When it comes to issues crucial to their health, women seem to lose both on the roundabout and on the swing. Just as we were celebrating the fact that the government would provide all pregnant and lactating women Rs 6,000 each for two live births under the maternity benefit scheme comes news that this will now be restricted to one child. And the 60% funding promised by the Centre has been cut down to 50%, leaving states to make up the shortfall.
The problem is predictable – lack of finances. With just Rs 2,700 crore allocated for this, only 90 lakh of the 2.6 crore live births can be covered when the actual requirement is Rs 14,512 crore. Two things are clear from this, the government did not do its homework and raised expectations and the other is that there is a cavalier attitude to women’s health. This is not all, this sounds coercive to suggest to women that they should limit their families in order to benefit from the government’s funds. The airy assurance from the ministry of women and child welfare that it could always ask the ministry of finance for money later sounds Panglossian given the excruciatingly slow manner in which the wheels of finance move in officialdom.
Apart from coercion element in the latest move, even the earlier provision of money for two live births for those over 19 excludes millions of women, especially tribals and Dalits who tend to get married and have children much earlier. This means that without any official restriction on the number of children a woman can have under the national population policy, the second child is discriminated against. But there are even more problems ahead. The reduced amount now suggested will only be given to the woman once she registers her pregnancy, has the first antenatal check up, registers the birth and confirms the vaccination of the child for BCG, OPV, DPT and Hepatitis-B. Given the extreme poor conditions in our public health system, this will be a difficult task for most women. The very lack of access to primary healthcare is the first obstacle. This is the first thing that has to be addressed if this rather paltry amount is to make any difference to the health of the mother and child.
{{/usCountry}}Apart from coercion element in the latest move, even the earlier provision of money for two live births for those over 19 excludes millions of women, especially tribals and Dalits who tend to get married and have children much earlier. This means that without any official restriction on the number of children a woman can have under the national population policy, the second child is discriminated against. But there are even more problems ahead. The reduced amount now suggested will only be given to the woman once she registers her pregnancy, has the first antenatal check up, registers the birth and confirms the vaccination of the child for BCG, OPV, DPT and Hepatitis-B. Given the extreme poor conditions in our public health system, this will be a difficult task for most women. The very lack of access to primary healthcare is the first obstacle. This is the first thing that has to be addressed if this rather paltry amount is to make any difference to the health of the mother and child.
{{/usCountry}}In a situation where there is high infant and maternal mortality – IMR of 40 per 1,000 live births and MMR of 167 for the same, the answer does not lie in giving the woman Rs 6,000 for one child and leaving her to her own devices. Many women who may be less than 19 and who should be eligible for this scheme have little say in the number of children they have. While there is a provision for a cafeteria approach to contraception, this does not impact on the majority of women who are forced to produce children until the requisite number of sons is born. If the basket of contraceptives approach worked, then women could pace their children and have them at an age which would be more suitable to the health of the mother and child. But even today, women have as many children as their husbands want and then have to opt for sterilisation which many of them are loath to do. By all means, the government must extend financial help to women that is not selective and discriminatory. But most of all, it must ensure that women in the low income group have access to subsidised healthcare. And this has to begin with upgrading and professionalising the public health system.