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Did the Prime Minister announce a new scheme for pregnant women?
Not exactly. Such a scheme — the Indira Gandhi Matritva Sahyog Yojana, or IGMSY — was begun by the UPA 2 government in October 2010 on a pilot basis in 53 districts. The National Food Security Act, 2013, made it incumbent upon the incoming NDA government to ensure universal coverage under the scheme. In an affidavit filed before the Supreme Court in October 2015, in reply to a petition by the People’s Union for Civil Liberties (PUCL), the Ministry of Women and Child Development (WCD) under Maneka Gandhi said the scheme would be extended to all districts, beginning with 200 districts in 2016-17. That commitment has not been met.
Several civil society organisations have estimated the annual budgetary requirement for universal coverage under the scheme at Rs 16,000 crore. As against this, in 2016-17, Finance Minister Arun Jaitley made a total allocation of only Rs 17,408 crore for the entire WCD Ministry.
So, what are the provisions of IGMSY?
It is a conditional cash transfer scheme applicable to pregnant and lactating women of ages 19 and above for up to 2 living children. The scheme originally provided Rs 4,000 to each beneficiary through her aanganwadi centre, in all districts selected for the pilot project. All women are eligible, unless they have already received paid leave and maternity benefits from their employers in the private or government sector. The scheme is aimed at arresting high maternal mortality rates by encouraging institutional delivery and ensuring proper nutrition for the mother and child. It is also meant to offset wage losses suffered by women due to pregnancy, and is especially important for women in the unorganised sector, who make up 90% of the country’s female workforce. Fear of losing wages often forces women in the informal sector to work through pregnancy and immediately thereafter, to the detriment of their and their babies’ — who require at least 6 months of regular breastfeeding — health.
And why has the scheme gone from being a targeted to a universal one?
Section 4 (b) of the National Food Security Act, which came into force on September 10, 2013, states that every pregnant and lactating mother would be entitled to “maternity benefit of not less than Rupees six thousand”. On September 27 that year, the maternity benefit under the IGMSY was enhanced to Rs 6,000 in the 53 districts where it was ongoing. But universal implementation was not supported by commensurate Budget allocations. In 2015, PUCL went to Supreme Court against the flawed implementation of the Food Security law.
Among other things, it pointed to the non-implementation of Section 4 (b).
Tamil Nadu is currently the only state that provides universal cash assistance to Below Poverty Line pregnant women: Rs 12, 000 in 3 instalments under the state government’s Muthulakshmi Reddy Maternity Benefit Scheme. At 20 deaths per 1,000 live births, Tamil Nadu has the lowest infant mortality rate after Kerala and, at 79 maternal deaths per 100,000 live births, among the lowest maternal mortality rates in the country.
But why is a universal maternity benefit scheme needed?
India’s maternal and infant mortality indicators are very poor. Every third woman is undernourished and every second woman is anaemic, government statistics show. An undernourished woman would likely give birth to a low-weight baby. As per the UN Millennium Development Goals Report 2014, India recorded the highest number of maternal deaths in the preceding year, and accounted for 17% of global deaths due to pregnancy- and childbirth-related complications (some 50,000 of 2.89 lakh such deaths worldwide).
Less than 40% of births in India are institutional deliveries. Data from the Registrar General of India, Sample Registration System (RGI-SRS) show a recent decline in Maternal Mortality Ratios (MMR) — from 212 per 100,000 live births in 2007-09 to 167 per 100,000 live births in 2011-13 — but there’s a long way to go still. The Infant Mortality Rate is 40 per 1,000 live births, according to SRS 2011-13.
How will the PM’s announcement be implemented?
The WCD Ministry has said it will release Rs 6,000 in 3 instalments for the first 2 live births — Rs 3,000 during the first trimester following early registration of pregnancy and one antenatal check-up, Rs 1,500 at the time of institutional delivery, and Rs 1,500 three months later, after the child is administered the necessary vaccination. The Ministry estimates that 51.70 lakh women will be benefitted annually. States will have to bear 40% of the cost, and the Centre will provide the rest. The Ministry conservatively estimates the scheme to require a total Rs 7,932 crore until 2019.
Will the scheme achieve its intended purpose?
The Ministry is yet to issue the fine print of the policy’s implementation. But it has retained the condition that the woman must not have more than 2 living children. A study by the National Alliance for Maternal Health and Human Rights has shown that this precondition excludes 60% of women in the 15-49 age group, most of whom are Dalits and tribals, and a majority of whom have 3-7 pregnancies — which further affects their health. Several civil society organisations have asked for such conditions to be removed so that the scheme could be truly effective.