An Analytical Report on Gender Based Ratio of the

India (NFHS 5 & NFHS 4)

Semester-2

M.A. in Rural Development

Submitted to

DR. SHYAMA PRASAD MUKHERJEE UNIVERSITY RANCHI, JHARKHAND

DR. SHYAMA PRASAD MUKHERJEE UNIVERSITY RANCHI, JHARKHAND

An Analytical Report on Gender Base

Ratio of the India

Submitted by,

Bittu Kumar Saw

Class Roll: - 23
Roll No: - 21M294513
M.A in Rural Development (DSPMU, Ranchi)

Under the supervision of

Dr. Rajeev Kumar

M.S.W., (TISS Mumbai), M. Phil., (CIP, Ranchi), U.G.C. – J.R.F., Ph.D., (IIT Kharagpur)
 CONTENTS

Chapter 1
What is Gender Based Ratio ............................................................(1)

Chapter 2
Literature Review ........................................................................... (1-2)

Chapter 3
Study on India ..................................................................................(3-9)
Introduction
Horizontal Analysis
Vertical Analysis
Comparison
Findings from the Study
Chapter 5
Study on the state of Jharkhand ............................................................. (10-16)
Introduction
Horizontal Analysis
Vertical Analysis
Comparison between India and Jharkhand
Findings from the Study
 CONTENTS

Chapter 6
Study on district of Dumka ..................................................................... (17-22)
Introduction
Vertical Analysis
Comparison between Jharkhand and Dumka
Findings from the Study

Chapter 7
Conclusion ........................................................................................ (23)
1. What is Gender Based Ratio?

The ratio between the number of males and females in a society is referred to as the gender
ratio. This ratio is not stable but instead shaped by biological, social, technological,
cultural, and economic forces. And in turn the gender ratio itself has an impact on society,
demography, and the economy.

In this entry we provide an overview of the variation and the changes of the gender ratio
across the world. We study how it changes from birth to late life; the forces that change
the ratio of men to women.

Many argue persuasively that the terms ‘gender’ and ‘sex’ are not to be used
interchangeably.

In this context here we have however decided to make an exception: we speak of the
‘gender ratio’ because it’s the established term and it will help all those who want to be
informed about this topic and search this term. But we also speak of the ‘sex ratio’ because
this is arguably the more accurate term and it is increasingly used within the academic
literature.

2. Literature Review
The study found that the development activities have spread a significant positive impact
on the women of north-east after Independence. More women are gradually going out to
seek employment, However, limited control over and access to resources cause women to
still lag behind. In spite of the fact that women had played active roles in various social
movements both pre-Independence and post-Independence. Their participation of grass-
root as well as electoral politics is very minimal. The legal system is also very
inaccessible to most women. The armed conflicts in the region have intensified violence
faced by women in the form of sexual, mental or physical abuse.
In this study, it was shown that sociocultural norms reflected leverage of women in
domestic decision-making. Both tribal and non-tribal women get beaten in the hands of
their husbands. There is lack of economic autonomy among tribal women. Domestic
violence has strong sociocultural components associated with gender norms prevalent in
society.

1
This study points out that witch-hunting is widely prevalent in indigenous communities
all across the world and India. In most cases women are targeted, however, weaker
sections of people such as the elderly and children are also attacked. Local belief systems
play a vital role in this.
Violence against is an underreported public health issue. The study found that 53.6%
respondents faced some form of violence during their marital life. Verbal form of
violence was most common (78.4%), followed by physical violence (48.2%). Risk of ever
having faced violence was significantly associated with increasing number of children,
husband being a smoker and husband being an alcoholic.
The study pointed out that domestic and workplace violence among Indian female
agricultural laborers – especially working conditions of female tea plantation workers of
the north-east, who form the lion’s share hired female agricultural labor in India. The
study finds that women whose families have a history of domestic violence and women
whose partners drink frequently are about 20% more likely to be survivors of domestic
violence themselves. Women who are employed, especially in commercial plantations are
more likely to be survivors of domestic violence. Work-place and domestic violence
therefore needs to be looked at in connection with each other.

