Indmedica Home | About Indmedica | Medical Jobs | Advertise On Indmedica
Search Indmedica Web
Indmedica - India's premier medical portal

Indian Journal of Community Medicine

Gender Preference and Awareness Regarding Sex Determination among Married Women in Slums of Chandigarh

Author(s): S Puri, V Bhatia, HM Swami

Vol. 32, No. 1 (2007-01 - 2007-03)

Female foeticide resulting in decline of child sex ratio has led to enforcement of Preconception and Prenatal diagnostic Techniques (PNDT) act since February 2003.

Sex ratio, an important social indicator measuring extent of prevailing equity between males and females in society, is defined as no. of females /1000 males. Changes in sex ratio refl ect underlying socioeconomic, cultural patterns of a society. As per 2001 census sex ratio in India is 933/1000 males, which continues to be significantly adverse towards women and is the lowest amongst 10 most populous countries in world. Russia tops the list in sex ratio (1140) followed by USA (1029)1.

Most alarming is decrease in CSR (Child sex ratio 0-6). In Punjab the number was least (793) in 2001, followed by Haryana (820) and Chandigarh (845).

Advances in technology and diagnostic facilities have opened up avenue for the girl haters leading to serious disturbances in sex ratio as a result of female foeticide.

Desire for male child manifests so blatantly that parents have no qualms about repeated, closely spaced pregnancies, premature deaths and even terminating child before it is born. Birth of female child is perceived as a curse with economic and social liability2.Therefore the present study was conducted among married women dwelling in slums and semi-rural area to find out the level of their awareness regarding sex determination and attitude towards gender.

Material and Methods

The study was conducted in the year 2004 that enrolled 373 married females in the age group of 20-45 years attending General OPD, Family Welfare clinic and Antenatal Clinic of health centre attached to Govt. Medical College, Chandigarh. The centre has excellent infrastructure in form of logistics and trained manpower of Doctors and Paramedicals. The centre is located in modern urban locality and caters to slum population (nearly 35,000).

Around 60-80 patients visit this health centre daily. Usually, the number of patients from urban, rural and slum area account for 45%, 30% and 25%. The antenatal, nursing and other married female patients account for 40% of the total OPD patients. A pre-designed proforma was used to elicit information on the knowledge of sex determination techniques along with preference for the male child among women attending OPD. Every 2nd pregnant women coming from slum area was interviewed by lady doctors. Consent was taken before filling the questionnaire (12% of females refused to participate). Hence 373 females got enrolled in the study.


The sample of 373 females over a period of 6 months (Dec. 2003 to May 2004) comprised of 88 (22.2%) primi gravida and 290 (77.7%) multi gravida. 245 (65.6%) married females, desired of two children followed by 104 (27.8%) who wanted to have 3 children. Only 12 (3.2%) desired more than 3 children.

Table 1: Awareness of subjects regarding sex determination

Awareness No. of Subjects
% age
Place where sex determination can be done.
Aware (44)  
Pvt. Hospital 43 11.4
Govt. Hospital 01 0.3
Not Aware (331) 88.3
Determining sex of child considered crime
Aware (305)  
Yes 244 65.4
No 61 16.3
Do Not Know (68) 18.3
Legal punishment/penalty for determining sex
Aware 61 16.4
Not Aware 312 83.6
Implication of female foeticide
Aware 42 11.5
Not Aware 331 88.5

331 (88.4%) were not aware of sex determination techniques where as 44 (11.6%) were aware. 244 (65.5%) agreed to the fact that sex determination is a crime. 61 (16.3%) and 42 (11.4%) knew about punishment for sex determination and implications of killing of female child, respectively.

Table 2: Preference for Sons by Different Sex Composition of Children in a Family

Current Children Preference for Boy
None 57.8
Boy 44.3
Girl 79.5
1st Baby Boy & 2nd Baby Boy 6.06
1st Baby Girl & 2nd Baby Girl 75.0
Combined 56.0

Table 3: Awareness of subjects regarding sex determination

No. of Alive Children Currently
Desire of Next Child
  No. %
Boy (N=124) Boy Girl 55 32 44.325.8
  Either 29 23.3
  None 4 3.3
Girl (N=93) Boy Girl 74 1 79.5 1.07
  Either 13 13.9
  None 5 5.3
1st Baby Boy & 2nd Baby Boy (N=33) Boy Girl Either 2 11 6 6.06 33.3 18.18
  None 14 42.42
1st Baby Girl & 2nd Baby Girl (N=40) Boy Girl Either 30— 75.0  
  None 10 25.3
Primigravida (N=83) Boy Girl 48 12 57.814.4
  Either 23 27.7
Combined Preference (N=373) Boy Girls 209 56 5615
  Either 71 19
  None 37 9.9
* Conventional baby boy and baby girl combination is a natural distribution and taken as complete family. So this group was excluded from study presuming that the families are satisfied with this composition.

