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Modi’s cash transfer scheme for pregnant women shortsighted, healthcare quality needs attention first

By Maya Palit

On social media on 1 January, I got here throughout many quips about Prime Minister Narendra Modi’s New Year’s Eve speech. “Judging from the speech, the happiest person in the country should be a 65-year-old pregnant farmer,” went one. These have been, in fact, prompted by Modi’s promise to introduce a scheme that may transfer Rs 6,000 to the financial institution accounts of pregnant women. He portrayed it as a brand new scheme that may assist to curb maternal mortality, however because the nationwide media has pointed out, there’s nothing new concerning the idea of advantages for pregnant women. They have been talked about in a clause within the National Food Security Act handed in 2013. And have been a part of numerous different schemes just like the Janani Suraksha Yojana (JSY) launched in 2005 and the Indira Gandhi Matritva Sahyog Yojana (IGMSY), a centrally sponsored ‘pilot’ scheme launched in 53 districts across the nation in 2010 which had 61,972 beneficiaries between 2010-2011 and 2013-14. And within the meantime, like Tamil Nadu have already adopted their very own model of maternity advantages, utilizing their very own assets, just like the Dr. Muthulakshmi Reddy Maternity Benefit Scheme which offers Rs 12,000 for pregnant women under the poverty line.

Although Modi didn’t spell out in his speech exactly the circumstances that may make women eligible, if his scheme resembles earlier maternal profit schemes, it might be a massively exclusionary measure. The IGMSY, for occasion, mandated that Rs four,000 can be transferred to women in installments in the event that they:

1. Registered their pregnancies at an Anganwadi centre (AWC) or health centre.
2. Gave start in authorities establishments, carried out unique breastfeeding for six months.
three. Received at the very least one antenatal check-up and counseling session at an AWC.
four. Ensured that their youngsters have been vaccinated for polio, BCG and DPT.

Representational picture. AP

And these are solely 4 of the various circumstances. Although you would nicely argue that these necessities are meant to encourage pregnant women in the direction of ‘healthier’ behaviour, they find yourself successfully excluding roughly 60 percent of the nation’s women who don’t ship in hospitals, and a overwhelming majority of these with out financial institution accounts of their very own, or management over monetary issues within the household. How many day by day wage labourers, for occasion, have the privilege of breastfeeding their youngster for a whole six months?

And maybe most significantly, as Rakhal Gaitonde, a public health researcher with Medico Friend Circle, defined, conditional cash transfers shift the discourse and priorities of the general public health system (PHS): “I recall the case of a young woman in Tamil Nadu who had diarrhoea after pregnancy and requested the nurse to treat her, but the nurse was single-mindedly focused on filling out the forms related to the scheme. The PHS becomes more focused on eligibility criteria and neglects its larger work. When the Rural Women’s Social Education Centre asked women about their priorities when giving birth, they came up with suggestions including clean surroundings and helpful doctors. Incentivising people who need the money, rather than instituting changes at the PHS level, is a bizarre insult to the innate intelligence of people who often avoid healthcare facilities because of the appalling conditions there.”

The obstacles to women accessing healthcare within the first place are innumerable. “In Odisha, we asked for maternity death review reports and found that there is an entire spectrum of factors, rather than a single barrier that make access to institutionalised healthcare difficult for women,” stated Sarita Barpanda, who works with the reproductive rights initiative on the Human Rights Law Network (HRLN). “In the North East, many maternal deaths occur because of the lack of transportation and difficult roads, and in Odisha women tend to lose their lives because sufficient health services are not available. But the bottom line is that health services are disrespectful and often abusive,” she defined.

According to Jashodhara Dasgupta, the present coordinator of SAHAYOG and member of civil society programmes just like the National Alliance on Maternal and Health Rights, a current try and doc near 150 maternal deaths revealed that one huge issue was the shortage of obtainable transportation. Particularly in Adivasi areas in Odisha, Jharkhand, and Andhra Pradesh with out cellphone connectivity and dependable transport, it isn’t straightforward for a lady to make it to a hospital in time. And if a lady has the infant on the best way, it renders her disqualified from the scheme. Furthermore, the IGMSY circumstances that women needs to be over 19 years of age (provided that the national mean for the age of marriage was 19.three years in 2011, that is an exclusionary situation in itself) and have not more than two youngsters tended to disqualify the poorest households, which embrace Dalit and Adivasi women, who actually need the scheme.

But Dasgupta singled out one main type of exclusion stopping women from accessing healthcare. “In Malda and Murshidabad, Muslim-dominated regions in West Bengal, we found that there were doctors present in peripheral districts, but women did not opt for hospital deliveries because of immense hostility, and only went when there were serious complications. They were usually poor and had more than the approved number of pregnancies, and were treated badly – in UP, for instance, Dalit women were left to lie bleeding in a verandah – so they preferred being in a more empathetic environment.”

Fact discovering studies by HRLN in Balasore, (Odisha) North Cachar (Assam), and Bilaspur (Chhattisgarh) cite docs’ negligence, obstetric violence, anaemic conditions, and delays in ambulance arrivals as the key causes for maternal deaths. An HRLN research in Seelampur, a sub-district of Delhi, corroborates Barpanda and Dasgupta’s findings, displaying that women had not acquired maternal advantages as a result of they prevented authorities hospitals being afraid of bodily and verbal abuse from the employees. But others, who had gone by way of the processes that made them eligible for maternal advantages, have been nonetheless not made conscious of or given any advantages, and sometimes solely knowledgeable about one type of contraception.

Perhaps, as Ravi Kumar, a rural surgeon working in Tamil Nadu, emphasised, enhancing the quality of health providers in authorities hospitals, and making residence deliveries safer, should be focussed on earlier than providing incentives for individuals to ship in authorities hospitals. Given the array of things stopping women from accessing healthcare, Modi’s declaration that a conditional cash transfer scheme, which disqualifies an enormous part of women, will deliver down maternal mortality seems counter-intuitive and shortsighted (notably given that offering cash advantages to pregnant women in all states would require Rs 16,000 crores, whereas the present price range stands at Rs 400 crore).

As Dr Prasanta Tripathy, a board member of Ekjut, an NGO engaged on maternal health in districts throughout India, stated sadly, within the meantime it’s jugaad fairly than conditional schemes that saves maternal lives.

The Ladies Finger (TLF) is a number one on-line women’s journal delivering recent and witty views on politics, tradition, health, intercourse, work and all the things in between.

First Published On : Jan three, 2017 17:37 IST

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