The long wait for maternity benefits: How bureaucracy drowned out a central system in the Dahod district in Gujarat

Segway-like vehicles were also used by the police to keep an eye on the large crowd on Marina Beach.

Protest songs and slogans on the lips and toddlers in the arms march nearly 70 women in a row in the three-story Panchayat office in the Gujarat district in Dahod. The women confidently climb the first two floors and park in front of the Chief District Health Officer's office. While many young mothers sit along the corridor, taking care of their young children and breastfeeding, others dance in circles to spontaneously play folk songs that aim to shame government officials for nine district mothers' deaths and the prevalence of malnutrition. The main ban, however, is that officials force mothers living in remote villages to travel for hours to claim their legitimate benefits if they are actually supposed to look after their young. "Sisters were pushed around and forced to come to Panchayat District," they say.

Dahod is primarily a tribal district bordering Madhya Pradesh. “74.3% of the population [is] from the planned 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 a larger family size are typical profiles of the rural areas of Dahod, ”explains Neeta Hardikar, co-founder of ANANDI, an NGO that works for poor rural women in Gujarat.

These are also the reasons given by the Population Foundation of India for a high decade population growth of the district lineages in the district between 2001 and 2011, which at 34% was almost twice the population growth of the country. It was 30% for Dahod and 19.28% for Gujarat. Four to five children in a family also seem to be the norm on site.

A 120 km journey for young mothers

The mothers are here to claim maternity benefits under Pradhan Mantri Matru Vandana Yojana (PMMVY) from the central government and Kasturba Sahay Poshan Yojana (KSPY) from the government of Gujarat. Coming from the remote villages of Piplod, Dabhva, Bara, Fulpura and Juni Bedi in Devgadh Baria taluka, they traveled almost three hours and covered a distance of around 120 km with jeeps.

The women's protest coincides with the third anniversary of Prime Minister Narendra Modi's television speech, in which he promised pregnant women and young mothers across the country an amount of £ 6,000 for the birth of their first child. This program was later christened Pradhan Mantri Matru Vandana Yojana. The program provides for a total of £ 5,000 to be paid in three installments to pregnant women and nursing mothers. Those who receive similar benefits from their employers and government employees are excluded from the scheme.

The benefit is granted only on the first live birth and the money is credited to the beneficiary's Aadhaar-linked savings account at different intervals over a period of almost 14 months. Each installment is paid after the mothers have met certain conditions – the first installment after early pregnancy registration; the second installment after six months of pregnancy after completing at least one prenatal exam; and the third installment after registration of the child's birth and child's first vaccination cycle.

The government has linked this to Janani Suraksha Yojana, which offers a £ 700- £ 1,000 advantage to claim that women get "on average" £ 6,000 for every first child.

A mother with her second child in the Junibedi village of Dahod Taluka, Gujarat.

A mother with her second child in the Junibedi village of Dahod Taluka, Gujarat.

| Credit: Vijay Soneji

In Dahod, a sad and expressionless 26-year-old Ushaben Girishbhai Naik lives among the residents of the corridor on the second floor. Although she does not join the protest choir, she is here to mark her presence. On December 12, she lost her 20-month-old daughter Vilasben after severe diarrhea and vomiting.

Back at her village house, Juli Bedi, the girl's grandfather, takes out an iron suitcase from among the few memorabilia he owns – a piece of paper on which Vilas' date of birth, April 3, 2018, is scribbled ; and death date, December 12, 2019. The child's father brings a framed photo of her, neatly wrapped in red and white Gamcha and the whole family breaks down in a collective outpouring of shared grief.

When Vilas was 14 months old, an examination by health workers at ANANDI, the NGO, found that she only weighed 5.2 kg. H. 30 to 45% less than their ideal weight. According to the World Health Organization (WHO) children's growth standards, the toddler was categorized as "red" or "severely underweight" while the local Anganwadi worker marked her green in her growth chart to identify her as a child with healthy growth , At the NGO's intervention, the child was admitted to the local Child Malnutrition Treatment Center for 14 days, where it showed signs of recovery and gained 2 kg. But when her last check-up was done on August 22, she not only had a fever, it turned out that her progress had stalled and she had started losing weight again.

