CM9.2-3 | CM9.2-3 | Demographic Indices and Sex Ratio — Summary & Reflection

KEY TAKEAWAYS

This module has built the numerator-denominator discipline essential for demographic analysis:

Fertility hierarchy: CBR (live births per 1,000 total population) → GFR (per 1,000 women 15-49) → TFR (sum of ASFRs × 5; India NFHS-5 = 2.0) → GRR (daughters per woman; TFR × female birth fraction) → NRR (GRR × survival; NRR = 1 at replacement). Each step corrects for a limitation in the previous measure.

Mortality hierarchy: CDR (all deaths per 1,000 population; India SRS 2020 ≈ 6.2) → ASDR (age-specific) → SDR (standardised for comparison) → IMR (deaths <1 year per 1,000 live births; India ≈ 28) → U5MR (deaths 0-4 years per 1,000 live births; India ≈ 41.9) → MMRatio (maternal deaths per 100,000 live births; India ≈ 97, SRS 2018-20).

Sex ratio: Overall = 943 (all ages, Census 2011); Child sex ratio = 919 (0-6 years, Census 2011). Child sex ratio is the sensitive indicator of sex-selective behaviour. Causes: son preference, female foeticide (proximate), dowry system, lack of social security (distal). Interventions: PC-PNDT Act 1994 (amended 2003), Beti Bachao Beti Padhao, CCT schemes.

Population pyramids: Expansive (high fertility/mortality, Stage 2), constrictive (low fertility, ageing, Stage 4), stationary (replacement level). Dependency ratio = [(< 15) + (≥ 65)] / (15-64) × 100.

Application: Select the index that matches the decision (TFR for FP, IMR for child health, SRB for sex selection monitoring). Always communicate both the rate and the absolute number.

REFLECT

You are reviewing monthly HMIS data for your district and notice that the sex ratio at birth has fallen from 940 to 910 girl births per 1,000 boy births over the past six months. What is your immediate interpretation? What additional data would you request to confirm whether this represents a real change or a data artefact? What action under the PC-PNDT Act 1994 would you initiate? Reflect on the tension between the programmatic response (inspecting ultrasound centres) and the deeper social determinants (son preference, dowry) that the PC-PNDT Act cannot address alone.