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A detailed analysis published this week in the peer-reviewed British Medical Journal (BMJ) Open highlighted the extent of sex-selective abortions in Nepal, a result of widely accessible prenatal tests. Social scientists estimate that roughly one in 50 female births were ‘missing’ from the records between 2006-11 (22,540 female births in total), implying that they had been aborted.
In Arghakhanchi, the most affected district, one in every six female births were ‘missing’ in the census data. The analysis found that sex-selective abortion was geographically concentrated around Kathmandu valley and Lumbini province, with 53% of missing females found in 11 out of 75 districts.
In the Kathmandu valley, Nepal’s main urban centre, around 115 males are born for every 100 females. Without sex selection, scientists said they would expect only 105 males born for every 100 females.
Like many other countries in the region, Nepal has a son preference. Sons are seen as economic and social assets and in some parts of the country while females are seen as a burden due to the expenses involved in marriage.
There has been growing concerns about female foeticide but so far there was little empirical research about the scale of the issue. For this analysis researchers used data from the 2011 population census and 2006, 2011 and 2016 Demographic Health Survey (DHS). While the census had limited data on a large sample size, the DHS data was a more detailed one but with a much smaller sample size.
Discrimination before and after birth
Abortions due to the results of sex determination tests are illegal in Nepal and carry a prison sentence. But the researchers writing in the BMJ-Open suggest that these laws are not effectively enforced.
The sex ratio was worse in wealthier groups compared to the poor ones, according to the analysis. It also found that in districts where more sex-selection occurred, females were more likely than males to die by age five, indicating discrimination both before and after birth.
“As fertility falls and urbanisation increases, there is more access to prenatal sex identification technology in Nepal,” said Melanie Channon from the University of Bath’s Department of Social & Policy Sciences, and the study’s lead author. “Our study shows some of the impact this has had over recent years, and we expect there will be a ‘trickle-down’ of ability to select the sex of a baby from the wealthiest and most educated as the technology becomes more widely available and more affordable. Put simple and starkly, without concerted effort, there will be an increase in sex-selective abortions in Nepal.”
Countries like India have banned sex selective abortions but there are routine reports of clandestine tests that prospective parents are offered.
“In view of the easy accessibility to prenatal sex-determination technologies, religious and socio-economic values given to sons, coupled with lack of focussed policy and programme to address gender inequality and weak enforcement of law relating to sex determination tests, the practice of sex selective abortion could further increase in the future,” said Mahesh Puri from the Center for Research Environment Health and Population Activities (CREHPA) in Nepal and the study’s co-author. “Targeted interventions to enable gender equality, increase value of females, as well as social and economic incentives for vulnerable females, such as conditional cash transfer schemes and effective enforcement of the law would be required.”
Globally around 140 million women are believed to be missing, according to the United Nations Population Fund. Since 1990s some areas have seen up to 25% more male births than female births. The resulting imbalance has been linked to increased instances of sexual violence and trafficking.
I am a science journalist based in India. I write on climate change, environment and public health. I have reported extensively on maternal health, malnutrition,