According to the United Nations, this child will be born in India, and statistically should be a girl. But many of India’s girls are going missing at birth, because of parents’ desire to have boys. In 2008, the number of missing girls in India increased in 2008 to 275,000 as compared to 1,000 for the rest of South Asia.
If a girl child is lucky enough to be born, she faces high female mortality in infancy and early childhood in South Asia. What causes excess mortality among girls during infancy and early childhood? One possible explanation that has received a lot of attention is discrimination by parents against girls. Certainly, in parts of the world like Afghanistan, China, northern India, and Pakistan, such discrimination is a serious problem. Studies have shown delays in seeking medical care and lower expenditures for girls. In India, despite stellar economic growth in recent years, maternal mortality is almost six times what it is in Sri Lanka.
Bringing down mortality risks for boys and girls in low income countries today is largely a question of providing the basic public health services that governments in most European countries provided in the early part of the 20th century. Reducing the burden of infectious diseases will produce declines in child mortality, more for girls than boys. Bangladesh, which have managed to reduce overall infant mortality through clean water and better sanitation, has also reduced female mortality in infancy and early childhood.
The region continues to have unacceptably high rates of malnutrition with Bangladesh and India—arguably the fastest growing countries in the region in recent times—having a higher proportion of malnourished children than even the poorest countries in Sub-Saharan Africa. There is considerable evidence that malnutrition affects not only children’s chances of survival but also their cognitive capacity and learning ability. Losses of up to 25 IQ points have been attributed to micronutrient deficiencies in children under two. And children, who learn less, earn less.
Access to education for girls’ in South Asia is less bleak. Considerable gains have been made in the last decade with female enrollments growing faster than male enrollments. In 2008, there were about 95 girls for every 100 boys in primary school. A cumulative gender bias against girls builds over the educational lifecycle, however. Poor girls face a significant schooling disadvantage in much of Africa and South Asia, a disadvantage that increases at lower incomes. In both India and Pakistan, while boys and girls from the top income fifth participate in school at similar rates, there is a gender gap of almost five years in the bottom income fifth. Afghanistan and Pakistan are two of the few countries where female enrollment remains low even at the primary level. In Pakistan a 500-meter increase in the distance to school decreased female enrollment by 20 percentage points.
When a woman in South Asia decides to have children of her own, her likelihood of dying during childbirth is still comparable to that of Northern Europe in the 19th century. Bangladesh and India have maternal mortality ratios comparable to Sweden’s around 1900, and Afghanistan’s is similar to Sweden’s in the 17th century. In 2008 there were 63,000 maternal deaths in India. One of every 10 women in Afghanistan die from maternal causes, and a much larger fraction suffer long-term health issues due to complications during and after childbirth.
Gender equality matters in its own right but is also smart economics. The World Bank is investing more than a billion dollars with governments in South Asia to improve the quality of basic services in health, nutrition, water and sanitation, education at all levels, and infrastructure. For example, in India, the World Bank has just launched a $106 million nutrition project that focuses on the first 1,000 days of life, from pregnancy to age two, so that each child gets the best start in life.
The key asset of South Asia is its people. South Asia has a young population and the second lowest female participation rate in the labor force. The demographic transition will result in more than 350 million people to enter the working age population over the next two decades. Boosting economic growth in Asia will contribute to rising living standards and expanded thirst for goods and services around the globe. Investing in this demographic dividend can provide a tailwind for the next three decades in much of South Asia.
Sharing the fruits of growth and globalization equally between men and women is essential to meeting key development goals and boosting the world economy. Countries that create better opportunities and conditions for women and girls can raise productivity, improve outcomes for children, make institutions more representative, and advance development prospects for all. Such a reform agenda is challenging, but feasible. Governments should use the resources made available by South Asia’s demographic transition wisely. It’s the only sustainable pathway out of poverty.
Let’s make sure that today’s 7 billionth child has not only a healthy start in life but the support she needs to grow up to a safe, productive and secure adulthood.