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The long wait for maternity benefits: How red tape drowned a central scheme in Gujarat’s Dahod district

Ushaben Girishbhai Naik and her family are inconsolable as they mourn the death of Vilas, her 20-month-old daughter, in Dahod, Gujarat.

Ushaben Girishbhai Naik and her family are inconsolable as they mourn the death of Vilas, her 20-month-old daughter, in Dahod, Gujarat.   | Photo Credit: Vijay Soneji

The Pradhan Mantri Matru Vandana Yojana announced by Prime Minister Modi three years ago offered a lifeline to pregnant mothers. However, in Gujarat’s tribal district of Dahod, Jagriti Chandra finds mothers struggling to receive their entitlements as the scheme gets entangled in a bureaucratic maze of paperwork

Protest songs and slogans on their lips and toddlers cradled in their arms, nearly 70 women march in single file into the three-storied District Panchayat office in Gujarat’s Dahod. Confidently, the women climb the first two floors and park themselves outside the office of the Chief District Health Officer. While many young mothers sit along the corridor tending to their young infants and nursing them, others dance in circles to impromptu renditions of folk songs that are aimed at shaming the government officials for nine recent maternal deaths in the district and prevalence of malnutrition. The primary refrain, though, is that the officials are forcing the mothers, who live in remote villages, to travel for hours to demand their rightful benefits, when they should actually be caring for their young ones. “Sisters have been pushed around and forced to come to the district panchayat,” they say.

Dahod is primarily a tribal district bordering Madhya Pradesh. “74.3% of the population [is] from the Scheduled Tribes such as Bhil, Nayak, Rathwa, Bhabhor; people travel to different parts of the State in search of work. Poverty, early marriage and illiteracy with higher family size is the typical profile of the rural areas of Dahod,” explains Neeta Hardikar, co-founder of ANANDI, an NGO which works for poor rural women in Gujarat.

These are also the reasons cited by the Population Foundation of India for a high decadal growth in the population of Scheduled Tribes in the district between 2001 and 2011 which, at 34%, was nearly double that of the rate of population growth in the country. For Dahod as a whole, this figure was 30%, and for Gujarat, it was 19.28%. On the ground, too, four to five children in a family seems to be the norm.

A 120-km travel for young mothers

The mothers are here to demand their maternity entitlements under the Central government’s Pradhan Mantri Matru Vandana Yojana (PMMVY) and the Gujarat government’s Kasturba Sahay Poshan Yojana (KSPY). Coming from the remote villages of Piplod, Dabhva, Bara, Fulpura and Juni Bedi in Devgadh Baria taluka, they have travelled for nearly three hours and covered a distance of about 120 km in jeeps.

The protest by the women is timed to coincide with the third anniversary of Prime Minister Narendra Modi’s televised address, in which he promised a sum of ₹6,000 to pregnant women and young mothers across the country, on the birth of their first child. This programme was later christened Pradhan Mantri Matru Vandana Yojana. The scheme promises a total sum of ₹5,000, to be given in three instalments to pregnant women and lactating mothers. Those who receive similar benefits from their employers and government employees are excluded from the scheme.

 

The benefit is provided only for the first live birth and the money is to be credited to the beneficiary’s Aadhaar-linked savings account in different intervals over a period of nearly 14 months. Each instalment is paid after the mothers meet certain conditions — the first instalment after early registration of pregnancy; the second instalment after six months of pregnancy on the completion of at least one ante-natal check-up; and the third instalment after the registration of child-birth and the first cycle of immunisation of the child.

The government has clubbed this with the Janani Suraksha Yojana, which provides a benefit of ₹700-₹1,000, to claim that women will get “on an average” ₹6,000 for every first child.

A mother with her second child at the Junibedi village of Dahod taluka, Gujarat.

A mother with her second child at the Junibedi village of Dahod taluka, Gujarat.   | Photo Credit: Vijay Soneji

 

In Dahod, among those occupying the second-floor corridor is a grief-stricken and expressionless 26-year-old, Ushaben Girishbhai Naik. While she does not join the chorus of protest, she is here to mark her presence nevertheless. On December 12, she lost her 20-month old daughter, Vilasben, after a severe bout of diarrhoea and vomiting.

Back at her home in village Juli Bedi, the girl’s grandfather pulls out from an iron trunk among the few memorabilia he possesses — a piece of paper on which is scribbled Vilas’s date of birth, April 3, 2018; and date of death, December 12, 2019. The infant’s father brings a framed photo of hers neatly wrapped in a red and white gamcha and the entire family breaks down in a collective outpouring of shared grief.

When Vilas was 14 months old, an examination by a local health worker affiliated with ANANDI, the NGO, revealed that she weighed merely 5.2 kg, (i.e.) 30%-45% less than her ideal weight. As per the World Health Organization (WHO)’s child growth standards, this placed the toddler in the ‘red’ or ‘severely underweight’ category, while the local anganwadi worker had marked her in green on her growth chart, identifying her as a child with healthy growth levels. At the NGO’s intervention, the child was admitted to the local Child Malnutrition Treatment Centre for 14 days, where she showed signs of recovery and gained two kg. But when her last follow-up was conducted on August 22, not only did she have fever, it was found that her progress had retarded and she had begun to lose weight again.

