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PCPNDT ACT

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Scope of presentation

• Introduction• Prenatal diagnostic techniques• Legal Initiatives • Pre-conception and pre-natal diagnostic

techniques(prohibition of sex selection) act,1994

• The pre-natal diagnostic techniques (regulation and prevention of misuse) rules, 1996

• Ammendments in act

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• Implementation of PCPNDT Act in Nagpur

• Referances

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World Scenario

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Child Sex Ratio and Development-The linkages

• Child Sex Ratio is an

important indicator to

measure the extent of

prevailing equity

between men and

women

• Changes reflect

underlying

socioeconomic & cultural

patterns

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Socio Cultural factors

Preference for male child

Subordinate status of woman

Social and economic dependence enhancing vulnerability

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Belief

ConvictionPerception

Myth

True salvation -last rites

Lineage &inheritance

Old agesecurity

Bread winners

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“We don’t kill cats, dogs as often as female children”

Spend Rs 5000 today and save Rs 5 lakh tomorrow…”

Reasons for missing girls

Small families but not without sons

According to NFHS-2 survey, in Delhi, for an average ideal family size of 2.4, the desired number of sons is 1.2, daughters 0.9, and either sex 0.3

According to NFHS-3 ( 2006) survey, in Punjab: Married women with two living son: only 8.8 percent wanted additional children while those with two living daughters nearly 60 percent wanted additional children

Families say,

“We do not dislike daughters. But, we need at least one son!”

Son Preference & Daughter Aversion

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Legal Initiative

• 1978: government issued a directive banning the misuse of amniocentesis in Government Hospitals and Laboratories

• 1988: Law to prevent sex determination tests was passed in Maharashtra “Maharashtra Regulation of Prenatal Diagnostic Technique Act 1988”

• 20th September1994: PNDT Act

: This act came into force in 1996

According to one micro-study conducted in some hospitals of Delhi:

Birth Order

Sex of previous child

Sex Ratio at birth (girls to 1000

boys)

2nd order One male child 959

One female child 542

3rd order One male and one female child

558

Two female children 219

* This information is from a study done by Christian Medical Association of India. It takes into account 11267 births for the year 2000-2001 collected from one of the public hospital in Delhi

Sex Ratio at Birth by sex of the previous children*

Who does it ?

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What was the need for such an Act?

• The PNDTAct 1994and its subsequent amendment in 2003 as the PC & PNDTAct(Prohibition of Sex Selection) Act were not brought into force because common people were resorting to sex selection,but because the medical fraternity made it possible and easy for them to do so

• Abandoning their moral responsibility to the tenets of our profession, a few doctors,took advantage of the discriminatory social practice of son-preference and daughter-aversion

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Act Provides – Permits – after registration

Use & regulation of Diagnostic Techniques

-  Genetic disorders

-  Metabolic disorders

-  Chromosomal malformation

-  Congenital disorders

-  Sex linked disorder

Prevention of Misuse

- Sex selection before conception

- Prenatal Sex Determination

- Female Foeticide

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• the pre conception – post conception / selection / determination of sex

• Communicating Sex

• prohibits the advertisement in any manner

• provides – punishment for violation

Act - Prohibits

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Indications of Prenatal Diagnostic Technique

1) Chromosomal abnormalities

2) Genetic Metabolic Diseases

3) Hemoglobinopathies

4) Sex linked genetic disease

5) Congenital anomalies

6) Any other abnormalities / or disease as may be specified by the Central Supervisory Board.

Reasons – record in writing

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Sex Selection

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An example of the implications of declining sex ratio

In Dang district, Gujarat-Rajasthan border, 8 brothers of the same family are married to Sarup, in the centre. Getting a wife is extremely difficult in this region—Sept. 2001, India Today

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An offence under this law is

Cognizable – A police officer may arrest the offender without warrant-

Non-bailable – Getting bail is not the right of the

accused. The courts have discretion to grant bail

Non-compoundable - Parties to the case cannot

settle the case out of court and decide not to

prosecute.( Sec 27 )

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Genetic Counseling Centre

- any hospital/ nursing home/

any place whatever name

Clinic

- prenatal diagnostic procedures

Laboratory

- Conducting analysis or tests of

samples received from genetic

clinic for prenatal diagnostic

test.

Institutions

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Ultrasound Clinics &Imaging Centers Included

Vehicles / Mobile ultrasound machine included

Health Melas / Non functional Machines at clinics included

Registered Medical Practitioner

-  Recognized medical qualification Indian Medical Council Act 1956 + Name registered in State Medical Register

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Registration

• Registration time up to 90 days

• Start work after registration

• No clinic shall be registered unless AA is satisfied about the equipment or standard prescribed

• AA after satisfying itself, with regards to advise of Advisory Committee

• Rejection by reason recorded in writing

• Renewal every after five years

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• Certificate of registration is non transferable

• Change of ownership, management or ceasing to functions – surrender the certificate

• New owner shall apply afresh

• Validity – 5 years

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Board (Central Supervisory Board)• Minister in charge, Ministry of health & Family

Welfare – Chairman Ex- officio

• Secretary – Vice Chairman Ex- Officio

• 2 Women Member – 1 Minister of Child Development Ex Officio + Minister represent of Law & Justice Ex Officio DGHS (Ex-officio)

• 2 Members (Each)

(i) Eminent medical geneticist

(ii) Eminent gynecologists & obstetrician 3 years

(iii) Eminent pediatricians

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• An officer – not below rank of Joint Secretary or equivalent of Central Government – Member Secretary Ex-Officio

(iv) Eminent social scientists &

(v) Representative of woman welfare organization

• 3 Woman Member of Parliament

• 2 shall be elected by House of people

• 1 by council of states

• 4 members of Central Government approved by – 1 years

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Functions of the Board

1) To advice the Government on policy matters relating to use of prenatal diagnostic techniques.

2) To review the implementation of the Act and the Rules made there under and recommend changes in the said Act and Rules to Central Government.

3)  To create public awareness.

4) To lay down code of conduct to be observed by persons working at Genetic Counseling Centre, Genetic Laboratory & Genetic Clinic.

5) Any other function as may be specified under the Act.

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Code of Conduct• Display board.• Availability of copy of the act- waiting

area/ sonography room.• Display original certificate- waiting

area/ sonography room.• Use of authorized machine.• Filling F form completely & signature

of concerned sonologist.• Authorized person performing

sonography.• Submission of report in time.

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Observations

• Unregistered centre carry out technique/procedure.

• Unauthorized person carry out technique/ procedure.

• F form not filled up completely.• F form signed by person other than the

one actually performing the technique/procedure.

• F form signed by owner instead of concerned person.

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Cont….

• Notice board not displayed.• Copy of the act not available.• Registration Certificate not displayed.• Photocopy of certificates displayed at

unregistered place.• Monthly reports not submitted to AA• Unregistered nursing homes. (other than

maternity homes)

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To say “No” to requests for performing sex selection, sex detection and gender-specific MTPs and to discourage colleagues from doing so.

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Common Reactions of Doctors

This is a draconian law ?

We have to maintain too much records, it is not possible because of our busy schedule.

Too much records: We have similar reactions for other laws, e.g. Income Tax, MTP, birth registration, nursing home act, etc. We have to abide by rules, records and reports, as made mandatory by Law.

Appropriate Authorities unnecessarily harass us.

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India Rajasthan Punjab Haryana HimachalPradesh

NFHS-I NFHS-II

No. of girls to boys

Sex Ratio at Birth