An estimated 239,000 girls under the age of five die in India each year due to neglect linked to gender discrimination, a new study has found.
The figure, which amounts to 2.4 million deaths a decade, does not include pre-natal mortality rates.
"Gender-based discrimination towards girls doesn't simply prevent them from being born, it may also precipitate the death of those who are born," wrote the study's co-researcher Christophe Guilmoto in the Lancet medical journal.
"Gender equity is not only about rights to education, employment or political representation. It is also about care, vaccination, and nutrition of girls, and ultimately survival," added Guilmoto.
The report is the first to examine the number of avoidable deaths among girls under five in India at a district level, showing specific geographic patterns of avoidable female mortality across India's 640 districts.
Avoidable or excess mortality is defined as the difference between observed and expected mortality rates.
To determine that figure for India, researchers used UN population data from 46 countries to calculate the difference between the expected morality rate for girls aged under five in areas of the world without gender discrimination and the reality inside India.
The researchers found that 29 out of 35 Indian states showed overall excess mortality in girls under five, and all Indian states and territories, apart from two, contained at least one district with excess mortality.
The average level of excess mortality in girls aged 0-4 in India between 2000-2005 was 18.5 per 1,000 live births, or close to a quarter of a million deaths a year.
"Around 22% of the overall mortality burden of females under five is therefore due to gender bias," the study's authors, the International Institute for Applied Systems Analysis (IIASA) a scientific institute based in Austria, said in a statement released Monday.
IIASA researchers found that the problem was most pronounced in northern India, where the four largest states, Uttar Pradesh, Bihar, Rajasthan, and Madhya Pradesh, accounted for two thirds of the total excess deaths of infant girls under five.
The study showed that the areas worse affected were typically in rural regions, with low levels of education, high population densities and high birth rates.
The study's co-author Nandita Saikia, from the IIASA, said that the findings reinforced the need to address directly the issue of gender discrimination in addition to "encouraging social and economic development for its benefits on Indian women."
The report suggests many of the deaths are at least partly due to unwanted female child bearing in a society that has a preference for sons.
"The sustained fertility decline currently observed in north India is likely to lead to a reduction in postnatal discrimination. Unless son preference diminishes, lower fertility, however, might bring about a rise in gender-biased sex selection," said Saikia.
A preference for boys and the availability of sex-selective operations, although illegal in India, means there's a gender gap of as many as 63 million girls.
As a result, India has one of the most skewed sex ratios in the world. For every 107 males born in India, there are 100 females. According to the World Health Organization the natural sex ratio at birth is 105 males for every 100 females.