2
3. Study on India

Introduction of India
The National Family Health Survey 2019-21 (NFHS-5), the fifth in the NFHS
series, provides information on population, health, and nutrition for India and
each state/union territory (UT). Like NFHS-4, NFHS-5 also provides district-
level estimates for many important indicators. The contents of NFHS-5 are
similar to NFHS-4 to allow comparisons over time. However, NFHS-5 includes
some new topics, such as preschool education, disability, access to a toilet
facility, death registration, bathing practices during menstruation, and methods
and reasons for abortion. The scope of clinical, anthropometric, and biochemical
testing (CAB) has also been expanded to include measurement of waist and hip
circumferences, and the age range for the measurement of blood pressure and
blood glucose has been expanded. However, HIV testing has been dropped. The
NFHS-5 sample has been designed to provide national, state/union territory
(UT), and district level estimates of various indicators covered in the survey.
However, estimates of indicators of sexual behavior; husband’s background and
woman’s work; HIV/AIDS knowledge, attitudes and behavior; and domestic
violence are available only at the state/union territory (UT) and national level.
This fact sheet provides information on key indicators and trends for
India. NFHS-5 fieldwork for India was conducted in two phases, phase one
from 17 June 2019 to 30 January 2020 and phase two from 2 January 2020 to 30
April 2021 by 17 Field Agencies and gathered information from 636,699
households, 724,115 women, and 101,839 men. Fact sheets for each State/U T
and District of India are also available separately.

3
 As in the earlier rounds, the Ministry of Health and Family Welfare,
Government of India, designated the International Institute for Population
Sciences, Mumbai, as the nodal agency to conduct NFHS-5. The main objective
of each successive round of the NFHS has been to provide high-quality data on
health and family welfare and emerging issues in this area. NFHS-5 data will be
useful in setting benchmarks and examining the progress the health sector has
made over time. Besides providing evidence for the effectiveness of ongoing
programmes, the data from NFHS-5 help in identifying the need for new
programmes with an area specific focus and identifying groups that are most in
need of essential services

Horizontal Analysis (Urban-Rural) of the Indicators of NFHS 5 (2019-21)

GENDER BASED URBAN RURAL TOTAL

RATIO NUMBERS
INDICATORS
3 985 1037 1020
4 924 931 929

Chart Indicators of NFHS 5 (2019-21)Title

1060
1040
1020
1000
980
960
940
920
900
880
860
Indicators 3 Indicators 4

Urban Rural Total numbers

4
Horizontal Analysis (Urban-Rural) of the Indicators of NFHS 4 (2015-16)

GENDER BASED URBAN RURAL TOTAL

RATIO NUMBERS
INDICATORS
3 985 1037 991
4 924 931 919

Chart TitIndicators of NFHS 4 (2015-16)le

1060
1040
1020
1000
980
960
940
920
900
880
860
Indicatora 3 Indicatora 4

Urban Rural Total Numbers

Vertical Analysis (NFHS 5 & NFHS 4) of the indicators

INDICATORS TOTAL NUMBERS

NFHS-4(2015-16) NFHS-5(2019-20)

3 991 1020

4 919 929

5
 TOTAL NUMBERS
1040

1020

1000

980

960

940

920

900

880

860
Indicators 3 Indicators 4

NFHS-4 NFHS-5 Column1

Interpretation:
This rate is high in rural areas and minimum low number in urban areas.

Result:
A vast amount of knowledge on sex discrimination in India has been
accumulated over the past several years. The reason for this dramatic shift stems
from the introduction of methods of prenatal sex determination, such as
ultrasound and other technologies in India. The combination of sex
discrimination and advanced technologies for prenatal sex determination and
abortion proved to be a dramatic cocktail. Ultrasound now has become an
efficient sex-selection device. In the process of selective modernization of
thoughts of society, believing in double-income single-kid have unfortunately
failed to understand the importance of woman and are conveniently accepting
this imbalance without understanding unforeseen consequences. The
government has taken action on strengthening the Pre-Conception & Pre-Natal
Diagnostic Techniques Act (PC & PNDT Act) as well as creating awareness on
the issue through various mechanisms. We, as community of doctors, should
participate actively in correcting this imbalance, by first, not doing sex
determination, prohibiting our doctor friends from doing so, utilizing the
opportunity by educating every patient coming to us about the seriousness of
issue, and lastly doing surveillance of this problem at every possible step.

