India’s demographic landscape tells a complex story of progress and persistent challenges. While the country has made significant strides in health and education, the data reveals troubling patterns in how women fare compared to men. From declining sex ratios to millions of “missing women,” these numbers expose systemic gender inequalities that continue to shape Indian society. Understanding these demographic patterns is crucial for addressing the deep-rooted discrimination that affects women’s survival, health, and opportunities.
Table of Contents
The declining sex ratio
India’s sex ratio-the number of females per 1,000 males-stood at 940 in the 2011 Census, showing a slight improvement from 933 in 2001. However, this still falls well below the natural biological ratio. Historically, India has witnessed a steady decline in its sex ratio, dropping from 972 in 1901 to its lowest point in recent decades. This pattern reflects systematic neglect of female health and nutrition, coupled with cultural preferences for male children.
The child sex ratio-measured for children aged 0-6 years-paints an even more alarming picture. While the overall sex ratio showed marginal improvement, the child sex ratio decreased in many states, with districts like Fatehgarh Sahib recording just 754 females per 1,000 males. This sharp decline signals the impact of sex-selective practices and differential care for girl children.
State-level disparities
The variation across states reveals how social and economic factors influence demographic outcomes. Kerala leads with a sex ratio of 1,084, while states like Haryana and Punjab lag behind with ratios below 900. Southern states generally perform better, benefiting from higher literacy rates and stronger social development indicators. In contrast, northern states with deeply entrenched patriarchal norms continue to struggle with skewed ratios.
The phenomenon of missing women
In his groundbreaking 1990 analysis, economist Amartya Sen first identified that more than 100 million women were “missing” from Asia’s population. These women hadn’t disappeared-they simply never existed due to sex-selective practices and unequal access to resources. Sen’s calculation compared actual sex ratios in countries like India and China with those in regions where men and women receive equal care, revealing a massive deficit.
The missing women phenomenon stems from deep-rooted son preference driven by patriarchal social structures, economic factors, and cultural traditions. Families often perform a harsh cost-benefit analysis: boys are seen as future wage earners and caretakers of aging parents, while girls require dowries and leave their natal families after marriage. This calculation leads to discrimination in nutrition, healthcare, and even the decision to abort female fetuses.
Understanding the causes
Several interconnected factors contribute to the deficit of women. Research estimates that over 126 million women are now missing worldwide, with the majority concentrated in South and East Asia. Unlike natural sex ratios where females slightly outnumber males due to their biological survival advantage, countries with strong son preference show the opposite pattern.
Interestingly, the patterns differ between countries. In India, wealthier and more educated urban families show higher rates of missing women, as they invest significant resources in children and use sex-selective technologies to ensure male offspring. The rise of prenatal sex determination technology has intensified this problem, even as overall female mortality rates have improved.
Population growth dynamics
Population growth occurs naturally through the difference between crude birth rates and crude death rates. India has experienced three distinct phases of population growth since independence. While overall growth has slowed, female population growth rates varied significantly by state during the 1991-2001 decade, with Kerala recording the slowest growth and states like Haryana showing much higher rates.
Both crude birth rates and death rates have declined steadily due to development and improved healthcare. However, India continues to face concerning levels of maternal and infant mortality. The Maternal Mortality Rate measures deaths during pregnancy or within 42 days of delivery, while the Infant Mortality Rate tracks deaths before the first birthday. These indicators reveal persistent gaps in healthcare quality and access, particularly affecting women and children in poorer states.
Fertility rates and education
The Total Fertility Rate-the average number of children a woman would have during her reproductive years-has declined dramatically. India’s TFR dropped from 3.6 in 1995 to 2.9 in 2005, and has now fallen below the replacement level of 2.1. This transformation reflects changing social norms, improved access to contraception, and rising education levels.
Education emerges as the strongest factor influencing fertility decisions. Women with no schooling have a TFR of 3.3, while educated women average just 1.8 children. The relationship between female literacy and fertility is remarkably consistent: as education levels rise, family sizes shrink. Research suggests that increasing female literacy from 26 percent to 70 percent could reduce the TFR by one child per woman.
The Kerala model
Kerala achieved replacement-level fertility in the early 1990s, when the national TFR was still around 4. The state’s success stemmed from high female literacy rates, accessible healthcare, and social empowerment of women. This demonstrates that fertility decline need not wait for high income levels-social development and education can drive demographic transitions even in economically modest contexts.
Life expectancy trends
Life expectancy at birth has improved substantially for both sexes, with females consistently outliving males since 1981. This female survival advantage reflects biological factors and improving access to healthcare. As of 2021, life expectancy for females in Kerala reached nearly 80 years compared to 72 years nationally.
However, significant variations exist across states. While Kerala reports life expectancy exceeding 76 years for women, states like Assam, Odisha, and Madhya Pradesh lag behind at 59-60 years. These disparities mirror broader patterns in healthcare infrastructure, nutrition, education, and women’s social status. States with better health systems, higher literacy, and greater gender equality consistently show better life expectancy outcomes.
Maternal health outcomes
Maternal mortality has declined sharply over recent decades. India’s Maternal Mortality Ratio fell from 398 per 100,000 live births in 1998 to 88 in 2023, a remarkable achievement. Yet approximately 22,500 women still die each year from pregnancy-related causes, and India remains distant from the UN target of 70 deaths per 100,000 births by 2030.
Regional disparities persist. Kerala and Andhra Pradesh report just 30 maternal deaths per 100,000 births, comparable to developed nations, while Assam records 195 deaths-more than six times higher. These gaps reflect unequal access to institutional deliveries, skilled birth attendance, and emergency obstetric care.
The major causes of maternal death include obstetric hemorrhage, hypertensive disorders, and unsafe abortions. Poor states struggle primarily with bleeding complications, often due to delayed treatment. Wealthier states face more deaths from pregnancy-induced hypertension. Underlying factors include early marriage, malnutrition, anemia, and inadequate antenatal care-issues that disproportionately affect poor and rural women.
What do you think? How can India address the deep cultural preferences for sons that lead to millions of missing women? What role should education play in improving women’s demographic outcomes and health indicators across different states?
References
- https://www.census2011.co.in/sexratio.php
- https://en.wikipedia.org/wiki/Missing_women
- https://www.asianstudies.org/publications/eaa/archives/asias-missing-millions-how-policy-and-social-pressure-made-millions-of-women-disappear/
- https://www.sciencedirect.com/science/article/pii/S1353829222002039
- https://www.drishtiias.com/daily-updates/daily-news-analysis/decline-in-india-s-total-fertility-rate
- https://visionias.in/current-affairs/monthly-magazine/2025-10-04/social-issues/decline-in-fertility-rate-in-india
- https://eprints.lse.ac.uk/6663/1/Fertility,_Education_and_Development.pdf
- https://journals.sagepub.com/doi/pdf/10.1177/0021909614541087
- https://en.wikipedia.org/wiki/Kerala_model
- https://www.dataforindia.com/maternal-mortality/
- https://www.ijnrd.org/papers/IJNRD2403032.pdf
- https://www.statista.com/statistics/1023245/india-maternal-mortality-ratio-by-state/
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