An increase in prenatal sex selection in India – where some families have strong preferences for sons over daughters – leads to a reduction in malnutrition among the surviving girls. The improvements in their health do not seem to be because girls are more likely to be born into richer families but because they are more likely to be born into families that want them. Indeed, the health improvements are strongest in families that are likely to have conducted an ultrasound test.
These are among the findings of research published in the September 2015 issue of the Economic Journal. The study by Luojia Hu of the Federal Reserve Bank of Chicago and Analia Schlosser of Tel Aviv University analyses individual data from the Indian National Family Health Surveys for children born between 1980 and 2005.
The authors comment:
''Our research implies that simply banning prenatal sex selection would not necessarily improve girls'' overall wellbeing since parents might substitute between prenatal and postnatal sex discrimination.''
''On the other hand, a continuing rise in the practice of prenatal sex selection in India will amplify the imbalances in the sex ratio in marriage and labour markets with detrimental effects to the economy and wider society.''
''This suggests that more effective policy interventions should aim at fundamentally changing the parental preferences that favour sons over daughters.''
In the absence of a direct measure of parental access to prenatal sex selection, the researchers use as a proxy the male to female ratio of births (MFR) in the year and state in which the child was born. They find evidence that from the 1990s, MFR at birth has increased considerably in certain regions in India, particularly in the northern and western states, reflecting the practice of prenatal sex selection.
The authors then examine changes in girls'' outcomes over time relative to boys in states where the prevalence of prenatal sex selection has been increasing and compare them with changes in the outcomes for girls and boys born in states where prenatal sex selection has remained low and stable. They find that:
· An increase in prenatal sex selection leads to a significant and sizable reduction in malnutrition – in particular underweight and wasting – among surviving girls. An increase in the MFR of 0.07 points (for example, from 1.07 to 1.14) is associated with a four percentage point reduction in the proportion of girls who are underweight, which is an 8% reduction relative to the average outcome for girls.
· For example, in Punjab (a state with one of the strongest preferences for sons and which has experienced the largest increase in the MFR), this estimate would mean that the eight percentage point increase in the fraction of missing girls observed between 1991 and 2001 led to a six percentage point reduction in the proportion of underweight girls.
· There is no association between an increase in prenatal sex selection and boys'' outcomes, which suggests that the relative improvements of girls are actually absolute improvements, rather than merely reflecting less deterioration in girls'' outcomes compared with boys. Moreover, improvements for girls are strongest in families that are likely to have conducted an ultrasound test.
· Both findings suggest that girls'' outcomes improved as a consequence of the diffusion of prenatal sex selection technology rather than other unobserved confounding factors, such as improvements in health conditions in those states that have a high prevalence of prenatal sex selection.
Broadly speaking, there are two ways in which access to prenatal sex selection can lead to changes in girls'' outcomes: selection and treatment. The selection effect arises from girls being born into families with different characteristics and son preferences that result in changes in the average outcomes of the population of girls.
The treatment effect, on the other hand, comes from changes in the behaviour of a given family, in response to access to prenatal sex selection (or changes in MFR). Within this framework, the researchers further explore some specific channels linking prenatal sex selection and girls'' outcomes. They find that:
· There is no evidence that prenatal sex selection leads to a selection of girls into families with different observable socio-economic characteristics. In particular, there is no differential improvement in background characteristics among families with girls relative to families with boys. This means that the improvement in girls'' nutritional status is unlikely to be explained by the fact that girls are born into richer or better-endowed families.
· But consistent with some of the expected consequences of prenatal sex selection, girls are more likely to be born into families that want them. Specifically, there is an increase in the proportion of girls born in families with weaker self-reported preferences for sons.
· There is also evidence of a larger reduction in family size for girls, which is likely to increase the amount of family resources available for girls. This change is also expected since with access to prenatal sex selection, parents of girls would not necessarily need to have more children to attain the desired sex composition of their family.
· There is also some suggestive evidence of better treatment of girls as reflected in breastfeeding practice. In particular, there is an increase in the proportion of girls who are breastfed for 24 months or longer in states with a higher increase in MFR.
· On the other hand, prenatal sex selection does not appear to be associated with a reduction in girls'' mortality or a regional decline in reported preferences for sons.
The research implies that simply banning prenatal sex selection would not necessarily improve girls'' overall wellbeing since parents might substitute between prenatal and postnatal sex discrimination.
On the other hand, a continuing increase in the practice of prenatal sex selection will lead to and amplify the sex ratio imbalance in future marriage and labour markets with detrimental effects to the economy and society. This suggests that more effective welfare-enhancing policy interventions should aim at fundamentally changing parental preferences that favour sons over daughters.
Some policies of this kind – such as conditional cash transfer schemes for parents of girls – have started to be implemented in recent years. But as yet, there is little evidence on their effectiveness – see Sekher (2012) for a review of some of these programmes in India.
''Prenatal Sex Selection and Girls'' Well-being: Evidence from India'' by Luojia Hu and Analia Schlosser is published in the September 2015 issue of the Economic Journal. Luojia Hu is at the Federal Reserve Bank of Chicago. Analia Schlosser is at the Eitan Berglas School of Economics, Tel Aviv University.