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The main underlying causes is the social attitude of the people which results from the cultural fabric of the country , where there is general preference for male child. People tend to have male children and also there are illegal practices of female infanticide and in modem times pesticides rampant. The states with highest per capita income have lowest child sex ratio because these states have facilities of pre natal sex determination resulting sex selective abortion resulting in low child sex ratio. Also after the birth of female child, the negligence on health care of the female child leads to higher infant mortality rates for female kids resulting in low child sex ratio.