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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.

New Delhi, May 15: Union Health Minister Harsh Vardhan has appealed to all states and Union Territories to ban the sale of smokeless tobacco products and spitting in public places in line with the orders of the Rajasthan and Jharkhand governments to prevent the spread of coronavirus infection.

In a letter to all state health ministers, Vardhan said smokeless tobacco users have a tendency to spit in public places or otherwise and therefore, increase health risks especially those of spreading contagious diseases like COVID-19, tuberculosis, swine flu, encephalitis and others.

"Use of smokeless tobacco also creates an unhygienic environment which further spreads the diseases. The large gathering at the retail outlets where smokeless tobacco products are sold, also pose the risk of spread of COVID-19," he said.

In the letter dated May 11, the Union minister underlined that tobacco use is a major threat to public health globally. He also mentioned the Indian Council of Medical Research's (ICMR) appeal to the public not to consume and spit smokeless tobacco products in public places.

Chewing tobacco products and areca nut increases the production of saliva followed by a very strong urge to spit. Spitting in public places could enhance the spread of the COVID-19, Vardhan said.

"By banning spitting in public places, states and UTs can help in achieving not only Swachh Bharat but also Swasth Bharat (Clean India and Healthy India)," he said.

Vardhan also mentioned the May 1 guidelines issued by the Union Home Ministry under the National Disaster Management Act, 2005, which stipulate that "spitting in public places shall be punishable with fine as may be prescribed by the state/UT local authority and consumption of liquor, pan, gutkha, tobacco etc in public places is not allowed".

Appreciating the efforts of Rajasthan and Jharkhand in this direction, the Union Health Minister urged all states to take similar measures and create widespread awareness regarding the harm of spitting in public places.

The Rajasthan government had by an ordinance banned spinning in public places and sale of paan, gutka and tobacco in the wake of the coronavirus outbreak. The Jharkhand too has imposed a complete ban on all types of tobacco products to prevent spitting in public places that could increase the spread of coronavirus infection.

"I am happy to note that the governments of Jharkhand and Rajasthan have already completely banned the sale of tobacco products and spitting in public places. Therefore, I urge upon you to take similar measures and also create widespread awareness in your state/ UT regarding harms of spitting in public places.

"It is also requested that the directions of Ministry of Home Affairs in this regard may be implemented scrupulously and effectively," Vardhan said in the letter.

Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of related diseases. A review of studies by public health experts convened by WHO on April 29 found that smokers are more likely to develop severe diseases, compared to non-smokers, said Binoy Mathew, senior programme officer of Voluntary Health Association of India.

It is one of the main risk factors for a number of chronic ailments, including cancer, lung and cardiovascular diseases, he said, adding that according to the Global Adult Tobacco Survey, with 268 million or 28.6 per cent of all adults in India, the country has the second largest number of tobacco users in the world.

At least 12 lakh die from tobacco-related diseases every year, Mathew said.

Those keen to quit smoking and smokeless products can avail of free of charge telephone-based services launched by the government. The Ministry of Health has set up a National Tobacco Quit Line Services to provide counselling services to help tobacco consumers quit the habit.

Coronavirus lockdown in India has been extended till June 30 with more relaxations.

While the lockdown has been extended in containment zones, relaxations outside containment zones include reopening of religious places for public  from June 8. 

Hotels, restaurants and shopping malls also to open from June 8. Decision on opening educational institutions to be taken in July.