A discussion on the Indira Gandhi Matriva Sahyog Yojana was organized by the NAMHHR on the 25th February 2011. A panel consisting of various speakers critically analyzed the Scheme from various perspectives. Ms. Dipa Sinha (Commissioners to the Supreme Court) presented a brief outline of the Scheme. Critically analysing the scheme from the nutritional perspective, she said that the IGMSY was the first such scheme centred round maternity entitlements, however the serious flaw in the scheme was that it saw maternity benefit not as a ‘right’ but as an ‘incentive’ for ‘right behaviour’. Besides, the other problem with the scheme was the insufficient amount of money given to the beneficiaries which was not linked to wages. She also feared that this scheme could be seen as a pilot for Conditional Cash Transfers (CCTs).
Prof. Imrana Quadeer provided a health systems perspective to the analysis of the Scheme. She held that while analysing the IGMSY; it is necessary to situate it in the scheme of larger things. Looking back at history, a shift in vision is clearly discernable- earlier health was a service, but now it has become a commodity. The present policy and planning of our government has led to an erosion of what had been created by post independence India. She mentioned that it was necessary for us to stress that the primary responsibility of the state was to provide free quality health care. In conclusion she reiterated that we must first ensure that basic infrastructure exists, basic services are insured and then providing people with short term benefits such as the IGMSY would be welcome.
Ms. Sandhya Mishra (Sikhar Prasthan Sansthan) critiqued the scheme from the informal worker’s perspective. She began by saying that the conditionalities in the scheme had ignored the patriarchal nature of Indian society. In a country where women had no control over their reproductive decisions and marriage, barring under 19 year women and women with more than two children was unfair. She also mentioned that rolling out of the scheme through the ICDS was highly problematic since there were many Dalit colonies where Anganwadi centres did not exist. The push for six months exclusive breastfeeding without making provisions for enabling conditions and a mother friendly work place would deprive poor informal sector women workers the benefits of the scheme.
Dr. Evangeline Dutta (CMAI) critiqued the scheme from the ASHA perspective. She began by saying that the entire ASHA system was incentive driven; this she claimed had resulted in an erosion of the basic value of community health workers. The consequence was that community health workers were slowly becoming an extension of a small bureaucracy. The government, she held, was doing its best to commodify the provisioning of services by health workers. The huge amount of corruption and competition in the system was only going to intensify with this scheme and so would the confusion in the minds of the people and the community health workers regarding their responsibilities.
The Anganwadi workers perspective was given by All India Federation of Anganwadi Workers and Helpers. The concerns expressed by the Federation in regard to the IGMSY, was that it would increase the burden of the already burdened Anganwadi Workers (AWW) and Helpers. The proposed incentive that was to be given to the AWW was critized as being too small and too late. Instead it was suggested that the Scheme be rolled out through the ASHAs and the government concentrate on strengthening the AWW system.
An outline of the budgetary allocations of the Scheme was given by Ms. Trisha (CGBA). She shared that the IGMSY scheme hoped to cover a target population of 13.80 lakh women in the first year. The budgetary allocations for the scheme are Rs.390 crore and Rs.610 crore for 2010-11 and 2011-12 respectively. She went on to say that as the money would be transferred to the beneficiary’s bank accounts this could create a problem as most rural women did not have accounts. She went on to point out that while as a special intervention, two additional staff would be provided in District ICDS Cell, there was to be no increase in the number of frontline workers.
The presentations were followed by an enriching discussion wherein it was decided to take the following strategic position:
• The scheme is eroding the entire system
• It will result in the loss of credibility of the health system and the government
• We must use this as an opportunity to state what we want form the women’s point of view
• Stress on the strengthening of the health system
• Push for a holistic view of health
• Create an enabling environment for women
The discussion ended with a set of asks being outlined which would be placed before the Planning Commission:
1. The existing health system must be strengthened
2. Question how the health system will support the woman’s wellbeing
3. We want this scheme to be a maternity benefit scheme and not a wage compensation
4. Simplify the disbursement pattern
5. Remove all conditionalities
6. What is the evaluation framework of the scheme
7. What is the accountability mechanism of the scheme
8. Incorporate the learnings from the JSY scheme into the IGMSY
9. Increase AWW and ANM services
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