The Indian government recently announced the new Janani Suraksha Yojana (Safe Motherhood scheme) in an attempt to end gender discrimination and female infanticide. The scheme now offers a higher incentive (Rs 1000 [$US1=Rs47.5] instead of Rs 500) to poor mothers giving birth to girls.
Previously, a woman got Rs 500 at the birth of a boy or girl. But now if she gives birth to a daughter, she will receive Rs 1,000. Union Health Minister Sushma Swaraj claimed that the new scheme would encourage the nurturing of baby girls and induce women to go to a hospital for their delivery in order to collect the cash incentives. In several rural areas, babies continue to be born in homes without even trained midwives.
Under the new scheme, pregnant women will also receive Rs 150 "for transport to a hospital" for pre-natal check-ups. Lack of access to adequate health care facilities causes death of 407 women for every 100,000 live births in the country (the comparable Maternal Mortality Rate (MMR) in developed countries is between seven and 10 per 100,000 births). In addition, 67 newborns out of every 1,000 die before their first birthday in India (comparable Infant Mortality Rates (IMR) too, are in single digit
figures in developed countries).
Incentives, including monetary assistance, to reduce MMR and IMR are undoubtedly welcome, as are measures that would discourage the practice of female infanticide, female feticide or the pervasive neglect of girl children. But how effective will an additional incentive of Rs 500 be in practice?
Several women (from both rural and urban areas) are skeptical about the scheme. Ellamma, mother of 22-year-old Varalakshmi, is not sure whether the scheme will be a success. Her daughter recently delivered a girl child in Bangalore. "I don't think Rs 500 will make a difference, whether to our expenses or in attitudes. I had to pay Rs 300 at the hospital just to be able to see my newborn grandchild. The staff knew I was poor. But they didn't clean my daughter and the infant till the money was paid. Now, if they know that the government is paying an extra amount, they will only extract higher amounts."
Lakkhi, a tribal woman from Andhra Pradesh, says, "Instead of giving money to the pregnant woman, why doesn't the government use the amount to ensure that the Primary Health Centre (PHC) in our village works properly? It would benefit many more women." Lakkhi complained that the PHC in her
village is never open. "There is no doctor for months, no equipment and no medicines. We are forced to walk several kilometres to get to the nearest town. Last month, a woman in labor had to travel eight km to the nearest medical centre. It took her more than three hours." In most states, PHCs
exist merely on paper. They fail to provide medical benefits to the community.
Lakkhi believes that Rs 150, earmarked for travel, will be spent by most families on food or other expenses. Even a weak pregnant woman will use it to feed the family, not herself. "That's what poverty does. The only way to ensure that the women benefits is to provide services, not money." Lakkhi also questions how the government is going to ensure that the funds provided for this scheme reach the intended beneficiaries.
Babu, who is also from Lakkhi's village, says wryly, "The money will not bring a bus service to our village or enable families to buy a vehicle. And we know what happens when money is promised on paper. The system ensures that we poor people never get it."
The news of the scheme has not reached many women. Lack of awareness invariably results in potential beneficiaries not claiming the amount due to them, and in corrupt functionaries pocketing the funds with impunity.
Also, the scheme assumes that only poor families practice discrimination. Dhanvanti, married into a prosperous business family in Bangalore, is under pressure from her husband and in-laws to produce a son after two daughters. "It is not just poor families who discriminate against females. A few hundred rupees cannot change this prejudice against baby girls. What is required is a change in attitudes."
UNICEF consultant Satish Agnihotri's studies have found that the incidence of female feticide is, in fact, higher in the prosperous regions of the country, resulting in a significant decline in the sex ratio even in urban areas. The Census of India 2001 says there is a 32-point decline in the sex ratio in urban areas, as against a 14-point fall in rural regions.
Agnihotri's study found, for instance, that prosperous families have fewer daughters in Madhya Pradesh; and some parts of Punjab have a sex ratio of just 800 females (per 1,000 males). Increasing prosperity has resulted in mobile diagnostic facilities reaching even the rural areas. The Indian Medical Association estimates that five million female fetuses are aborted every year.
Many are also unsure about the government's new idea of offering Rs 25 to every trained midwife for assisting deliveries. Women activists believe a midwife would get ten times that amount to assist in an infanticide case.
A medical doctor from Tamil Nadu (on condition of anonymity) virtually defends the practice: "We have to be pragmatic. These families will be ruined by the dowry menace. Once these daughters grow up, who is going to help them? Will a thousand rupees, which most likely will be appropriated
by the male householder, help in feeding and raising the girl and buying gold for her marriage?"
Can new schemes such as this one, bring about a qualitative change in society? Dowry, though prohibited by law, has grown to monstrous proportions after four decades of legislation. What needs to change is the attitude. And you cannot legislate against attitudes.