Discussion:
6
Nationwide, the overall sex ratio at birth in 2011, Census has improved by 7 %
points to 940 against 933 in census in present study, average sex ratio for 6
years was 908 females born per 1,000 live born males (0.97), which is less than
the expected 952 females for every 1,000 males, were sex ratio at birth had been
normal. Sex ratio was 972 females per 1,000 males in primi para, which
decreased to 879 females per 1,000 males in second para, further reduced to
784 females per 1,000 males in third para. Since sex ratio at birth is the most
accurate and redefined indicator of sex selection at birth, no other explanation
for this decline could be reached. One important point to highlight is that, sex
selection is neither done nor encouraged in any form in our center. Out of
29,603 deliveries, only 22 women delivered were of the parity more than
three.Sex ratio at birth in fourth para of 864 females per 1,000 males is
unexpectedly favorable for females than in third para. This could be because,
either they did not want to do sex selection or were not successful in getting it
done, or because the failed contraceptive measures or just wanting to have the
fourth child—the last one is hard to believe. A similar study of sex ratio in
relation to birth order was carried out in Bhopal city from August 2011 to
September 2011 states; sex ratio is 946 for the first birth order, which is
declining to 788, 731, and 525 as the birth order is increasing [4]. In our study,
out of 200 antenatal women interviewed the majority 46 % (n = 92)
women were in the age group of 26–30 years. Five percent (n = 10) were elderly
gravida, i.e., more than 35 years. In age group 20–30 years out of 100
primigravidae, 52 % (n = 52) were willing to take next chance and extend their
family irrespective of sex of child being born in this pregnancy; 46 % (n = 42)
were not willing for the same, and remaining 2 % (n = 2) were not sure. Out of
100 multigravidae, 98 % (n = 98) were not willing to take next chance. Two
percent (n = 2) with previous two female children wanted to take third chance
hoping for the male child. We observed that as age increases, females are in a
hurry to complete the family with at least one male child. Out of ten, eight (80
%) families seem to prefer male child—all of them had previous female
children. In a study conducted to trend analysis of the sex ratio at birth in the
United States, a reduced sex ratio at birth has been linked to older age at
childbearing [5]. Majority 56 % (n = 112) were earning Rs. 5,000–10,000 per
month. Sixty four percent (n = 128) of husbands and 57 % (n = 114) of wives
were educated up to higher secondary and above. Unfortunately, no correlation
has been found with income and education in relation with preference of male
child. A study of sex ratio in relation to birth order in Bhopal city was carried
out from August 2011 to September 2011. Literacy-wise sex ratio shows that
education of women empowers them sufficiently to ensure their say in decision
Table 2 Distribution of antenatal women as per age Age (years) Percentage \20
4 21–25 31 26–30 46 31–35 14 36–40 5 41–45 0 [45 0 Table 3 Distribution of
antenatal women as per monthly income Monthly income Percentage \2,000 0
2,000–5,000 23 5,000–10,000 56 10,000–15,000 5 [15,000 16 Table 4 Shows
level of education of antenatal women and their husbands Level of education

