Patiala, July 5 -- Punjab's struggle with gender imbalance has intensified, with the state recording its fourth consecutive annual decline in the number of girls born per 1,000 boys, according to the Vital Statistics of India-2024 report. Released on July 1 by the Office of the Registrar General and Census Commissioner, India (ORGI), the data pushes Punjab down to a dismal 20th position among the 27 states surveyed. The state's sex ratio at birth (SRB) has seen a steady, year-on-year erosion. It stood at 925 in 2020, before slipping to 924 in 2021, 923 in 2022, 922 in 2023, and finally hitting a five-year low of 921 in 2024. The continuous slide indicates that hard-won past gains are being rapidly undone. Within the state, Fatehgarh Sahib emerged as the worst-performing district in Punjab, recording a sex ratio of 895 girls per 1,000 boys. It was followed closely by Gurdaspur, which recorded an equally concerning ratio of 899. Bathinda and Sangrur jointly recorded the third-lowest sex ratio at 901. Close behind them, SAS Nagar (Mohali) and Shahid Bhagat Singh Nagar were tied at 904 girls per 1,000 boys. Public health experts point to deep-seated patriarchal attitudes, male-heir preference, and shrinking family sizes as long-term drivers of sex selection, but they emphasise that institutional failure is the immediate catalyst. Experts squarely attribute Punjab's poor SRB to the weak implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PC-PNDT) Act. A primary concern is that several accused booked under the Act, despite facing multiple FIRs, are yet to be convicted. Most secure bail soon after their arrest and resume illegal sex determination activities. Police have failed to identify and dismantle the supply chain of the portable ultrasound machines used for these illegal operations, allowing offenders to continue carrying out prenatal sex determination with impunity. Dr Ijyaa Singh, a public health expert, echoed these concerns, saying that Punjab's strong healthcare infrastructure rules out natural data fluctuations. She said a four-year consecutive decline points directly to pre-birth sex-selective practices, noting that the real problem is not healthcare access, but how strictly PC-PNDT laws are enforced. Dr Jasbir Aulakh, a gynaecologist and former civil surgeon, said few raids are actually conducted on radiodiagnostic centres to curb the practice. He shared a personal account of how he was threatened by a sitting MLA in Ludhiana after catching a diagnostic centre red-handed a year ago. Declining to name the MLA, Dr Aulakh said he was subsequently transferred for conducting the raid, an action that had a demoralising effect on other civil surgeons in the state. Regionally, Punjab's neighbours present a mixed picture. Haryana continues to trail significantly, recording a dismal SRB of 910. Himachal Pradesh outperformed both neighbours with an SRB of 934, despite experiencing its own slight decline compared to 2023. Despite the 2024 report concerns, the state health administration claims the tide is already turning based on internal metrics. Dr Aditi Salaria, director of health and family welfare, said that current internal figures show a rebound for the state. According to Dr Salaria, Punjab's SRB stands at 924 at present, reflecting an improvement from 922 in the 2024-25 data to 924 in 2025-26. She said efforts are underway to improve the numbers further, and the department is stepping up raids under the PC-PNDT Act to curb illegal practices....