Chao Fengqing, Kc Samir, Ombao Hernando
Statistics Program, Computer, Electrical and Mathematical Sciences and Engineering Division, King Abdullah University of Science and Technology, Thuwal, 23955-6900, Saudi Arabia.
Asian Demographic Research Institute, Shanghai University, Shangda Road, Shanghai, 200444, China.
BMC Public Health. 2022 Feb 19;22(1):358. doi: 10.1186/s12889-022-12693-0.
The sex ratio at birth (SRB; ratio of male to female births) in Nepal has been reported around the normal level on the national level. However, the national SRB could mask the disparity within the country. Given the demographic and cultural heterogeneities in Nepal, it is crucial to model Nepal SRB on the subnational level. Prior studies on subnational SRB in Nepal are mostly based on reporting observed values from surveys and census, and no study has provided probabilistic projections. We aim to estimate and project SRB for the seven provinces of Nepal from 1980 to 2050 using a Bayesian modeling approach.
We compiled an extensive database on provincial SRB of Nepal, consisting 2001, 2006, 2011, and 2016 Nepal Demographic and Health Surveys and 2011 Census. We adopted a Bayesian hierarchical time series model to estimate and project the provincial SRB, with a focus on modelling the potential SRB imbalance.
In 2016, the highest SRB is estimated in Province 5 (Lumbini Pradesh) at 1.102, corresponding to 110.2 male births per 100 female births, with a 95% credible interval (1.044, 1.127) and the lowest SRB is in Province 2 at 1.053 (1.035, 1.109). The SRB imbalance probabilities in all provinces are generally low and vary from 16% in Province 2 to 81% in Province 5 (Lumbini Pradesh). SRB imbalances are estimated to have begun at the earliest in 2001 in Province 5 (Lumbini Pradesh) with a 95% credible interval (1992, 2022) and the latest in 2017 (1998, 2040) in Province 2. We project SRB in all provinces to begin converging back to the national baseline in the mid-2030s. By 2050, the SRBs in all provinces are projected to be around the SRB baseline level.
Our findings imply that the majority of provinces in Nepal have low risks of SRB imbalance for the period 1980-2016. However, we identify a few provinces with higher probabilities of having SRB inflation. The projected SRB is an important illustration of potential future prenatal sex discrimination and shows the need to monitor SRB in provinces with higher possibilities of SRB imbalance.
据报道，尼泊尔全国层面的出生性别比（SRB；男婴与女婴出生比例）处于正常水平。然而，全国性的SRB可能掩盖了该国国内的差异。鉴于尼泊尔在人口和文化方面存在异质性，在次国家层面构建尼泊尔SRB模型至关重要。此前关于尼泊尔次国家层面SRB的研究大多基于调查和人口普查的观测值报告，尚无研究提供概率预测。我们旨在使用贝叶斯建模方法估计并预测1980年至2050年尼泊尔七个省的SRB。
我们汇编了一个关于尼泊尔省级SRB的广泛数据库，包括2001年、2006年、2011年和2016年的尼泊尔人口与健康调查以及2011年人口普查。我们采用贝叶斯分层时间序列模型来估计和预测省级SRB，重点是对潜在的SRB失衡进行建模。
2016年，估计第5省（蓝毗尼省）的SRB最高，为1.102，即每100例女婴出生对应110.2例男婴出生，95%可信区间为(1.044, 1.127)，而第2省的SRB最低，为1.053(1.035, 1.109)。所有省份的SRB失衡概率普遍较低，从第2省的16%到第5省（蓝毗尼省）的81%不等。估计SRB失衡最早于2001年在第5省（蓝毗尼省）开始，95%可信区间为(1992, 2022)，最晚于2017年在第2省（1998, 2040）开始。我们预测所有省份的SRB将在2030年代中期开始回归到全国基线水平。到2050年，预计所有省份的SRB将接近SRB基线水平。
我们的研究结果表明，在1980 - 2016年期间，尼泊尔的大多数省份SRB失衡风险较低。然而，我们发现有几个省份SRB上升的可能性较高。预测的SRB是未来潜在产前性别歧视的一个重要例证，表明需要对SRB失衡可能性较高的省份进行监测。