The year 2019 was difficult for the family. Their entire maize cultivation on a land of about 1.5 hectares was washed out by heavy rains and there was very little to eat. Ushaben and her husband traveled to Navagam near Rajkot for two months, as they do every year. Here they worked hard on cotton fields and earned £ 100 for every 20 kg of plucked cotton. But when the news of their daughter's illness came to them, they had to leave the castle, camp and barrel for their village with the little money they had been able to earn. Despite these difficulties, Ushaben was excluded from the PMMVY because Vilas was their second child. Senior government officials have admitted that this is one of the shortcomings of the system, which is associated with a lack of funds.

High child malnutrition rate

According to the National Family Health Survey 2015-2016, 44.4% of children in Dahod can be classified as "stunted". 24.9% as "wasted"; and 50.8% as "underweight". Approximately 58.9% of children in the age group from 6 months to 59 months and 56.3% of women in the age group from 15 years to 49 years are anemic. Around 44% of women have a below-average body mass index.

The long wait for maternity benefits: How bureaucracy drowned out a central system in the Dahod district in Gujarat

While the Gujarat government's KSPY program has been revised after PMMVY's announcement to cover the second and third births, it has been hit by the money crisis. According to village level health workers at the June Bedi Health Sub-Center, beneficiaries were no longer granted cash benefits after August 2018. As a result, not even 19 women received a single benefit.

For this reason, a program like PMMVY can make the difference, but the beneficiaries say that the process is lengthy and makes it very difficult for women to take advantage of the benefits. The few who are able to complete the documentation work often have to wait several months, sometimes years after the birth of their child, before they receive the cash benefit.

32-year-old Kailash Shailesh and her husband applied for the program on January 22, 2018, almost a month after the birth of their daughter. In the Panchayat district, records show that their registration was successful and their application was approved, but a response from the public financial management system, the electronic platform for paying government subsidies, was pending. The money arrived almost a month later on January 27, 2020, after her daughter turned two. “Even if £ 5,000 is not enough, I could have used the money immediately after the birth of my child, when I needed it most. I had to take out a loan to buy fruit, ghee, almonds, and milk. For two to three months after delivery, my monthly expenses increased by £ 1,700 to £ 2,200. We should get the money at least four months after the birth, but in almost all cases it never happens. The program does not serve the purpose for which it was designed, ”explains her husband Shailesh Kumar Saiba.

A tedious process

Saiba, with an MA and a B.Ed., is one of the few educated residents of the village and is also a local activist. But even for him, filling out the application was a tedious and arduous task, requiring almost four visits to the local bank, 20 km from his home, to link his wife's Aadhaar card to her account. He was also asked to take his heavily pregnant wife with her to give her thumbprint.

Saiba's neighbor, 21-year-old Patel Parvati Ben Aditya, submitted her application for the program more than a year ago. However, during this visit to Zilla Panchayat's office, she was informed that there was no record of her application. Members of the local women's collective inquired about their village and found that their application was sent by the Anganwadi worker, but was not processed in the Taluka office. It turned out that the computer operator was unable to enter Parvati Ben's information into the system because the computer had not been repaired for several months. The money would have been of great help to the family, whose total monthly income is only £ 2,000 to £ 3,000.

The lengthy documentation work involves filling out six documents with a total of 32 pages – an application form to be completed for each of the three installments; an application to link the Aadhaar card to the bank account; another to link the Aadhaar card to the postal account; and a feedback form. The applicant must also submit at least nine additional documents for review. This includes an Aadhaar card (or a registered letter if no card is available), proof of identity and a voter ID card (as proof of age). Each of these documents must be submitted by the beneficiary wife and her husband. You must also have a copy of the grocery card given to the husband's family, a bank passbook, and the mother and child protection card. To top it off, the woman's name must be noted on the woman's Aadhaar card. Most young mothers have their first child in the first year of their marriage. Collecting the documents alone can take six to seven months.

Patriarchy in the game

Try it out – a woman has to get a new electoral pass due to changing her address after marriage and then asks to put her husband's name on her Aadhaar card. Once this is done, she can put her name on the marital family's grocery card. These require visits to the local Taluka block level official, who is housed in a village primary school, Aadhaar Kendra in Taluka, and then to the magistrate. "This is patriarchy. A woman must be married and live with her husband to use PMMVY services. If she is left and returns to her birth family, she will not be able to present her husband's Aadhaar card and it will not be the responsibility of the system. When a woman is pregnant, it is visible to everyone. She should be able to provide her own Aadhaar card and claim the money incentive owed to her, ”said Seema Shah of the NGO ANANDI.

