sex determination has expanded considerably over the last few decades. In India, sex determination for non-medical purposes is illegal as per the Pre-Conception Pre-Natal Diagnostic Techniques Act

Post birth discrimination

In many situations girls are denied access to nutrition, health care, education and other basic human rights, and are subjected to abuse and neglect leading to reduced chances of survival

Consequences: What is the consequences?

Discrimination against girls (both pre-birth and post-birth) manifested through declining CSR can have some severe adverse consequences. It:

Prevents girls from access to primary education, and adequate nutrition

Pushes them towards child, early and forced  marriage and early child bearing

Contributes to increased violence against women, rape, abduction, trafficking

Leads to increase in practices such as polyandry

Contributes to overall rise in crime and social disorder

Can lead to bride shortage in regions with long history of skewed sex ratios; In such regions, women are already being 'bought' or ‘trafficked’ as brides

Undermines women’s economic empowerment, rights to resources, and land

Solutions: How can we reverse the decline in CSR?

Since Census 2011, declining CSR has gained increasing attention in India’s development agenda. The announcement of the national flagship programme on BetiBachaoBetiPadhao dedicated to increasing the value of girls has communicated a strong political will to address the sex ratio imbalance and provides an opportunity to accelerate efforts  to help change the lives of women and girls across our country. Addressing declining CSR requires work on multiple fronts to ensure a comprehensive response. We need to understand the different drivers of the decline in CSR and how they operate in different contexts to be able to design interventions that are relevant and effective.

Girls Count advocates for sustainable interventions that are coordinated, well-resourced and that have benefited from collective learning. There are two broad programme areas where the majority of our efforts are invested:

Challenge Patriarchy; Enhance the value of women and girls

Enabling girls to lead healthy, safe and fulfilling lives can go a long way towards ensuring that they will be self reliant in the future, and will be valued by families and communities. Specific interventions that contribute to enhanced value of women and girls:

  • Support for health care and nutrition for girls.
  • Enable girls to continue education especially secondary and higher education.
  • Equip girls with life skills and livelihood skills.
  • Provide safe spaces for girls- within homes, educational institutions, workplace and public spaces.
  • Enable access to housing rights and property ownership for girls.
  • Engage men and boys to promote gender equality.

Stop Sex Selection; Effectively Implement the Pre-Conception Pre-Natal Diagnostic Techniques Act

  • In the immediate period, interventions to prevent misuse of technology for purposes of sex determination leading to sex selection can go a long way towards deterring both service providers and clients from the illegal practice of sex selection.
  • Initiatives to build capacities of the medical community, judiciary, civil society and media on effective implementation of the PCPNDT Act and advocacy to ensure accountability for Act implementation are critical for ensuring effective implementation of the law.

These two areas are illustrative of the types of interventions that can contribute towards arresting the decline in CSR across the country.

The Law: PCPNDT Act

The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was enacted by the Parliament of India to stop sex selection and sex determination, and arrest the declining child sex ratio in the country. The purpose of this Act is to prevent the misuse of techniques for sex selection and sex determination (before or after conception). This Act was first brought into effect in 1994 (then known as PNDT Act) to prohibit the use of pre-natal diagnostic techniques for the purpose of sex determination test. This is important to highlight that the PCPNDT Act is women friendly Act and has laid down certain rules and regulations that apply to clinics and hospitals that provide pre-conception and pre-natal services and employ ultrasound technology.


  • No centre will conduct, associate or help in conducting pre-natal diagnostic techniques (PNDT) unless registered under the PCPNDT Act.
  • No person will conduct or help in conducting pre-natal diagnostic technique on contract, voluntary or charitable basis unless the place is registered and unless the person is authorized to conduct it at that place.
  • No person will conduct a pre-natal diagnostic technique including an ultrasonography for the purpose of sex determination.
  • No person is allowed to communicate the sex of the foetus either through words, signs or in any other manner whatsoever.
  • No person or center will issue, publish, distribute or communicate any advertisement in any form regarding facilities of sex selection and sex determination.
  • No manufacturer, importer, supplier or dealer of ultrasound machines will sell, rent or allow the use of any ultrasound machines to any centre not registered under the PCPNDT Act.


  • If any person acts contrary to the prohibitions including advertisement, he/she will be liable to be punished with imprisonment, which may extend to 3 years and fine which may extend to Rs 10,000. On subsequent conviction imprisonment may extend to 5 years and the fine may extend to Rs.50, 000.
  • If any person seeks the aid of a centre for conducting pre-natal diagnostic techniques on any pregnant woman for sex selection or sex determination then the person will be punishable with imprisonment which may extend to 3 years and fine which may extend to Rs.50,000. Any subsequent conviction entails imprisonment, which may extend to 5 years and fine that may extend to Rs.1 lakh.(Pregnant women are exempted under this Act, unless proven otherwise)
  • For breaking of any provision of the Act or rules for which no penalty has been mentioned in the Act the person will be punishable with an imprisonment which may extend to 3 months or with fine, which may extend to Rs 1,000 or with both.

Other laws that support women’s rights

It is equally important to enact and implement laws that tackle the factors that contribute to declining CSR. Such as laws related to dowry, inheritance, domestic violence and other laws on violence and against women, child marriage, and crimes in the name of honour. It is only when women’s rights are fully supported, that a conducive environment will be created for girls to grow and prosper.

Coalition Partners