The Delhi government is planning to increase inspections at clinics and diagnostic centres to curb sex determination tests after meeting just 10% of the target.
Only 715 inspections out of the planned 7,096 were conducted between April 2024 and March 2025 across 1,774 medical facilities in the city that are registered under the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994, according to the Health Department’s annual report.
To address this gap, the department will urge district authorities to prioritise inspections under the Act and form additional teams to conduct them, officials said. The Act mandates quarterly inspection of every clinic, with penalties including fines and imprisonment for those conducting sex determination tests.
Though Delhi fell short of its annual target, it was still an improvement from the previous year, when just 455 inspections took place across 1,737 facilities such as diagnostic centres, speciality clinics, maternity and ultrasound centres, and IVF clinics and hospitals.
Action against violators
In March, Delhi Health Minister Pankaj Kumar Singh had launched a web portal to enhance action against violators of the Act. He said Delhi being the Capital must lead by example in eliminating sex determination practices.
The Act applies to medical practitioners (geneticists, gynaecologists, paediatricians, sonologists, radiologists, and imaging specialists) and owners of facilities (genetic counselling centres, genetic clinics, and laboratories), imposing penalties for violations. While ultrasound machines can be used to detect genetic abnormalities and other disorders, using them for sex determination is prohibited under the Act.
In 2024-2025, authorities took action against violators, issuing 70 show-cause notices, suspending 13 clinics, cancelling 53 registrations, and sealing 22 ultrasound machines.
According to the district annual report, inspections remained low across districts, with the percentage of targets met ranging from 5.69% in North West district to 15.88% in West district.
Under the Act, the Central government has to appoint one or more Appropriate Authorities for implementing its provisions. According to a 2014 gazette notification, Delhi’s Deputy Commissioners and District Magistrates were designated as Appropriate Authorities in their respective districts. Despite attempts via e-mails and calls, The Hindu received no response from authorities across 11 districts on the low rate of inspection.
Impact on sex ratio
Delhi’s sex ratio at birth improved from 896 in 2014 to 922 in 2023, according to the Civil Registration System data. However, despite the overall improvement over the decade, the ratio has been declining steadily since 2020, from 933 that year to 932 in 2021, 929 in 2022, and 922 in 2023.
Dr. Neelam Singh, a gynaecologist and member of the National Inspection and Monitoring Committee, constituted under the PCPNDT Act, stressed the importance of quarterly inspections. “Every clinic is to be checked quarterly and a report is to be made,” she said.
She noted that increased inspections in States such as Haryana, Rajasthan, and Maharashtra have led to improved sex ratios, suggesting that stricter enforcement can deter sex determination practices.
Doctors at Delhi clinics report that despite the Act being in place for 30 years, they still receive requests to determine the sex of a child, although such requests have decreased over time.
A gynaecologist on condition of anonymity said about 10% of couples still request sex determination, but are counselled on its illegality. She said some couples opt to travel to countries like Thailand or the UAE, where sex determination is allowed and gender disclosure is standard practice.
‘Ramp up efforts’
“Of late, district authorities are saying they are preoccupied with other tasks,” a Health Department official said, adding that the department will urge them to form more inspection teams and prioritise inspections to improve the sex ratio.
The official explained that inspections also include monitoring advertisements for sex determination, random checks of Form F (a mandatory record to track ultrasound scans, where patients and doctors declare no sex determination is done), and noting inconsistencies like missing records. Inspections may also include decoy operations, the official said.
Published – June 16, 2025 01:34 am IST