Pcpndt act

1. PCPNDT ACT 1

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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 of PCPNDT Act in Nagpur Referances 4

5. World Scenario 5

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17. 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 17

18. Socio Cultural factors Preference for male child Subordinate status of woman Social and economic dependence enhancing vulnerability Discrimination against girl child 18

19. True salvation -last rites Lineage & inheritance Old age security Bread winners 19

20. “We don’t kill cats, dogs as often as female children” Spend Rs 5000 today and save Rs 5 lakh tomorrow…” 20

21. 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

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” 20 th September1994: PNDT Act : This act came into force in 1996 22

23. 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) 2 nd order One male child 959 One female child 542 3 rd 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 ?

24. 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 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 - Female Foeticide 25

26. the pre conception – post conception / selection / determination of sex Communicating Sex prohibits the advertisement in any manner provides – punishment for violation Act - Prohibits 26

27. Indications of Prenatal Diagnostic Technique 1) Chromosomal abnormalities 2) Genetic Metabolic Diseases 3) Hemoglobinopathies 4) Sex linked genetic disease 5) Congenital anomalies Any other abnormalities / or disease as may be specified by the Central Supervisory Board. Reasons – record in writing 27

28. Sex Selection 28

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30. An example of the implications of declining sex ratio 30

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32. 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 ) 32

33. 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 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 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 35

36. 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 36

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38. 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 38

39. 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 39

40. 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. 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 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. 42

43. 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) 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 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. 45

46. No. of girls to boys Sex Ratio at Birth