Abstract

PIP: Deviation from the normative sex-pattern of infant deaths is so large in Egypt that nearly 1/3 of female deaths can be attributed to a sex-specific cause: lesser care of the female child. This article reports on child neglect which may account for the relatively lower survival rate of the female infant, despite its biological advantage over the male. This knowledge is seen as vital in planning interventions. The investigation answers 3 questions relating to the sex-specific factors of death among female infants: do girls display a poorer level of nutrition compared to boys? Is there evidence to show that sickness episodes of female infants are treated more carelessly than those of male infants? Are there reasons to believe that girls are more exposed to life-threatening psychological factors than are boys? A group of 598 families in low-income districts of Cairo was randomly chosen to receive regular monthly visits by a team of trained field invstigators over a 1-year period. The sample is thought to represent life in urban quarters of Egypt, described as pervasively rural in orientations despite urban occupations and living conditions. The study finds no significant sex difference in nutritional status until the 6th month of life. Around this period, 2/5 of the female group but 1/4 of the male show signs of malnutrition as measured by weight. The difference continues to increase and is very statistically significant by the end of the year. Nutritional status of female infants tended to decline with an addition of daughters in the family. Also, at birth orders 2 ot 5 and in large families of 4-5 children, the relative nutritional disadvantage of the female infant is statistically significant. Moreover, a very distinct sex-difference in dietary patterns is observed as no boy was deprived of supplementary feeding during the 2nd 1/2 of the year but only 1/15 girls received food other than breast milk during this period. Despite some evidence highly suggestive of lesser attention to health problems of female infants, the finding is not conclusively tested. Further research is recommended using more objective methods of studying parental behaviour in child sickness. With respect to psychological attitudes, the authors argue that "girl neglect" on the part of mothers is a reflex to the "boy preferance" displayed by fathrs. "Boy preferance" contributes to infant mortality and to increased fertility and should therefore be a common concern to both health and population planners. Finally, the authors argue for a change in attitude towards daughters which would promote sex equality in child care. A diversified and wide-reaching communication program for altering attitudes and behaviour could be based on relevant sayings from the Sunnah, a major source of Islamic ethics.