Out of 93 women with first child as a baby girl 74 (79.5%) keenly wanted second baby as a boy and only 5 (5.3%) did not want any further child. Out of 33 women who had two baby boys previously, 11 (33.3%) wanted their third baby as a girl and 14 (42.42%) did not want to conceive further. A strong desire for male baby in 30 (75%) women was seen among women with two baby girls. Overall the study observed male preference was in 209(56%) married women.


The study done in the age group of 20-35 years included married women belonging to poor socioeconomic groups residing in rural and slum area. Sample of 373 women is representative of 35000 slum population which is catered by Urban Health Training Centre.

Out of 373 females 22.2%were primi gravida and 77.7% were multi gravida. About two-third intended to have two child norm as compared to 3.2% who opted for one child and 13.2% for more than three children

The preference for a male heir and birth of girl child, not an occasion to celebrate has its origin in the age-old custom.

Dowry is a major reason for parents to resent a daughter birth and moreover they think it is pointless to spend so much on a girl education and upbringing only to leave for anothers home, without repaying.

The present study too shows the desireness for males Majority (57.8%) intended to have male as their first child and14.4% wanted second child too as male even with the first male baby. Three-fourth women wanted to have their third baby as boy after two baby daughters and 6% wanted a boy even after two baby boys. Similar kind of preference has been observed in different parts of the country evident from studies of Mumbai, Himachal Pradesh and other states3-5. The unabashed preference for son has been documented in other studies too. The studies is done in Haryana shows that with one son living 27% wanted to have next child as male baby and with two sons desireness was seen in 3.5%6. Strong desire for male leads to bias in various aspects of life between boy and a girl which has been corroborated in various studies. Rao observed in this studies that boys are given the privilege of good food, education where as girls are entitled for household chores7. The disparity was seen in immunization of the child too. Study done by Joy depicted that male children outnumbered females in maturity of state in India. Immunization factor was found to be 0.33 in Punjab as compared to 0.17 in Himachal Pradesh8. This fact was very well supported by study done by Puri Nina who found that inspite of having biological advantage over boys, more girls die due to gender discrimination and gross neglect10. Sex ratio has declining in the country recently. Its lowest in Punjab (793) an in Chandigarh it is (845)1. This has been attributed to the alarming trend of female foeticide has a result of pre-determination of sex. Sex determination has become with in the reach of people because of ultrasonography, being cheap easily accessible. The implication of this only led to be inception of PNDT act. The various modifications done under this now includes that not only the person, but also the one getting the patient along with the patient would be punished and the placed and the nursing home / private hospital not registered as MTP centre would be closed.

The present study showed that only 11.66% of subjects had knowledge where sex determination can be done and 65.5% agreed to the fact that it is a crime. Acquaintance about the legal punishment and penalty for sex determination was found to be only 16.3% its surprising that inspite of so much development and improvement in literacy status still the dislike for female child and women is groped in the society that is evident from many studies9. This calls for an effective advocacy by ruling authorities for enforcement of PNDT act to curb female foeticide . An integrated approach of Govt and NGO’s is desired. Govt. of India has done substantial work throwing considerable light on subjects of girl child through implementation of various programmes to restore the rights and dignities of girl child, giving her a world where she can live, live and dream and enrich our lives.

The present study has shown a clear picture of recent scenario of the female foeticide and infanticide and a strong desire for male child among women from urban slums. This calls for a need to educate women from under privileged population about gender equality and recommendations under PNDT act in order to improve declining sex ratio in our country.


  1. Focus-Population Environment Development: A Bulletin of Population Foundation of India: 2004.
  2. Kanitkar T and Mistry M. Status of women in India- an interstate comparison: The Indian Journal of social work:2000;381-3.
  3. Mutharayappa R, Arnold F and Roy T.K. Son preference and its impact on fertility in India, National family health subject reports no. 3,Mumbai: International Institute for population sciences.
  4. Sunday Times of India: son preference in India, Mumbai May 11-2000.
  5. Malhi P, Raina G, Malhotra D. Preference for the sex of children and its implications for reproductive behaviour in Urban Himachal Pradesh 1999;23-9.
  6. Malhi P. Infl uence of gender preference for children on fertility behaviour: A comparative study of men and women in Haryana 1995; 53-7.
  7. Rao N. Gender Bias in Nutrition, Some Issues. Journal of Family Welfare 1995; 1-9.
  8. Elamon J. Gender differentials in child immunization-A study based on NFHS data. Journal of Family Welfare 1998; 12-7.
  9. Puri N. Girl child in India. Journal of Family Welfare 1998; 1-9.

Department of Community Medicine, Govt. Medical College, College
Building, Sector 32-A, Chandigarh – 160047
Email: [email protected]
Received: 24.03.05

Access free medical resources from Wiley-Blackwell now!

About Indmedica - Conditions of Usage - Advertise On Indmedica - Contact Us

Copyright © 2005 Indmedica