Friday, June 3, 2011

Prenatal sex selection and selective abortion in East Delhi

Under the Pre-conception and Pre-natal Diagnostic Techniques (PC & PNDT) Act, every radiologist is required to fill a Form F before conducting an ultrasoundon a pregnantwoman.However, the audit carried out by NGO Action India in east Delhi, on behalf of the Delhi government, showed that not even 10% of the forms were complete.

The form has 19 questions, including the reason for conducting the sonography, along with the details of the patient and the doctor.

AbortionClinics, which carry out prenatal sex selection and selective abortion, leave most details incomplete, deliberately skipping sections mentioning doctor’s name, signature, patient’s address, age of fetus and pregnancy record.

Since March 2010, the district commissioner’s office received 7,000 Form Fs from around 132 clinics located in three east Delhi sub-districts — Preet Vihar, Vivek Vihar and Gandhi Nagar. Only about 50 forms were complete.

Action India’s Sulekha said, “Leaving even a single question unanswered in the form is a violation of the Act. In east Delhi, not even 50-60 form Fs were complete. Some didn’t have note from doctors, specifying reason for the ultrasound, and the rest didn’t mention address of patient.”

The Union health ministry has intensified pressure on states to get every ultrasound clinic to fill Form F. Last week, the ministry asked the states to carry out medical audit of all PNDT records.

“The Central Supervisory Board, constituted under the PNDT Act 1994, in its last meeting has recognized the importance of medical audit of records regarding all preconception or pregnancy-related procedures to curb the rampant misuse of medical technology for sex selection,” the letter says.

The ministry instructed that the district/sub-district appropriate authorities would have to ensure vigorous monitoring of all facilities, offering ultrasound diagnostic under the following norms. They have to identify facilities not maintaining or submitting records as per the provisions of Section 29 of the Act.

They would also have to analyze and scrutinize monthly reports submitted by such facilities by checking whether name of the referring doctor is mentioned
and referral slip is preserved, whether clear medical ground has been documented and weeks of pregnancy and parity (no. of previous children with sex) mentioned, whether name, address and contact details of patient is documented, whether declarations are duly signed by pregnant women and doctor with date and consent.

District authorities have been told to check under-reporting of ultrasound procedures by checking inpatient registers. “Action taken report may accordingly be sent to ministry on a priority basis,” the letter said. An official added, “A careful examination of the form will tell us who is involved in sex determination.”

Law against sex tests

All unregistered ultrasound machines and scanners that can determine sex of an unborn child will be seized and the “service provider” will be liable for both a fine and imprisonment.

The offender has to pay a fine of Rs 10,000 and will also face a maximum three-year jail term. If there is a recurrence of the offence, then the guilty has to cough up Rs 50,000 as fine as well as undergo five years of imprisonment.

The Union health ministry amended the Pre-natal Diagnostic Techniques (PNDT) rules on Thursday to enforce these stringent measures to curb sex selection.

The existing rules have little teeth. If irregularities are found in a clinic, the service provider can reclaim the ultrasound machine and scanner against a paltry fine.

Health minister Ghulam Nabi Azad gave his assent to the amendment on Thursday. However, the formal notification is likely to come through on Saturday, which also coincides with the Central Supervisory Board meeting that will take stock of India’s skewed sex ratio.

Now, Rule 11 (II) of the PNDT Rules 1996 says, “Appropriate authority or officer authorized may seal and seize any ultrasound machine, scanner or any other equipment, capable of detecting sex of fetus used by any organization if the organization hasn’t got itself registered under the PNDT Act.”

It further states, “These machines of organizations may be released if such an organization pays penalty equal to five times of the registration fee to the appropriate authorities concerned and gives an undertaking that it shall not undertake detection of sex before and after conception.” The amended rule says, “These machines will be confiscated and further action taken as per section 23 of the PNDT Act for non-registration.”

A ministry official said, “Every ultrasound machine in India has to be registered under the PNDT Act. Earlier, a company or a person having an unregistered ultrasound machine would pay Rs 20,000 (five times the registration fee) and take back his machine.”

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