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EDUCATION AND DEBATE: Fariyal F Fikree and Omrana Pasha Role of gender in health disparity: the South Asian context BMJ 2004; 328: 823-826 [Full text]

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What is the policy response to sex disparities?

sushila j zeitlyn   (26 May 2004)

Persistence of bias against females can be tested in migrants

Raj S Bhopal   (15 July 2004)

What is the policy response to sex disparities? 26 May 2004
sushila j zeitlyn, senior social development adviser DFID Department for International Development, 1 Palace Street, London SW1E5HE Send response to journal: Re: What is the policy response to sex disparities?	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
Persistence of bias against females can be tested in migrants 15 July 2004
Raj S Bhopal, professor of public health Edinburgh University, Edinburgh EH89AG Send response to journal: Re: 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