WHY DO WE NEED TO TALK ABOUT IT?
WHY in India do we need to have a campaign dedicated solely to the girl child? Why couldn’t we simply
talk about healthy children? Let me introduce you to some hard realities. For every 1000 male children,
we have 86 missing girl children. Moreover this ratio is far worse in urban “educated” areas than in its
rural counter-parts and has in-fact been dipping since independence. Where did all these girls go? Do we
know that a girl child in India is 75% more likely to die than a boy child? Why this disparity? If this isn’t
enough to shake you up, then try and consume this piece of information- 50% of young girls in India are
malnourished, 53% of girls in the age group of 5 to 9 years are illiterate and 1 out of 4 girls is sexually
abused before the age of 4!
In a land where ‘girl child’ has historically been given the status of a Goddess, how did we come to a
stage where millions of goddesses are malnourished, illiterate, weak and abused?
Poor Health outcomes of a girl child are a result of deeper rooted Social and Economic determinants.
Even if she escapes a feticide, a girl child is less likely to receive immunization, nutrition or medical
treatment compared to a male child due to inherent discrimination in an Indian home. Let us suppose
she is fortunate enough to receive formal education, sadly enough she ends up in a school which can’t
even offer her an operational toilet! Now let us not even begin to talk about sanitary and menstrual
health. Hasn’t that been a big Taboo in Indian societies for generations? But what we do believe is in
marrying off 48% of the women before the age of 18. This weak, uneducated and disempowered girl
gives birth to a weaker and an unhealthier child; and the entire cycle of poverty, poor health and
WHAT DO WE DO ABOUT IT?
Interestingly, modern day campaigns and write ups regarding social issues unduly harp about the
innumerable problems and challenges that we face. Although it may be easier to sit and count what
needs to be done. But it is much more difficult to not only find but act on practical and actionable
solutions for the same. If I were to mention that ‘one’ (prima facie) thing that I learnt during my Masters
training at Harvard, it would be the need for “context based solutions” for most of our Global Health
and Development problems. Sitting 10, 000 miles away with no understanding of social and cultural
contexts, we cannot be providing artificial solutions for very “real” problems like discrimination and
marginalization of girl child. Hence solutions have to emerge from the problems itself and cannot be
read in isolation for all practical purposes. Moreover the solution lies not only in government & donor
funded programs but in having a sustained change in social mindsets and norms.
This change begins at home. And it begins with a mother giving equal preference to both male and
female child. We all know that a mother should not discriminate between them in matters of nutrition,
education and access to formal health care when needed. But this rhetoric falls on deaf ears, when you
try argue the same with the head of a rural household. “Utilitarian” logic teaches them, that a girl is
financial liability which needn’t be invested upon in terms of education, health or employment. One day
she will leave them & go to her husband’s house is what they say, thus giving them no economic
dividends in return.
Gandhi once reiterated a Kantian logic, that human beings can’t be treated as a means to an end, but
that they are an end in itself. This line of thought, has given rise to what today we know as the Human
Rights approach. Here we don’t justify equal rights for the girl child on account of the fact that even girls
can be taught and gainfully employed to become an “asset” for an economic and rational Indian
household. But we demand the same because human rights are so intrinsic in nature that by virtue of
birth alone, they need to be respected as such. Still, education and monetary compensation for young
working women has unleashed an entire unexplored “utility” of female power.
And it is this attitude that we at “Swastha Balika”/Healthy Girl Child campaign are aiming to eradicate
for a healthier tomorrow. This campaign plans to cover all the 29 states and UTs and reach every Indian
household to bring about a change in our social-cultural mindset which will result in successfully
eliminating the discriminatory health seeking behaviors against and amongst girl children. We also plan
to initiate discussions and create a sense of urgency around health sector reforms, particularly those
that relate to the health & wellbeing of a girl child. This will include incorporating suggestions and ideas
around redesigning of ICDS (Integrated Child Development Services) as a focal point for all round
development of girl child, testing ‘Financial incentives for Doctors on delivering a girl child and to school
authorities for retaining female students up until secondary school and a renewed focus on Health
education of a girl child in at least 4 important domains including Nutrition, Sanitation, Menstrual
Health, and Healthy Lifestyles & Yoga. And these recommendations collected from the common masses
including you and me, complemented with evidence shared by Health and Policy experts, shall be
thereafter compiled into an actionable document. This compilation of our experiences, learnings and
suggestions to improve the health and social status of a girl child would then be circulated and
disseminated across various domains including the CSO, multilateral development agencies, media,
government authorities and most importantly back to where these came from- the people.
Dr. Ananya Awasthi
Masters in Global Health (Harvard University)