IJCM₃A: Child Sex Ratio – Declining trend and it’s determinants: a qualitative community- based study in a selected urban primary care setting, Puducherry.

Background: Child sex ratio (CSR) is defined as the number of females consistent with thousand males in the age group of zero to six years. This serves as a valuable indicator for measuring socio-economic development in a particular region. Objective: To understand community perspectives on gender preference at birth and its potential influence on the decreasing Child Sex Ratio in a selected urban primary care setting in Puducherry, aiming to identify key determinants contributing to the observed declining trend. Methodology: A qualitative study was conducted among residents of the 4 wards under the care of JIPMER Urban Health Centre, Puducherry. Participants were purposively selected among mothers, family members attending well baby clinic at the centre and frontline health workers. Two FGDs involving 8-10 participants were conducted till saturation of information is achieved. Collected data was transcribed in verbatim format. Descriptive manual content analysis was conducted to draw the categories and themes. Results: The qualitative study on Child Sex Ratio revealed that there is a prevailing inclination towards expecting female children. Moreover, the study found no evidence of gender selection practices at present. Participants mentioned awareness of schemes such as “CM Cares for the empowerment of newborn girl child” as contributing factors to these attitudes and behaviors. Gender revealment is found inadvertently in government and private hospitals in the studied population. Conclusion: The study region exhibits a declining CSR, and there is no evidence of gender selection practices at present in the selected region. While improving female literacy and economic standing is essential, it alone is insufficient for enhancing the overall life prospects of female children.