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Pcpndt act
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- 3. 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 3
- 4. • Implementation ofPCPNDT Act in Nagpur • Referances 4
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- 17. Child Sex Ratioand 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 17
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- 19. True salvation -lastrites Belief Old age Lineage & security Myth Conviction inheritance Perception 19 Bread winners
- 20. Spend Rs 5000 today and save Rs 5 lakh tomorrow…” “We don’t kill cats, dogs as often as female children” 20
- 21. Son Preference &Daughter Aversion 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!”
- 22. 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 22
- 23. Who does it? According to one micro-study conducted in some hospitals of Delhi: Sex Ratio at Birth by sex of the previous children* Sex Ratio at birth Birth Order Sex of previous child (girls to 1000 boys) 2nd order One male child 959 One female child 542 3rd order One male and one 558 female child 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
- 24. What was theneed 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 24
- 25. 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 25 - Female Foeticide
- 26. Act - Prohibits • the pre conception – post conception / selection / determination of sex • Communicating Sex • prohibits the advertisement in any manner • provides – punishment for violation 26
- 27. 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 27
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- 30. An example ofthe implications of declining sex ratio 30
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- 32. An offence underthis 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 ) 32
- 33. Institutions 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. 33
- 34. 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 34
- 35. Registration • Registration timeup 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 35
- 36. • Certificate ofregistration is non transferable • Change of ownership, management or ceasing to functions – surrender the certificate • New owner shall apply afresh • Validity – 5 years 36
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- 38. Board (Central SupervisoryBoard) • 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 38
- 39. (iv) Eminent socialscientists & (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 • An officer – not below rank of Joint Secretary or equivalent of Central Government – Member Secretary Ex-Officio 39
- 40. Functions of theBoard 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. 40
- 41. 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. 41
- 42. Observations • Unregistered centrecarry 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. 42
- 43. Cont…. • Notice boardnot 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) 43
- 44. To say “No”to requests for performing sex selection, sex detection and gender-specific MTPs and to discourage colleagues from doing so. 44
- 45. Common Reactions ofDoctors 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. 45
- 46. Sex Ratio atBirth No. of girls to boys 952 960 935 940 917 917 917 920 909 901 900 877 880 855 860 847 840 820 800 780 India Rajasthan Punjab Haryana Himachal Pradesh NFHS-I NFHS-II