Mohan Diwakar, Eschliman Evan L, Malhotra Anju, Kaufman Michelle R
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, USA.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Sci Rep. 2024 Dec 28;14(1):30817. doi: 10.1038/s41598-024-81137-z.
India has consistently had one of the highest birth sex ratios (i.e., most males per female) globally. This analysis seeks to describe the sex composition of live births over the past decades among subgroups of the Indian population considering ongoing efforts to mitigate sex selection practices. Distribution of sex from the birth history data from three cross-sectional rounds of India's National Family Health Survey (2005-06, 2015-16, 2019-21) were used. We describe changes in the sex composition of live births across time through different phases of the PreNatal Diagnostics Technique Act by place of residence, caste, education, and wealth. Multilevel random effects logit regression models were used to estimate odds ratios and adjusted estimates for the different periods. The proportion of male births remained stable across the 1980s and early 1990s for the country overall, followed by a decrease until 2000 and plateauing subsequently. This trend was not uniform, with the Northern region peaking in 2000 before falling to lower levels, while the Southern region peaked in the 80s and trending downward in the 1990s. Spatial analysis and regression models showed a decrease in the proportion of male births during 2004-11 time period in the Northern region compared to 1995-2003 time period with the higher wealth quintiles decreasing the most. The proportion of male births elicited through birth histories in India has trended downward influenced by demographic changes but the decrease was not uniform across regions and sub-groups, possibly influenced by antenatal sex selection practices.
印度一直是全球出生性别比最高的国家之一（即每女性对应的男性数量最多）。本分析旨在描述过去几十年间印度人口亚组中活产儿的性别构成情况，同时考虑到为减轻性别选择行为所做的持续努力。我们使用了印度全国家庭健康调查三轮横断面调查（2005 - 06年、2015 - 16年、2019 - 21年）中出生史数据的性别分布。我们按居住地、种姓、教育程度和财富状况，描述了在产前诊断技术法案不同阶段中活产儿性别构成随时间的变化。我们使用多水平随机效应逻辑回归模型来估计不同时期的比值比和调整后的估计值。从总体来看，该国在20世纪80年代和90年代初男性出生比例保持稳定，随后下降至2000年，之后趋于平稳。这种趋势并不统一，北部地区在2000年达到峰值后下降至较低水平，而南部地区在80年代达到峰值，并在90年代呈下降趋势。空间分析和回归模型显示，与1995 - 2003年相比，2004 - 11年期间北部地区男性出生比例下降，其中财富五分位数较高的群体下降幅度最大。通过印度出生史得出的男性出生比例受人口结构变化影响呈下降趋势，但各地区和亚组的下降情况并不一致，这可能受到产前性别选择行为的影响。