Women protest in the Panchayat office in Dahod.

Women protest in the Panchayat office in Dahod.

During their stay in New Delhi, senior trade union ministers and senior bureaucrats have repeatedly stressed that the purpose of an Aadhaar card is to enable the government to take advantage of the benefits and control theft, and that no one is denied access to a system can if he does not have Aadhaar In reality it can prove to be punishable if you do not have this ID. There are also several clauses that are likely to exclude many. For example, an applicant must be at least 19 years old, which excludes younger brides who are reluctant to register their marriages because the legal age of the 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 commitments from the wife and husband that the child they are applying for will be “the first child alive for both of them”, which further makes it unaffordable.

In “Anganwadi number one” in the village of June Bedi there is a lunch break and small children and pregnant women flock to the center for daily meals. Among the six pregnant women present, three are expecting their first child, but none of them are registered with PMMVY, the Anganwadi worker Savitaben admits. She explains that this is due to the fact that they do not have Aadhaar cards. Rewali Rakesh Naik and Jentaben Ramesh Bhai Naik either have no Aadhaar card or no card with their husband's name. They have no proof of address for their marital home. and do not have their name on their catering card. The third party, whose identity is withheld, is clearly a minor. She is married to a boy who is younger than her, as is customary on site. She does not have proof of identity, and she is unlikely to register her marriage to apply for ID due to fear of the law.

There is no record of how many women have benefited from the program at the local district office. However, data is available for the total amount paid out. 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 installment; 2,012 received the second and 1,534 the third installment. From the start of the program in 2017 until 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 which 1.24 Lakh are women according to the 2011 census.

Chief District Health Officer R. R. Parmar meets with the demonstrators and promises that the backlog of applications will be removed and the funds transferred to the beneficiaries' bank accounts. However, he is more concerned about the "large size" of some families and explains that the district "has instructions to raise awareness of family planning, promote birth intervals, and use contraceptives." The Child Malnutrition Treatment Center is now full. Records show that it is 120% busy in a given month, i.e. H. On average 24 children per month, where 20 children are expected. According to activists, nine mothers and eight children have been killed in Devgadh Baria in the past three months. The data is collected through a network of female volunteers in different villages.

Low coverage

According to an RTI application submitted by economists Reetika Khera, Jean Dreze and Anmol, 38.3 Lakh women nationwide or 61% of the 62.8 Lakh beneficiaries registered between April 2018 and July 2019 under the PMMVY received the full amount of £ 5,000 Somanchi. The researchers claim that the program did not reach at least 49% of the 123-lakh mothers who are estimated to have had their first child and could therefore benefit from only 31% of the intended beneficiaries. Even worse, economists claim that the total number of births in 2017 was 270.5 lakh, the number of births recorded was 23% of the total number of childbirths this year, and the proportion of those who actually received cash benefits is a poor 14%.

A family in the Poolpura village of Dahod taluka, Gujarat, supported by Pradhan Mantri Matru Vandna Yojna.

A family in the Poolpura village of Dahod taluka, Gujarat, supported by Pradhan Mantri Matru Vandna Yojna.
| Credit: Vijay Soneji

Ms. Khera explains how the system can be improved: “The PMMVY must be brought into line with the 2013 National Food Security Act (NFSA) by lifting the arbitrary restriction that only allows first-born babies to receive cash benefits. Second, the amount of the cash benefit must also be increased. Both are violations of the NFSA. In fact, the government should imitate Tamil Nadu's example, which offers £ 18,000 under its state system. Third, the mandatory use of Aad hair should be removed. Any government identification document should be acceptable so that beneficiaries are not forced to walk from the pillar to the post office. Instead, make the banking system more robust and widespread. NEFT is an effective way to transfer money electronically, while linking Aadhaar to bank accounts has created new problems. "

But for Dahod's mothers, it was an arduous wait for their claims. The PMMVY could have been a lifeline; instead, the scheme is lost in a labyrinth of bureaucracy.