 

The year 2019 was a difficult one for the family. Their entire maize cultivation on an approximate 1.5-bigha land was washed out in heavy rains and there was very little to eat. Ushaben and her husband left for Navagam near Rajkot, like every year, for two months. Here, they toiled hard at cotton fields, earning ₹100 for every 20 kg of cotton plucked. But when the news of their daughter’s ill-health reached them, they had to leave lock, stock and barrel for their village with the little money they had been able to earn. Despite these hardships, Ushaben stood disqualified from PMMVY on the grounds that Vilas was her second child. Top government officials have admitted that this is among the flaws of the scheme, linking it with a paucity of funds.

High child malnutrition rate

As per the National Family Health Survey 2015-2016, 44.4% of children in Dahod can be categorised as ‘stunted’; 24.9% as ‘wasted’; and 50.8% as ‘underweight’. Approximately 58.9% of children in the age group of 6 months-59 months and 56.3% women in the age group of 15 years-49 years are anaemic. Around 44% of women have below normal Body Mass Index.

The long wait for maternity benefits: How red tape drowned a central scheme in Gujarat’s Dahod district

While the Gujarat government’s scheme KSPY was revised after the announcement of PMMVY to cover second and third birth, it is dogged by cash crunch. According to the testimonies of village-level health workers at Juni Bedi Health Sub-Centre, no cash benefit has been provided to beneficiaries after August 2018. As a result, as many as 19 women have not received a single paise.

This is why a scheme like PMMVY can make all the difference, but beneficiaries say that the process is tedious and makes it very difficult for women to claim the benefits. Those few who are able to finish the documentation work have to often wait for several months, at times for years after their child is born, before they receive the cash benefit.

 

Kailash Shailesh, 32, and her husband had applied for the scheme on January 22, 2018, nearly a month after their daughter was born. At the District Panchayat office, records show that her registration was successful and her application was approved, but a response from the Public Financial Management System, the e-platform for payment of government subsidy, was “pending”. The money arrived nearly a month later on January 27, 2020, after their daughter had turned two. “Even though ₹5,000 is too little a sum, I could have used the money when I needed it the most —immediately after my child was born. I had to take a loan to buy fruits, ghee, almonds and milk. For two to three months after the delivery, my monthly expenditure went up by ₹1,700-₹2,200. We should get the money at least four months after childbirth, but in almost all cases that never happens. The scheme does not fulfil the purpose it is meant for,” explains her husband Shailesh Kumar Saiba.

An arduous process

Saiba, with an MA and a B.Ed, is among the few literate residents of the village and also a local activist; but even for him, filling in the application was a lengthy and arduous chore that called for nearly four visits to the local bank, 20 km from his home, to link his wife’s Aadhaar card with her account. He was also asked to bring his heavily pregnant wife to provide her thumb impression.

Saiba’s neighbour, 21-year-old Patel Parvati Ben Aditya, submitted her documents for the scheme more than a year ago, but on this visit to the Zilla Panchayat office, she has been told that there is no record of her application. Members of the local women’s collective inquired in their village and found out that her application was sent by the anganwadi worker but was not processed at the taluka office. It emerged that the computer operator couldn’t feed Parvati Ben’s information in the system because the computer had been lying unrepaired for several months. The money would have been a substantial help for the family whose total monthly income is a mere ₹2,000-₹3,000.

 

The lengthy documentation work includes filling up six documents, totalling 32 pages — an application form to be filled for each of the three instalments; an application for linking the Aadhaar card with bank account; another one for linking the Aadhaar card with the post office account; and a feedback form. Applicants have to also submit at least nine other documents for verification. These include an Aadhaar card (or enrolment slip when there is no card), an identity proof, a voter ID card (as age proof). Each of these documents have to be submitted by the woman beneficiary and her husband. Apart from these, there must be a copy of the ration card issued to the husband’s family, a bank passbook and the maternal and child protection card. To top it all, the woman’s Aadhaar card must have the husband’s name on it. Most young mothers have their first child in the first year of their marriage. Just collecting the documents can take six to seven months.

Patriarchy at play

Sample this — a woman has to first obtain a new election card because of the change in her address after the marriage and after that she places a request for adding her husband’s name to her Aadhaar card. Once this is done, she can have her name added to the ration card of the marital family. These require visits to the local taluka block-level officer deputed at a primary school in the village, to the Aadhaar Kendra in the taluka and then to the magistrate. “This is patriarchy at play. A woman has to be married and living with her husband to avail the benefits under PMMVY. If she is abandoned and she returns to her natal family, she can’t provide her husband’s Aadhaar card and she is left out of the purview of the scheme. When a woman is pregnant, it is visible to everyone. She should be able to provide her own Aadhaar card and demand the cash incentive owed to her,” says Seema Shah, from the NGO ANANDI.