7
 Husband Wife Uneducated 37
Primary school 0 0 Secondary school 32 36 Higher secondary 35 30
Graduation 28 26 Post graduation 2 1 Table 5 Preference for the sex of the child
of couples Preference for Husband Wife Nil Male Female Male Female
Primigravida 8 8 12 12 60 Multi gravida with previous male child 0 16 0 20 64
Multi gravida with previous female child 32 2 42 2 22 123 The Journal of
Obstetrics and Gynecology of India (January–February 2014) 64(1):23–26
Study to Review Sex Ratio at Birth 25 making and were more engaged in this
activity. Graduate and postgraduate mothers had a low sex ratio as compared to
illiterate and primary school [4]. Deep-rooted preference for males is thought to
be the main reason for gender bias in the sex ratio, and the sex ratio at birth, in
particular. People are hardly able to attach the same value to every human life,
as would be the case in an alternative context of equality. People unconsciously
suppress certain potential values. Here, we tried to evaluate the person’s ability
to develop the same values that she would develop in a context where freedoms
are fully guaranteed. In primigravid group, 60 % had no sex preference, 8 % of
husbands and 12 % of wives preferred male child, and remaining 8 % of
husbands and 12 % of wives preferred female child. In multigravidae with
previous male child, 64 % families had no preference for the sex, 16 % husband
and 20 % wives preferred female child. No one preferred for the second male
child. In multigravidae with previous female child, 22 % families had no
preference for the sex; 32 % husbands and 42 % wives preferred male child.
Two percent husbands and wives preferred for the second female child. Two
percent of the families admitted that they wanted to go ahead with sex
determination test, in spite of explaining them that it is being banned and in case
of unwanted sex of the child, they were keen to terminate the pregnancy.
People’s achievements do not fully match their preferences when they lack the
instruments that would enable them to act in accordance. A couple with a
preference for sons may not satisfy this preference (may have a daughter) if the
technology that would enable them to ensure the sex of their future child is
unavailable. Given an expansion of their freedom of choice, the couple would
ensure the sex of their child.

Findings from the Study:

A vast amount of knowledge on sex discrimination in India has been

accumulated over the past several years. The reason for this dramatic shift stems
from the introduction of methods of prenatal sex determination, such as
ultrasound and other technologies in India. The combination of sex
discrimination and advanced technologies for prenatal sex determination and
abortion proved to be a dramatic cocktail. Ultrasound now has become an
efficient sex-selection device. In the process of selective modernization of
thoughts of society, believing in double-income single-kid have unfortunately
failed to understand the importance of woman and are conveniently accepting
8
this imbalance without understanding unforeseen consequences. The
government has taken action on strengthening the Pre-Conception & Pre-Natal
Diagnostic Techniques Act (PC & PNDT Act) as well as creating awareness on
the issue through various mechanisms. We, as community of doctors, should
participate actively in correcting this imbalance, by first, not doing sex
determination, prohibiting our doctor friends from doing so, utilizing the
opportunity by educating every patient coming to us about the seriousness of
issue, and lastly doing surveillance of this problem at every possible step.

9
4. Study of Jharkhand

Introduction:

The National Family Health Survey 2019-21 (NFHS-5), the fifth in the
NFHS series, provides information on population, health, and nutrition for India
and each state/union territory (UT). Like NFHS-4, NFHS-5 also provides
district-level estimates for many important indicators. The contents of NFHS-5
are similar to NFHS-4 to allow comparisons over time. However, NFHS-5
includes some new topics, such as preschool education, disability, access to a
toilet facility, death registration, bathing practices during menstruation, and
methods and reasons for abortion. The scope of clinical, anthropometric, and
biochemical testing (CAB) has also been expanded to include measurement of
waist and hip circumferences, and the age range for the measurement of blood
pressure and blood glucose has been expanded. However, HIV testing has been
dropped. The NFHS-5 sample has been designed to provide national, state/union
territory (UT), and district level estimates of various indicators covered in the
survey. However, estimates of indicators of sexual behaviour; husband’s
background and woman’s work; HIV/AIDS knowledge, attitudes and behaviour;
and domestic violence are available only at the state/union territory (UT) and
national level. As in the earlier rounds, the Ministry of Health and Family
Welfare, Government of India, designated the International Institute for
Population Sciences, Mumbai, as the nodal agency to conduct NFHS-5. The
main objective of each successive round of the NFHS has been to provide high-
quality data on health and family welfare and emerging issues in this area.
NFHS-5 data will be useful in setting benchmarks and examining the progress
the health sector has made over time. Besides providing evidence for the
effectiveness of ongoing programmes, the data from NFHS-5 help in identifying
the need for new programmes with an area specific focus and identifying groups
that are most in need of essential services. Four Survey Schedules - Household,
Woman’s, Man’s, and Biomarker - were canvassed in local languages using
Computer Assisted Personal Interviewing (CAPI). In the Household Schedule,
information was collected on all usual members of the household and visitors
who stayed in the household the previous night, as well as socio-economic
characteristics of the household; water, sanitation, and hygiene; health insurance
coverage; disabilities; land ownership; number of deaths in the household in the
three years preceding the survey; and the ownership and use of mosquito nets.
The Woman’s Schedule covered a wide variety of topics, including the woman’s
characteristics, marriage, fertility, contraception, children’s immunizations and
healthcare, nutrition, reproductive health, sexual behaviour, HIV/AIDS,
women’s empowerment, and domestic violence.

