Sometimes I wonder what the world would be like if men, not women, were bearing and delivering babies. Quite likely, the maternity (oops, paternity) wards in hospitals would have the best equipment and doctors. The shelves of grocery shops would be filled with special food items for pregnant men. Women and children would be mobilised to attend to the needs and wishes of the heroic lads who give birth. An array of new professions, products and technologies would develop to make their life easier, and pregnant men would also have free bus passes and separate queues. Further, paternity benefits would be given through flagship social programmes, with hefty budgets.
In contrast, maternity benefits in India are a non-issue. The Central government is clueless about their legal, financial and political aspects; as are the Opposition parties.
Maternity benefits, of course, are reasonably generous (by international standards) for a small minority of Indian women employed in the formal sector and covered, in principle at least, under the Maternity Benefit Act. The vast majority of pregnant women, however, are left to their own devices.
We had a telling glimpse of the hardships they face last summer, during the Jaccha-Baccha Survey (JABS), conducted with student volunteers in six States of north India — Chhattisgarh, Himachal Pradesh, Jharkhand, Madhya Pradesh, Odisha and Uttar Pradesh. For lack of knowledge or power, most of the sample households were unable to take care of the special needs of pregnancy, whether it was food, rest or health care. Among women who had delivered a baby in the preceding six months, only 31% said that they had eaten more nutritious food than usual during their pregnancy. Their average weight gain during pregnancy was just seven kg on average, compared with a norm of 13 kg to 18 kg for women with a low body-mass index. In Uttar Pradesh, 39% of the respondents had no clue whether they had gained weight during pregnancy, and 36% had gone through it without a health check-up. It is only in Himachal Pradesh, where rural women are relatively well-off, well-educated and self-confident, that the special needs of pregnancy received significant attention.
Maternity benefits could help to relieve these hardships and give babies a chance of good health. Under the National Food Security Act, 2013, all pregnant women (except those already receiving similar benefits under other laws) are entitled to maternity benefits of ₹6,000 per child. For more than three years, the Central government simply ignored its duty to act on this. Whenever the Supreme Court enquired about it, the government made false promises. Finally, on December 31, 2016, the Prime Minister proudly announced that pregnant women nationwide would soon be getting maternity benefits of ₹6,000. He said this without any reference to the NFSA, as if maternity benefits were an act of generosity on his part — perhaps to sweeten the demonetisation pill.
In pursuance of this announcement, a maternity benefit scheme was rolled out in 2017: the Pradhan Mantri Matru Vandana Yojana (PMMVY). The modalities of the scheme, however, violate the NFSA: benefits are restricted to the first living child, and to ₹5,000 per woman. A budget provision of ₹2,700 crore was made for it in the 2017-18 budget — a fraction of the ₹15,000 crore required for full-fledged implementation of maternity benefits as per NFSA norms. The actual expenditure was barely ₹2,000 crore; the allocation oddly reduced to ₹1,200 crore in the revised Budget of 2018-19.
A damp squib
Until recently, little was known about the performance of PMMVY, but two helpful sources of information are now available: summary statistics obtained from the Ministry of Women and Child Development under the Right to Information Act, and the JABS survey.
According to the Ministry’s response to our RTI query, 80 lakh women received at least one instalment of PMMVY money between April 1, 2018 and July 31, 2019, and 50 lakh received all three instalments. On a 12-month basis, this would correspond to 60 lakh and 37.5 lakh partial and full beneficiaries respectively in the Financial Year 2018-2019. Based on an estimated population of 134 crore and a birth rate of 20.2 per thousand (2017 estimates), the annual number of births in India would be around 270 lakh. Of these, a little less than half would be first births.
These figures imply that in 2018-19 only around 22% of all pregnant women received any PMMVY money, and around 14% received the full benefits. This scheme, in other words, is a damp squib.
The JABS survey suggests that PMMVY has been ruined in three steps. First, the coverage and benefits were reduced (compared with NFSA norms, which are very modest in the first place). This defused public demand for PMMVY. Had the benefits been higher and universal, the scheme would have been a hit. Second, the application process is tedious. Aside from filling a long form for each instalment, women have to submit a series of documents, including their ‘mother-and-child protection’ card, bank passbook, Aadhaar card and husband’s Aadhaar card. Essential details in different documents have to match, and the bank account needs to be linked with Aadhaar. Had the government tried to discourage applications, it could not have done better. Third, there are frequent technical glitches in the online application and payment process. When an application is rejected, or returned with queries, the applicant may or may not get to know about it. Grievance redressal facilities are virtually non-existent.
Special mention must be made of Aadhaar-related problems. Some of them are replays of problems observed earlier with pensions, scholarships and the National Rural Employment Guarantee Act: for instance, rejected payments due to mismatch (say, in the spelling of the beneficiary’s name) between a person’s Aadhaar card and bank account. There are also new problems. For instance, more than 20% of the respondents mentioned that they had faced difficulties because the address on their Aadhaar card was that of their maika (parents’ home), not of their sasural (in-laws’ house). Why women are required to submit their Aadhaar card in the first place, let alone their husband’s Aadhaar card, is far from clear.
Examples of T.N., Odisha
Meanwhile, some State governments have put in place effective maternity benefit schemes of their own. One notable example is Tamil Nadu, the serial pioneer in the field of social security. Under the Dr. Muthulakshmi Reddy Maternity Benefit Scheme, pregnant women in Tamil Nadu receive financial assistance of ₹18,000 per child for the first two births, including a nutrition kit. Odisha’s Mamata scheme also covers two births, albeit with lower entitlements — ₹5,000 per child, as with the PMMVY. The JABS survey suggests that the Mamata scheme is working reasonably well: among women who had delivered in the last six months, 88% of those eligible for Mamata benefits had applied, and 75% had received at least one of the two instalments.
It would take very little to extend and consolidate these initiatives on a national basis. The Modi government, however, is not interested. Nor, it seems, are the Opposition parties: efforts to draw their attention to these issues earlier this year, in the run-up to the Lok Sabha elections, made little headway. Even the Congress Party, chief sponsor of the NFSA, did not mention maternity entitlements in its elaborate manifesto. If only men were the ones who give birth…
The author is a visiting professor at the Department of Economics, Ranchi University
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