The Government’s maternity benefit programme, PMMVY, suffers from critical drawbacks in both design and implementation. Not only is the application process cumbersome, it provides little assistance to pregnant women
Healthy women provide the foundation for a healthy India. To make universal healthcare a tangible milestone in the country’s development journey, women’s healthcare requirements need to be accounted for. A key period of health risk in most women’s lives is pregnancy. And Government-sponsored maternal health programmes have been instituted to provide safety and security to pregnant women. However, the key maternal benefit programme of the country, the Pradhan Mantri Matritva Vandana Yojana (PMMVY), which promises Rs 5,000 to pregnant women, suffers from critical drawbacks in both design and implementation. It is exclusionary by the eligibility criteria and impedes universal access to the scheme through an ill-designed enrolment procedure.
Under PMMVY, pregnant and lactating women are provided Rs 5,000 in three instalments. The gaping loophole in the eligibility criteria is that benefits are only provided for the birth of the first child. In a country with a Total Fertility Rate (TFR) of 2.33, the policy of restricting the scheme to just the first child is impractical to say the least and exclusionary when seen in totality.
In fact, the earlier form of the maternity benefit programme, the Indira Gandhi Matritva Sahyog Yojana (IGMSY), allowed women to access disbursement for two live births. The eligibility criteria have consciously been curtailed in the present scheme. Moreover, it makes no attempt to accommodate miscarriage or infant mortality. If an eight-month pregnant woman, who has already accessed the scheme, loses her child, she is not eligible for the second or third instalment for her next pregnancy.
If a woman loses her child within the first 28 days, then, too, she is deemed ineligible for future pregnancies. A NITI Aayog report on IGMSY stated that about 12 per cent of the beneficiaries under the scheme miscarried. The same 12 per cent would be ineligible under the present scheme.
By August 2018, only 52 per cent of the beneficiary enrolment target (of August 2018) had been met. As evident, even for women who manage to comply with these stringent eligibility criteria, there are inherent roadblocks in the enrolment process that prevent them from accessing the scheme.
This is because one of the critical documents required for the scheme, apart from the woman’s Aadhaar card and bank documents, is the Aadhaar card of her husband. Inclusion of the husband’s Aadhaar card is problematic as it hinders financial autonomy of the woman. It also makes her decisions about her own reproductive health dependent on her husband’s presence or consent.
This provision ignores the socio-economic realities of rural India. Chanchal Devi, a 21-year-old pregnant woman in Uttar Pradesh’s Ballia district, could not access the scheme because her husband works at construction sites in Delhi during the winter months. She had to run a household with her in-laws, hence all of her husband’s income was dedicated to the maintenance of the household, including daily food and emergency provisions. She had no money to take care of her during pregnancy and could not enroll under the scheme.
Her neighbours faced similar problems in accessing the scheme and, hence, abandoned hope for any Government maternity benefits. Seasonal migration is a well-recognised phenomenon in India. About 92 per cent, ie 12.6 million, makes up the majority of short-term rural migrants (NSSO 2007-08). Wives of these men, who become first-time mothers, would face significant hurdles in enrolling under the scheme.
What’s surprising and even contradictory is that the principle of women’s financial autonomy has been kept in mind in the case of other Government programmes. Take for example, the much-lauded Ujjwala scheme, where LPG connections are provided to BPL households with only the woman’s Aadhaar and bank account required for registration. Other State-level maternity benefit programmes like Tamil Nadu’s Dr Muthulakshmi Maternity Benefit scheme and Odisha’s MAMTA scheme only require the woman’s Aadhaar card and bank account details for disbursement.
In the future, while enrolment numbers can still be manipulated to achieve the set targets, the scheme still does not recognise the principle of female financial autonomy or practical concerns of migration. While PMMVY developed from a functioning maternity benefit programme, it does not exhibit any signs of a new and improved version. It is desired that schemes impacting a vulnerable section of the population like pregnant women should be piloted in the first stage to remove or rectify the loopholes. Social sector schemes when rolled out without adequate research do serve the cause of a Government’s achievement but not one of a universal healthy India.
(The writer is with Swaniti Initiative)