1
0
 JHARKHAND MAP
The Biomarker Schedule covered measurements of height, weight, and
haemoglobin levels for children; measurements of height, weight, waist and hip
circumference, and haemoglobin levels for women age 15-49 years and men age
15-54 years; and blood pressure and random blood glucose levels for women
and men age 15 years and over. In addition, women and men were requested to
provide a few additional drops of blood from a finger prick for laboratory testing
for HbA1c, malaria parasites, and Vitamin D3. Readers should be cautious while
interpreting and comparing the trends as some States/UTs may have smaller
sample size. Moreover, at the time of survey, Ayushman Bharat AB-PMJAY
and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) were not fully rolled
out and hence, their coverage may not have been factored in the results of
indicator 12 (percentage of households with any usual member covered under a
health insurance/financing scheme) and indicator 41 (percentage of mothers who
received 4 or more antenatal care check-ups).
This fact sheet provides information on key indicators and trends for
Jharkhand. Due to the Covid-19 situation and the imposition of lockdown,
NFHS-5 fieldwork in phase 2 States/UTs was conducted in two parts. NFHS5
fieldwork for Jharkhand was conducted from 20th January 2020 to 21st March
2020 prior to the lockdown and from 5th December 2020 to 18th April 2021
post lockdown by Development and Research Services Pvt. Ltd. (DRS).
Information was gathered from 22,863 households, 26,495 women, and 3,414
men. Fact sheets for each district in Jharkhand are also available separately

1
1
Horizontal Analysis (Urban-Rural) of the Indicators of NFHS 5 (2019-21)

GENDER BASED URBAN RURAL TOTAL

RATIO
INDICATORS
3 989 1070 1050

4 781 926 899

Indicators of NFHS 5 (2019-21)

1200

1000

800

600

400

200

0
INDICATOR 3 INDICATOR 4

URBAN RURAL TOTAL

Horizontal Analysis (Urban-Rural) of the Indicators of NFHS 4 (2015-16)

GENDER BASED URBAN RURAL TOTAL

RATIO NUMBERS
INDICATORS
3 967 1014 1002
4 893 926 919

1
2
 Indicators of NFHS 4 (2015-16)
1040
1020
1000
980
960
940
920
900
880
860
840
820
Indicators 3 Indicators 4

Urban Rural Total

Vertical Analysis (NFHS 5 & NFHS 4) of the indicators

INDICATORS TOTAL NUMBERS

NFHS-5(2019-21) NFHS-4(2015-16)

3 1050 1002

4 899 919

TOTAL NUMBERS
1100

1050

1000

950

900

850

800
Indicators 3 Indicators 4

NFHS-5 NFHS-4

1
3
NFHS-5 Comparison between India and Jharkhand:

INDICATOR JHARKHAND STATE NFHS-5 INDIA NFHS-5

ALIMENT
NUMBERS URBAN RURAL TOTAL URBAN RURAL TOTAL
NUMBER NUMBER

3 989 1070 1050 985 1037 1020

4 781 926 899 924 931 929

TOTAL NUMBERS NFSH-5

1100

1050

1000

950

900

850

800
INDICARORS 3 INDICARORS 4
NFHS -5 OF JHARKHAND NFHS -5 OF INDIA

NFHS-4 Comparison between India and Jharkhand:

