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More than 50 million people in India do not have access to effective handwashing, putting them at a greater risk of acquiring and transmitting the novel coronavirus, according to a study.

Researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in the US found that without access to soap and clean water, over 2 billion people in low- and middle-income nations -- a quarter of the world's population -- have a greater likelihood of transmitting the coronavirus than those in wealthy countries.

According to the study, published in the journal Environmental Health Perspectives, more than 50 per cent of the people in sub-Saharan Africa and Oceania lacked access to effective handwashing.

"Handwashing is one of the key measures to prevent COVID transmission, yet it is distressing that access is unavailable in many countries that also have limited health care capacity," said Michael Brauer, a professor at IHME.

The study found that in 46 countries, more than half of people lacked access to soap and clean water.

In India, Pakistan, China, Bangladesh, Nigeria, Ethiopia, Democratic Republic of the Congo, and Indonesia, more than 50 million persons in each country were estimated to be without handwashing access, according to the study.

"Temporary fixes, such as hand sanitizer or water trucks, are just that -- temporary fixes," Brauer said.

"But implementing long-term solutions is needed to protect against COVID and the more than 700,000 deaths each year due to poor handwashing access," Brauer said.

He noted that even with 25 per cent of the world's population lacking access to effective handwashing facilities, there have been "substantial improvements in many countries" between 1990 and 2019.

Those countries include Saudi Arabia, Morocco, Nepal, and Tanzania, which have improved their nations' sanitation, the researchers said.

The study does not estimate access to handwashing facilities in non-household settings such as schools, workplaces, health care facilities, and other public locations such as markets.

Earlier this month, the World Health Organization predicted 190,000 people in Africa could die of COVID-19 in the first year of the pandemic, and that upward of 44 million of the continent's 1.3 billion people could be infected with the coronavirus, the researchers said. 

United Nations, Jun 30: India accounts for 45.8 million of the world's 142.6 million "missing females" over the past 50 years, a report by the United Nations said on Tuesday, noting that the country along with China form the majority of such women globally.

The State of World Population 2020 report released on Tuesday by the United Nations Population Fund (UNFPA), the world organisation's sexual and reproductive health agency, said that the number of missing women has more than doubled over the past 50 years - from 61 million in 1970 to a cumulative 142.6 million in 2020.

Of this global figure, India accounted for 45.8 million missing females as of 2020 and China accounted for 72.3 million.

Missing females are women missing from the population at given dates due to the cumulative effect of postnatal and prenatal sex selection in the past, the agency said.

Between 2013 and 2017, about 460,000 girls in India were missing' at birth each year. According to one analysis, gender-biased sex selection accounts for about two-thirds of the total missing girls, and post-birth female mortality accounts for about one-third, the report said.

Citing data by experts, it said that China and India together account for about 90-95 per cent of the estimated 1.2 million to 1.5 million missing female births annually worldwide due to gender-biased (prenatal) sex selection.

The two countries also account for the largest number of births each year, it said.

The report cites data by Alkema, Leontine and others, 2014 National, Regional, and Global Sex Ratios of Infant, Child, and under-5 Mortality and Identification of Countries with Outlying Ratios: A Systematic Assessment' from The Lancet Global Health.

According to their analysis, India has the highest rate of excess female deaths, 13.5 per 1,000 female births, which suggests that an estimated one in nine deaths of females below the age of 5 may be attributed to postnatal sex selection.

The report notes that governments have also taken action to address the root causes of sex selection. India and Vietnam have included campaigns that target gender stereotypes to change attitudes and open the door to new norms and behaviours.

They spotlight the importance of daughters and highlight how girls and women have changed society for the better. Campaigns that celebrate women's progress and achievements may resonate more where daughter-only families can be shown to be prospering, it said.

The report said that successful education-related interventions include the provision of cash transfers conditional on school attendance; or support to cover the costs of school fees, books, uniforms and supplies, taking note of successful cash-transfer initiatives such as Apni Beti Apna Dhan' in India.

It said that preference for a male child manifested in sex selection has led to dramatic, long-term shifts in the proportions of women and men in the populations of some countries.

This demographic imbalance will have an inevitable impact on marriage systems. In countries where marriage is nearly universal, many men may need to delay or forego marriage because they will be unable to find a spouse, the report said.

This so-called "marriage squeeze", where prospective grooms outnumber prospective brides, has already been observed in some countries and affects mostly young men from lower economic strata.

"At the same time, the marriage squeeze could result in more child marriages, the report said citing experts.

Some studies suggest that the marriage squeeze will peak in India in 2055. The proportion of men who are still single at the age of 50 is forecast to rise after 2050 in India to 10 per cent, it said.

The UN report said that every year, millions of girls globally are subjected to practices that harm them physically and emotionally, with the full knowledge and consent of their families, friends and communities.

At least 19 harmful practices, ranging from breast ironing to virginity testing, are considered human rights violations, according to the UNFPA report, which focuses on the three most prevalent ones: female genital mutilation, child marriage, and extreme bias against daughters in favour of sons.

Harmful practices against girls cause profound and lasting trauma, robbing them of their right to reach their full potential, says UNFPA Executive Director Dr. Natalia Kanem.

This year, an estimated 4.1 million girls will be subjected to female genital mutilation. Today, 33,000 girls under age 18 will be forced into marriages, usually to much older men and an extreme preference for sons over daughters in some countries has fuelled gender-biased sex selection or extreme neglect that leads to their death as children, resulting in the 140 million missing females.

The report said that ending child marriage and female genital mutilation worldwide is possible within 10 years by scaling up efforts to keep girls in school longer and teach them life skills and to engage men and boys in social change.

Investments totalling USD 3.4 billion a year through 2030 would end these two harmful practices and end the suffering of an estimated 84 million girls, it said.

A recent analysis revealed that if services and programmes remain shuttered for six months due to the COVID-19 pandemic, an additional 13 million girls may be forced into marriage and 2 million more girls may be subjected to female genital mutilation between now and 2030.

The pandemic both makes our job harder and more urgent as so many more girls are now at risk, Kanem said.

Thiruvananthapuram, Jan 27: Kerala Chief Minister Pinarayi Vijayan on Monday urged Prime Minister Narendra Modi to arrange for airlifting the Indians stranded in Wuhan province of China, the epicentre of coronavirus, saying the ground situation there has further worsened.

In a letter to Mr. Modi, he said since the situation in Wuhan was grave, it would be appropriate to operate a special flight to Wuhan or a nearby functional airport and airlift Indian nationals stranded there.

Mr. Vijayan also wanted the Prime Minister to give necessary instructions to the Indian Embassy in China to act pro-actively and provide necessary assistance and reassurance to Indians, including Keralites, stranded in Wuhan and Yichang.

The Chief Minister offered assistance of medical professionals from the State in case of evacuation of the Indians from Wuhan.

Chinese health authorities have announced the death toll due to coronavirus has sharply increased to 80 with 2,744 confirmed cases.

The confirmed cases of pneumonia caused by the novel coronavirus officially described as 2019-nCoV included 461 patients who are in critical condition.