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Editor,
Fikree and Pasha raise grave issues relating to gender discrimation in
South Asia, writing 'Less notorious but more far reaching than infanticide
is the so called benign neglect that girls are subject to at all ages in
South Asia.' and 'This neglect may take the form of poor nutrition,lack of
preventive care (specifically immunisation),and delays in seeking health
care for disease.' It is vital to know whether such discrimation is
ingrained and sustained over generations or perpetuated by adverse
economic circumstances, and possibly amenable to rapid change.
Martineau and colleagues tested this hypothesis by looking at gender
differences in immunisation in Newcastle, UK. The study investigated the
uptake of complete courses of triple vaccine; measles, mumps, and rubella
vaccine; and BCG immunisation in the first two years of life. A name
search identified 346 Moslem south Asians and 115 Hindus and Sikhs who
were matched for age, sex, and general practitioner to 461 children of
White European origin. There were no sex differences in Newcastle south
Asians. This may reflect changes following migration in culture,
material circumstances, health care access and social expectations. Our
findings suggest that sex differences in health care use in British south
Asian children are absent or small and provide hope that differences of
this kind on the Indian subcontinent are amenable to change.
Hypotheses on the relative importance of material, environmental,
health care and cultural factors can be tested by observing the behaviour
of migrant populations.
Reference
Martineau A, White M, Bhopal R. No sex differences in immunisation
rates of British south Asian children: the effect of migration? Br Med J
1997; 314: 642-3
This paper makes shocking, depressing but familiar reading. Where are
the opportunities for health policy and health service providers to
intervene? How can health policy redress gender inequality by creating
incentives for parents to bring their daughters for life saving treatment?
Where are the incentives for health workers to encourage female patients
to seek health care? Education services in South Asia have made some
progress in redressing inequality by introducing policies that create
incentives for girls to enrol and be retained in school. Where are the
examples in the health sector? Health policy makers could make a powerful
and influential contribution to promoting human rights by actively seeking
to redress the sex disparities in health care. I would like to see a
special issue of the BMJ devoted to how policy makers can address this
important issue.
Competing interests:
None declared
Competing interests:
No competing interests
26 May 2004
sushila j zeitlyn
senior social development adviser DFID
Department for International Development, 1 Palace Street, London SW1E5HE
Persistence of bias against females can be tested in migrants
Editor,
Fikree and Pasha raise grave issues relating to gender discrimation in
South Asia, writing 'Less notorious but more far reaching than infanticide
is the so called benign neglect that girls are subject to at all ages in
South Asia.' and 'This neglect may take the form of poor nutrition,lack of
preventive care (specifically immunisation),and delays in seeking health
care for disease.' It is vital to know whether such discrimation is
ingrained and sustained over generations or perpetuated by adverse
economic circumstances, and possibly amenable to rapid change.
Martineau and colleagues tested this hypothesis by looking at gender
differences in immunisation in Newcastle, UK. The study investigated the
uptake of complete courses of triple vaccine; measles, mumps, and rubella
vaccine; and BCG immunisation in the first two years of life. A name
search identified 346 Moslem south Asians and 115 Hindus and Sikhs who
were matched for age, sex, and general practitioner to 461 children of
White European origin. There were no sex differences in Newcastle south
Asians. This may reflect changes following migration in culture,
material circumstances, health care access and social expectations. Our
findings suggest that sex differences in health care use in British south
Asian children are absent or small and provide hope that differences of
this kind on the Indian subcontinent are amenable to change.
Hypotheses on the relative importance of material, environmental,
health care and cultural factors can be tested by observing the behaviour
of migrant populations.
Reference
Martineau A, White M, Bhopal R. No sex differences in immunisation
rates of British south Asian children: the effect of migration? Br Med J
1997; 314: 642-3
Competing interests:
None declared
Competing interests: No competing interests