WATERING THE NEIGHBOUR'S GARDEN: THE GROWING - CICRED

DECREASES IN MALE AND FEMALE MORTALITY AND MISSING WOMEN …
level we did find evidence towards diminishing sex ratios derived from
censuses conducted in the past 50 years (except between 1991 and
2001). The sex ratio in a population is determined by many factors and
changes in this trend do not mean that one can conclude that they
were due to faster improvements in health conditions of females than
of males. The decline in sex ratios in Matlab HDSS area in 1974-96
was, however, more substantial than in Bangladesh as a whole and in
accordance with the hypothesis of considerable improvements in
female-to-male survival and health and less missing girls than in the
past. In spite of existence of strong parental son preference in Matlab,
the sex ratio at birth remained very constant over the years, suggesting
that there was little or no sex-selective abortion.
Next, we looked at trends in male-to-female life expectancy and in
survival in infancy and childhood in Matlab. We observed substantial
improvements in female survival in the past 20 to 25 years for the
various mortality indicators considered. We then decided to focus on
male/female differences in mortality in the age groups 1-4 years old.
The male/female mortality odds ratio increased considerably in recent
birth cohorts with a marked difference between the comparison and
the MCH-FP areas. This ratio increased from 0.56/1.00 in the 1976-79
birth cohort to 0.77/1.00 in the 1995-99 cohort in the comparison area
and from 0.53/1.00 in the 1976-79 cohort to 1.1/1.0 (which means
complete elimination of the female disadvantage) in the 1995-99 cohort
in the MCH-FP area. It could quite well be that since around 1995
boys and girls in the MCH-FP area benefited equally from easy access
to and use of high-quality child health services. This suggests that highquality
health services can be important in reduction of the female
disadvantage in survival.
The decrease in the male/female mortality ratio especially in children
1-4 years old occurred in a period in which fertility also declined
(until 1993) or remained at the same level (after 1993). The fertility
decline contributes to reduce sex differentials in mortality by lowering
the so-called “parity effect” that changes the balance between boys and
girls at different parities. Our results showed that first female children
(e.g., in families with one girl only) had a better chance of survival than
higher order girls (girls in families with older sisters) and the same
applies to a lesser extent to first male boys compared to higher order
boys. This is consistent with results of other studies (Muhuri and
Preston, 1991; Das Gupta, 1987). We had, however, more data at our
disposal than these two studies and, therefore, could conclude the
following. Neglect of and discrimination against higher order girls
(measured in terms of mortality) continued to exist in Matlab in most
177