INDICATOR JHARKHAND STATE NFHS-4 INDIA NFHS-4

ALIMENT
NUMBERS URBAN RURAL TOTAL URBAN RURAL TOTAL
NUMBER NUMBER

3 967 1014 1002 956 1009 991

4 893 926 919 899 927 919

1
4
 TOTAL NUMBERS NFSH-4
1020

1000

980

960

940

920

900

880

860
INDICARORS 3 INDICARORS 4

NFHS -4 OF JHARKHAND NFHS -4 OF INDIA

Findings from the Study:

The fifth edition of the National Family Health Survey (NFHS) confirmed
signs of a demographic shift in India. For the first time since the NFHS
began in 1992, the proportion of women exceeded men: there were
1,020 women for 1,000 men. In the last edition of the survey in 2015-16,
there were 991 women for every 1,000 men.
In Jharkhand the sex ratio is even better than national average. In
Jharkhand the number of females per thousand males has gone up to
1050. In the last survey, this figure was 1002. In rural areas, the situation
is much better. There, the number of women per thousand men has
increased to 1070, while in urban areas this figure is 989.
However, only the decadal census is considered the official marker of
population trends in India and has a wider surveillance programme. The
NFHS surveys are smaller but are conducted at the district level and are
a pointer to the future.
Most States and Union Territories (UTs) had more women than men, the
NFHS-5 shows. States that had fewer women than men included
Gujarat, Maharashtra, Arunachal Pradesh, Haryana, Madhya Pradesh,
Punjab and Union territories such as Jammu & Kashmir, Chandigarh,
Delhi, Andaman and Nicobar Islands, Dadar and Nagar Haveli, and
Ladakh.

The survey has also shown the effect of Beti Bachao- Beti Padhao
campaign in Jharkhand. The survey pointed out indicators showing
improvements in the health and social sector of women as well. Marriage
of girls under the age of 18 has declined. Earlier 37.9 per cent of girls
1
5
were married before the age of 18. Now this percentage has come down
to 32.2. Although this is also much more than many states of the country,
there has also been a decrease in the number of men married before the
age of 21. It was 30.5 per cent in the last survey, which has now come
down to 22.7 per cent.
The survey also pointed out that family planning measures is gaining
momentum in Jharkhand. The survey pointed out that in 2020-21, 61.70
per cent of couples adopted family planning, compared to 40.4 per cent
earlier.
The survey also pointed out various indictors in which state have shown
improvement. As per the survey, 64.50 per cent of girls (above six years
of age) went to school 94.30 per cent of the population was getting
electricity 86.6 per cent of the clean water 75.80 per cent of women
preferring delivery of child in hospitals 79.2 per cent of children were fully
vaccinated among others.

1
6
5. Study of Dumka

Introduction:

This fact sheet provides information on key indicators and trends for
Dumka. Due to the Covid-19 situation and the imposition of
lockdown, NFHS-5 fieldwork in phase 2 States/UTs was conducted in
two parts. NFHS5 fieldwork for Jharkhand was conducted from 20th
January 2020 to 21st March 2020 prior to the lockdown and from 5th
December 2020 to 18th April 2021 post lockdown by Development
and Research Services Pvt. Ltd. (DRS). In Dumka, information was
gathered from 942 households, 958 women, and 122 men.