Women protesting at the panchayat office in Dahod.

Women protesting at the panchayat office in Dahod.  

 

While in New Delhi, senior Union Ministers and top bureaucrats have time and again underlined that the purpose of an Aadhaar card is to enable the availing of government benefits and checking pilferage and that no one can be denied access to a scheme for not possessing an Aadhaar card, in reality, not owning this identity document can prove to be punitive. Further, there are several clauses that are likely to exclude many. For instance, an applicant has to be at least 19 years old, which leaves out younger brides who hesitate to get their marriages registered as the legal age of marriage is 18 years. In Dahod, at least 32.8% of girls are married before the age of 18. The application form also requires separate undertakings from the woman and her husband that the child for whom they are seeking the benefit will be “the first living child for both of them”, further making it prohibitive.

At ‘anganwadi number one’ of Juni Bedi village, it is lunchtime and young children and pregnant women flock to the centre for their daily meal. Among the six pregnant women present, three are expecting their first child, but none of them have been enrolled under PMMVY, admits anganwadi worker, Savitaben. She explains, matter of factly, that this is because they don’t have an Aadhaar card. Rewali Rakesh Naik and Jentaben Ramesh Bhai Naik either don’t have an Aadhaar card, or don’t have one with their husband’s name on it; they have no address proof for their marital home; and haven’t added their name to their marital family’s ration card. The third, whose identity is being withheld, is visibly a minor. She is married to a boy younger to her as is the practice locally. She does not have an identity proof either, nor is she likely to get her marriage registered to apply for identity documents for fear of the law.

At the local district office, there is no record available of how many women have benefited from the scheme. There is, however, data available for the total amount of money disbursed. Extrapolation of the data shows that between April 2018 and December 2019, a total of 2,042 women from Devgadh Baria taluka received the first instalment; 2,012 received the second instalment and 1,534 received the third instalment. From the start of the scheme in 2017 and till December 31, a total of 2,921 women have received at least some benefits. The taluka has a population size of 2.49 lakh of whom 1.24 lakh are women according to 2011 Census.

Chief District Health Officer R.R. Parmar meets the protesters and promises that the backlog of applications would be cleared and funds transferred to the bank accounts of the beneficiaries. However, he is more concerned about the “large size” of some families and explains that the district has “directions to spread awareness about family planning, encourage birth spacing and use of contraceptives”. Meanwhile the Child Malnutrition Treatment Centre is full. Records show that in any given month, it has 120% occupancy, i.e. an average of 24 children per month where it expects 20 children. Activists say there have been nine maternal deaths and eight infant deaths in Devgadh Baria in the past three months — the data is collected through a network of women volunteers across different villages.

Low coverage

Nationally, 38.3 lakh women, or 61% of 62.8 lakh beneficiaries registered under PMMVY between April 2018 and July 2019, received the full amount of ₹5,000 promised under the scheme, according to an RTI application filed by economists Reetika Khera, Jean Dreze and Anmol Somanchi. The researchers assert that the scheme failed to reach at least 49% of total 123 lakh mothers who are estimated to have given birth to their first child and, therefore, it was able to benefit only 31% of its intended beneficiaries. Worse, the economists contend, since the total number of births in 2017 was 270.5 lakh, the number of births covered stands at 23% of the total number of child births that year, and the proportion of those who actually received the cash benefit is a paltry 14%.

A family in Poolpura village of Dahod taluka, Gujarat, which is awaits benefit under the Pradhan Mantri Matru Vandna Yojna.

A family in Poolpura village of Dahod taluka, Gujarat, which is awaits benefit under the Pradhan Mantri Matru Vandna Yojna.   | Photo Credit: Vijay Soneji

 

Ms. Khera explains how the scheme can be improved: “The PMMVY needs to be brought in line with the National Food Security Act (NFSA), 2013, by removing the arbitrary restriction that permits a cash benefit only for the first-born. Second, the amount of cash benefit also needs to be increased. Both of the above are violations of the NFSA. In fact, the government should emulate the example of Tamil Nadu, which offers ₹18,000 under its State scheme. Third, mandatory use of Aadhaar should be removed. Any government identity document should be acceptable so that beneficiaries are not forced to run from pillar to post. Instead, make the banking system more robust and widespread. NEFT is an effective way to transfer money electronically, whereas linking Aadhaar with bank accounts has created new problems.”

But for the mothers of Dahod, it has been an exhausting wait for their entitlements. The PMMVY could have been a lifeline; instead the scheme is lost in a maze of bureaucracy.

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Printable version | Apr 3, 2020 8:06:54 AM | https://www.thehindu.com/news/national/other-states/the-long-wait-for-maternity-benefits-how-a-central-scheme-was-drowned-by-red-tape-in-gujarats-tribal-district-of-dahod/article30765290.ece

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