India accounts for one fifth of the world’s total births, with a maternal mortality rate of 113 per 100,000 live births. On January 1, 2017, the government rolled out the Pradhan Mantri Matru Vandana Yojana (PMMVY), which provides a ‘cash incentive of 5,000 directly into the bank/post office account of pregnant women and nursing mothers for the family’s first living child ( provided that specific conditions relating to maternal and child health are met)’. It is aimed at improving health seeking behavior and compensating for loss of wages for pregnant women, especially in the unorganized sectors. However, the scheme’s performance has been flawed, requiring urgent improvement, especially when the novel coronavirus pandemic has brought economic shocks to 260 lakh women who give birth to a child on average in India each year.

How the PMMVY does it

Since its inception, the PMMVY has nationally covered 2.01 crore women for a total amount of ₹8,722 crore. But the annual estimate of the intended beneficiaries by the Government of India has remained the same over the years. While the estimated eligible population of pregnant and nursing mothers in India was 128.7 lakh for 2017-18 (as stated in a report from the Center for Policy Research 2019-20), the target set by the government was 51.70 lakh beneficiaries, which is only 40. % of the eligible population. This means that we have had an exclusion error of at least 60% since 2017, as the target has remained unchanged over the years. Furthermore, enrollments and payouts under the scheme have declined over the past two years, as evidenced by data provided by the Department of Women’s and Child Development (WCD) in response to my parliamentary questions. In 2020-21, more than 50% of registered beneficiaries did not receive all three installments and there was a 9% decrease in the number of registrations under the scheme.

Despite the government’s continued emphasis on maternal and child health, the overall budget for women’s and children’s development has been cut by 20% for 2021-2022. Moreover, the budget allocation for the PMMVY has also been reduced as it has been clubbed under SAMARTHYA along with multiple other schemes such as Beti Bachao Beti Padhao, Mahila Shakti Kendra and Gender Budgeting/Research/Training. SAMARTHYA’s total budget is ₹2,522 crore, which is almost equal to PMMVY’s budget only in the previous fiscal years.

States lead the way

As the Center rolled out the PMMVY scheme at the national level, states such as Odisha, Telangana and Tamil Nadu respectively chose to implement state-specific maternity benefits schemes in the form of MAMATA (2011) or the maternity right scheme, the KCR Kit. (2017), featuring items such as baby oil, soap, mosquito nets, and dresses, and the Dr. Muthulakshmi Reddy Maternity Benefit Scheme (MRMBS) with relatively increased coverage and higher maternity benefits. For example, MAMATA of Odisha has been offering a conditional money transfer of ₹5,000 as a maternity allowance for up to two live births for over ten years.

In a comparative analysis between the PMMVY and MAMATA for 2020-21, the PMMVY shows poor performance with a 52% decrease in the number of policyholders, while MAMATA showed a 57% increase in women receiving all installments. The scheme is a testament to an inclusive and efficient implementation of the Maternity Benefit Program, thus serving as promising evidence for the Center to improve the PMMVY in line with the Odisha Government Scheme.

Steps to take

This is the way forward for the PMMVY. Extend the maternity benefit under the PMMVY to the second live birth.

The previous scheme, the Indira Gandhi Matritva Sahyog Yojana, applied to two live births. Of the total live births in India, 49.5% are first-order births and 29.9% second-order births, as shown by the Sample Registration Survey 2018. It is imperative to have a second live birth. in maternity benefit coverage, especially for women in the unorganized sector who are more vulnerable to economic shocks and nutritional loss for all child births.

There must be an increase in the amount of the maternity benefit. Since the primary purpose of the PMMVY is to provide partial wage compensation, we need to reconsider the amount of maternity benefit offered under the scheme. Most women continue to work during and after pregnancy because they cannot afford to lose wages; moreover, they also spend on out-of-pocket expenses during pregnancy. The current entitlement of 5,000 provided over a year amounts to a monthly loss of wages (under the Mahatma Gandhi National Rural Employment Guarantee Act wage of ₹202). In accordance with the Maternity Benefit Act, 1961, which mandates 12 weeks of maternity leave for women with two or more children, pregnant and nursing mothers are to receive 12 weeks of pay compensation of 15,000.

Simplify the process

Eliminate correction queues. Furthermore, the gaps in the implementation of the PMMVY scheme lead to reduced coverage. These gaps stem from a lack of awareness among the intended beneficiaries and challenges at the process level. The current registration form requires a Mother and Child Protection Card (MPC), a spouse’s Aadhaar card, a debit card and a registration form for each of the three terms resulting in delayed, rejected or pending applications. A simplification of the process could lead to an increased registration of beneficiaries.

To fulfill India’s commitment to the sustainable development goal of improving maternal health, Prime Minister Abhiyan’s ambitious Overarching Arrangement for Holistic Nutrition (POSHAN) (POSHAN) Abhiyan and a National Maternity Benefit Scheme are promising initiatives of the Center . However, the goals can only be achieved if we rethink the design and implementation of this scheme and learn lessons from states such as Odisha, which successfully prioritize maternal health and nutrition in a pragmatic way.

Amar Patnaik, a Member of Parliament, Rajya Sabha, from Odisha, was Chief Accountant General under the Comptroller and Auditor General of India (CAG). He is also an advocate.

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