The National Family Health Survey 2019-21 (NFHS-5), the fifth in

the NFHS series, provides information on population, health, and
nutrition for India and each state/union territory (UT). Like NFHS-4,
NFHS-5 also provides district-level estimates for many important
indicators. The contents of NFHS-5 are similar to NFHS-4 to allow
comparisons over time. However, NFHS-5 includes some new topics,
such as preschool education, disability, access to a toilet facility, death
registration, bathing practices during menstruation, and methods and
reasons for abortion. The scope of clinical, anthropometric, and
biochemical testing (CAB) has also been expanded to include
measurement of waist and hip circumferences, and the age range for
the measurement of blood pressure and blood glucose has been
expanded. However, HIV testing has been dropped. The NFHS-5
sample has been designed to provide national, state/union territory
(UT), and district level estimates of various indicators covered in the
survey. However, estimates of indicators of sexual behaviour;
husband’s background and woman’s work; HIV/AIDS knowledge,
attitudes and behaviour; and domestic violence are available only at
the state/union territory (UT) and national level. As in the earlier
rounds, the Ministry of Health and Family Welfare, Government of
India, designated the International Institute for Population Sciences,
Mumbai, as the nodal agency to conduct NFHS-5. The main objective
of each successive round of the NFHS has been to provide high-
1
7
quality data on health and family welfare and emerging issues in this
area. NFHS-5 data will be useful in setting benchmarks and examining
the progress the health sector has made over time. Besides providing
evidence for the effectiveness of ongoing programmes, the data from
NFHS-5 help in identifying the need for new programmes with an area
specific focus and identifying groups that are most in need of essential
services. Four Survey Schedules - Household, Woman’s, Man’s, and
Biomarker - were canvassed in local languages using Computer
Assisted Personal Interviewing (CAPI). In the Household Schedule,
information was collected on all usual members of the household and
visitors who stayed in the household the previous night, as well as
socio-economic characteristics of the household; water, sanitation, and
hygiene; health insurance coverage; disabilities; land ownership;
number of deaths in the household in the three years preceding the
survey; and the ownership and use of mosquito nets. The Woman’s
Schedule covered a wide variety of topics, including the woman’s
characteristics, marriage, fertility, contraception, children’s
immunizations and healthcare, nutrition, reproductive health, sexual
behaviour, HIV/AIDS, women’s empowerment, and domestic
violence. The Man’s Schedule covered the man’s characteristics,
marriage, his number of children, contraception, fertility preferences,
nutrition, sexual behaviour, health issues, attitudes towards gender
roles, and HIV/AIDS. The Biomarker Schedule covered
measurements of height, weight, and haemoglobin levels for children;
measurements of height, weight, waist and hip circumference, and
haemoglobin levels for women age 15-49 years and men age 15-54
years; and blood pressure and random blood glucose levels for women
and men age 15 years and over. In addition, women and men were
requested to provide a few additional drops of blood from a finger
prick for laboratory testing for HbA1c, malaria parasites, and Vitamin
D3. Readers should be cautious while interpreting and comparing the
trends as some States/UTs may have smaller sample size. Moreover,
at the time of survey, Ayushman Bharat AB-PMJAY and Pradhan
Mantri Surakshit Matritva Abhiyan (PMSMA) were not fully rolled
out and hence, their coverage may not have been factored in the
results of indicator 12 (percentage of households with any usual
member covered under a health insurance/financing scheme) and
indicator 33 (percentage of mothers who received 4 or more antenatal
care check-ups).

1
8
 Vertical Analysis (NFHS 5 & NFHS 4) of the indicators

INDICATORS TOTAL NUMBERS

NFHS-4(2015-16) NFHS-5(2019-20)

3 1017 1067

4 1021 946

TOTAL NUMBERS
1100

1050

1000

950

900

850

800
Indicators 3 Indicators 4

NFHS-5 NFHS-4

NFHS –5 Comparison between India and Jharkhand:

INDICATOR JHARKHAND STATE NFHS-5 DUMKA DISTRICT NFHS-5

ALIMENT
NUMBERS URBAN RURAL TOTAL
NUMBER TOTAL NUMBER

3 989 1070 1050

991
4 781 926 899
919

1
9
 TOTAL NUMBERS NFSH-5
1100

1050

1000

950

900

850

800
INDICARORS 3 INDICARORS 4
NFHS -5 OF JHARKHAND NFHS -5 OF DUMKA

NFHS –4 Comparison between India and Jharkhand:

INDICATOR JHARKHAND STATE NFHS-4 DUMKA DISTRICT NFHS-4

ALIMENT
NUMBERS URBAN RURAL TOTAL TOTAL NUMBER
NUMBER

3 967 1014 1002 1067

4 893 926 919 946

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 TOTAL NUMBERS NFSH-4
1100

1050

1000

950

900

850

800
INDICARORS 3 INDICARORS 4

NFHS -4 OF JHARKHAND NFHS -4 OF DUMKA

Findings from the Study:

With regards to Sex Ratio in Dumka, it stood at 977 per 1000 male compared to
2001 census figure of 962. The average national sex ratio in India is 940 as per
latest reports of Census 2011 Directorate. In 2011 census, child sex ratio is 966
girls per 1000 boys compared to figure of 975 girls per 1000 boys of 2001
census data.
Out of the total Dumka population for 2011 census, 6.82 percent lives in urban
regions of district. In total 90,178 people lives in urban areas of which males are
47,586 and females are 42,592. Sex Ratio in urban region of Dumka district is
895 as per 2011 census data. Similarly child sex ratio in Dumka district was 918
in 2011 census. Child population (0-6) in urban region was 11,645 of which
males and females were 6,071 and 5,574. This child population figure of Dumka
district is 12.76 % of total urban population. Average literacy rate in Dumka
district as per census 2011 is 83.72 % of which males and females are 89.16 %
and 77.62 % literates respectively. In actual number 65,749 people are literate in
urban region of which males and females are 37,014 and 28,735 respectively.

As per 2011 census, 93.18 % population of Dumka districts lives in rural areas
of villages. The total Dumka district population living in rural areas is 1,231,264
of which males and females are 620,928 and 610,336 respectively. In rural areas
of Dumka district, sex ratio is 983 females per 1000 males. If child sex ratio data
of Dumka district is considered, figure is 968 girls per 1000 boys. Child
population in the age 0-6 is 207,804 in rural areas of which males were 105,570
and females were 102,234. The child population comprises 17.00 % of total
rural population of Dumka district. Literacy rate in rural areas of Dumka district

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 is 59.28 % as per census data 2011. Gender wise, male and female literacy stood
at 71.65 and 46.72 percent respectively. In total, 606,660 people were literate of
which males and females were 369,261 and 237,399 respectively.

All details regarding Dumka District have been processed by us after receiving
from Govt. of India. We are not responsible for errors to population census
details of Dumka District.

Dumka District Density 2011:

The initial provisional data released by census India 2011, shows that density of
Dumka district for 2011 is 351 people per sq. km. In 2001, Dumka district
density was at 251 people per sq. km. Dumka district administers 3,761 square
kilometers of areas.

Dumka Child Population 2011:

In census enumeration, data regarding child under 0-6 age were also
collected for all districts including Dumka. There were total 219,449 children
under age of 0-6 against 199,238 of 2001 census. Of total 219,449 male and
female were 111,641 and 107,808 respectively. Child Sex Ratio as per census
2011 was 966 compared to 975 of census 2001. In 2011, Children under 0-6
formed 16.61 percent of Dumka District compared to 18.01 percent of 2001.
There was net change of -1.4 percent in this compared to previous census of
India.

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6. Conclusion
A vast amount of knowledge on sex discrimination in India has
been accumulated over the past several years. The reason for this
dramatic shift stems from the introduction of methods of prenatal sex
determination, such as ultrasound and other technologies in India. The
combination of sex discrimination and advanced technologies for
prenatal sex determination and abortion proved to be a dramatic
cocktail. Ultrasound now has become an efficient sex-selection device.
In the process of selective modernization of thoughts of society,
believing in double-income single-kid have unfortunately failed to
understand the importance of woman and are conveniently accepting
this imbalance without understanding unforeseen consequences.
The government has taken action on strengthening the Pre-Conception
& Pre-Natal Diagnostic Techniques Act (PC & PNDT Act) as well as
creating awareness on the issue through various mechanisms. We, as
community of doctors, should participate actively in correcting this
imbalance, by first, not doing sex determination, prohibiting our
doctor friends from doing so, utilizing the opportunity by educating
every patient coming to us about the seriousness of issue, and lastly
doing surveillance of this problem at every possible step.

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An Analytical Report on Gender Based Violence of the North East India 27