Breaking down the question
Though phrased as a demographic question about causes, this is at heart a sociological question about gender. Female mortality in India is not simply a matter of biology or health infrastructure; it reflects a social order in which the value placed on female life is systematically lower than that placed on male life.
The examiner expects the candidate to move beyond a medical list of diseases to the concept of excess female mortality — deaths that would not occur if women received the same care, nutrition and protection as men. Amartya Sen's missing women frames the scale of the problem.
The note on components of population growth situates mortality within the wider dynamics of the Indian population.
How to approach it
Distinguish at the outset between biological and social causes, and foreground the sociological argument: in most of the world women outlive men, so India's adverse sex ratio points to excess female mortality produced by discrimination. Organise the causes across the life course — pre-natal, infant and childhood, reproductive age, and later life.
Weave in son preference, nutritional and healthcare neglect, maternal mortality and violence, and link each to the underlying patriarchal structure. Conclude that female mortality is a barometer of gender inequality, so that lowering it requires social transformation as much as medical intervention.
Model answer
Biologically, women enjoy a survival advantage over men, and in most societies they live longer. India's historically adverse sex ratio therefore signals something abnormal — what Amartya Sen called the phenomenon of missing women, women who are absent from the population because of excess female mortality rooted in discrimination.
Son preference and pre-natal loss. A deep-seated son preference, tied to dowry, lineage continuity and the perception of daughters as paraya dhan, drives sex-selective abortion where technology permits. Barbara Miller documented this cultural devaluation of daughters, which begins mortality even before birth and depresses the child sex ratio.
Neglect in infancy and childhood. Girls receive less food, poorer medical attention and delayed treatment relative to boys. Leela Dube's work on the gendered logic of Indian kinship shows how daughters are socialised as transient members of the natal family, an outlook that translates into unequal investment in their nutrition and survival.
Maternal mortality. Early marriage, repeated and closely spaced pregnancies, anaemia and inadequate antenatal and obstetric care make childbirth a major cause of death for women of reproductive age. Maternal mortality is preventable, and its persistence reflects the low priority given to women's reproductive health.
Violence and its lethal forms. Domestic violence, dowry deaths and, in extreme cases, female infanticide add a directly violent dimension to female mortality. These are not aberrations but expressions of the same devaluation of female life that operates through neglect.
Structural and later-life causes. Poverty, illiteracy and restricted access to health services compound biological risks, while widowhood in old age often brings social and economic abandonment. Across the life course, the common thread is that women's health and survival are treated as secondary.
Female mortality in India is therefore best understood not as a series of medical accidents but as the demographic imprint of patriarchy — a measure of how unequally a society values the lives of women. Its reduction depends on transforming that valuation, alongside improvements in health provision.
Examiner's perspective
Weak answers offer a health-ministry list of diseases and cite poor infrastructure, missing the sociological point that female mortality is gendered. The examiner is looking for the concept of excess mortality and the recognition that, absent discrimination, women would outlive men.
High marks reward a life-course structure — pre-natal, childhood, reproductive age, old age — and the integration of son preference, maternal mortality and violence under the single frame of patriarchy. Sen's missing women and the work of Miller and Dube give the answer the theoretical anchoring expected at fifteen marks.