Tamil Nadu has a pioneering cash-based maternity benefit scheme titled Dr Muthulakshmi Reddy Maternity scheme which provides Rs 18,000 to every pregnant and lactating mother.
Telangana has a maternity benefit scheme which provides a cash transfer of Rs 12,000, and even a poorer state like Odisha is providing Rs 5,000 to pregnant women.
Other states had just begun to accept the principle of making financial allocations in terms of cash-based maternity benefit schemes under the Indira Gandhi Matritva Sahyog Yojana (IGMSY), which started as a pilot project in 2011 with a budget of Rs 230 crore in 53 districts by the UPA-II government.
Just when there were plans to extend the IGMSY across the country, Prime Minister Narendra Modi announced the launch of the Pradhan Mantri Matru Vandana Yojana (PMMVY) on December 31, 2016, which narrowed down the financial assistance of Rs 5,000 to the first birth only.
With an overall allocation of Rs 2,700 crore, the separate financial allocations for each state under the PMMVY have been made some weeks ago. The central government has made the financial allocations to the different states.
On paper, these allocations are hardly substantive. Madhya Pradesh has received over Rs 74 crore, Rajasthan has got Rs 70 crore, Gujarat Rs 62 crore, West Bengal Rs 93 crore, Bihar Rs 107 crore, Uttar Pradesh Rs 205 crore, Tamil Nadu has been given Rs 74 crore and Maharashtra Rs 115 crore.
Since the states have yet to come up with their matching grants, the scheme continues to be stymied. The result is that the (Accredited Social Health Activist) ASHA workers in the anganwadi centres are not willing to release the forms needed to be filled out by pregnant women in order to access this money.
Restricting assistance to the first childbirth has created its own logjams. In Uttar Pradesh, where women have an average of three children, giving maternity benefits only for the delivery and care of the first child deprives most pregnant women of their legal entitlements, say health workers. The other point of significance which has been overlooked by the PMMVY is that in Uttar Pradesh, 258 women die during childbirth for every one lakh live births.
Providing them with cash incentives for medical care and nutritional support at this crucial time will go a long way in saving the lives of these women.
In a large state like Uttar Pradesh, only seven out of ten have institutional deliveries and to receive the Rs 1,000 under the Janani Suraksha Yojana (JSY), the women are expected to bribe the medical staff of the hospitals before they can get the money.
Food rights activist Dipa Sinha, who is closely associated with the Right to Food Campaign, pointed out that since Uttar Pradesh has a much higher total fertility rate than states like Tamil Nadu and Kerala, there will be more women having their second, third or fourth children in Uttar Pradesh than in Tamil Nadu. Therefore, the scheme when implemented, will benefit a larger proportion of women in Tamil Nadu and Kerala who are having their first children as compared to women in Uttar Pradesh who had their first children before these benefits were announced.
The results on the ground are there for all to see. Recent research quoted in the Economic Survey of India 2017 pointed out that close to half the women in India are already underweight before they become pregnant, and gain an average of only seven kgs weight through pregnancy, instead of 13-18 kilos as recommended. Women who begin pregnancy too thin and do not gain enough weight during pregnancy are far more likely to have babies with low birth weights. These women suffer from persistent anaemia which in turn results in the birth of underweight children.