The key findings from the National Family Health Survey-5 (NFHS-5) of selected states have reminded us that India is facing a crisis of poor nutrition outcomes.
Prevalence of stunting among children has remained stagnant or increased in most of these states. The appalling under-nourishment of children reflects poor maternal nutrition, widespread anaemia and insufficient breastfeeding. Anaemia among women also remains very high and has, in fact, increased in several states.
Clearly, there is an urgent need to boost maternal well-being through comprehensive maternity protection, including health services, supplementary nutrition and wage compensation for the period during late pregnancy, childbirth and exclusive breastfeeding. The existing arrangements for maternity entitlements are inadequate as the Maternity Benefit Act (2017) addresses only those women who work in establishments with 10 or more workers.
The Periodic Labour Force Surveys (2019) show that labour force participation rates among women aged 15 and above is only 25% and among them only 12% work in such establishments. For all other women, the only maternity entitlement available is through the Pradhan Mantri Matru Vandana Yojana, a cash transfer scheme of only ₹5,000, grossly under-budgeted, and barely addressing 25% of pregnant women.
Women in agriculture, scheme workers such as anganwadi workers and ASHAs, street vendors and domestic workers are not even included in the Act. There was a possibility for addressing these lacunae in the Code on Social Security (2020) for which rules are being drafted. Unfortunately, this Code has missed the opportunity for creating a framework for universal maternity entitlements.
The Code and the draft rules are exclusionary in the provisions for maternity benefits, which are a cut-and-paste from the Maternity Benefit Act, 2017, where only women who are in formal employment are eligible. The Code specifies that to be entitled for a maternity benefit, a woman should have worked in an establishment for a period of at least 80 days in the 12 months preceding her expected date of delivery, which makes it further difficult to avail the benefit given the precarity of work.
The Code is further discriminatory towards women with more than two children and deprives the third or later child of the care and breastfeeding from their mother as she would get only 12 weeks leave instead of the recommended period of six months (World Health Organization). The maternity benefits are also limited to only three months in the case of adoptive and surrogate mothers. In fact, maternity benefits should be gender neutral as “parental benefit”, since sometimes men may need to care for the child, or the adoptive parent may not be a woman/mother.
Even for women who are eligible, the onerous documentation requirements as laid out in the draft rules include a certificate from a medical officer and a notice to the employer, as well as making submission of Aadhaar details mandatory for unorganised sector workers, and digital application is the norm. This puts an unnecessary burden on the pregnant woman. It would be simpler to rely on the registration of pregnancy with the health department or the Integrated Child Development Services, by just adding a column in the Mother and Child Protection Card, which can be the document used to make her automatically eligible for the payment of a maternity benefit.
While the amended Maternity Benefit Act as well as the Code specify that establishments that have 50 employees shall have a creche facility, the draft rules dilute this provision by stating that “in every establishment where fifty or more women employees are ordinarily employed”. This not only reduces the availability of these facilities of children, but it is likely to make employers reluctant about employing more women. In reality, what was required was expanding the creche provision to all children with a locality-based arrangement that permit the mother to go and breastfeed close to the workplace.
Given the fragile nature of social protection for these working women, all provision of maternity protection should be universally applicable to all working women regardless of the consistency or duration of work and independent of their current status of employment. If we recognise that maternity protection is essential to ensure that women have enough to eat, can rest and breastfeed the baby, and to improving the nutrition indicators, India must make it a universal entitlement.
The coverage of the maternity should neither be establishment-specific nor should it depend on the number of children. In fact, we would be penalising women for no fault of theirs, since during the pandemic and lockdown, lakhs of women went through unwanted pregnancy with no access to contraception or abortion services. Maternity benefits should be a right of all workers regardless of their employment status, or the number of children.
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- In the Large States category (overall), Chhattisgarh ranks 1st, followed by Odisha and Telangana, whereas, towards the bottom are Maharashtra at 16th, Assam at 17th and Gujarat at 18th. Gujarat is one State that has seen startling performance ranking 5th in the PAI 2021 Index outperforming traditionally good performing States like Andhra Pradesh and Karnataka, but ranks last in terms of Delta
- In the Small States category (overall), Nagaland tops, followed by Mizoram and Tripura. Towards the tail end of the overall Delta ranking is Uttarakhand (9th), Arunachal Pradesh (10th) and Meghalaya (11th). Nagaland despite being a poor performer in the PAI 2021 Index has come out to be the top performer in Delta, similarly, Mizoram’s performance in Delta is also reflected in it’s ranking in the PAI 2021 Index
- In terms of Equity, in the Large States category, Chhattisgarh has the best Delta rate on Equity indicators, this is also reflected in the performance of Chhattisgarh in the Equity Pillar where it ranks 4th. Following Chhattisgarh is Odisha ranking 2nd in Delta-Equity ranking, but ranks 17th in the Equity Pillar of PAI 2021. Telangana ranks 3rd in Delta-Equity ranking even though it is not a top performer in this Pillar in the overall PAI 2021 Index. Jharkhand (16th), Uttar Pradesh (17th) and Assam (18th) rank at the bottom with Uttar Pradesh’s performance in line with the PAI 2021 Index
- Odisha and Nagaland have shown the best year-on-year improvement under 12 Key Development indicators.
- In the 60:40 division States, the top three performers are Kerala, Goa and Tamil Nadu and, the bottom three performers are Uttar Pradesh, Jharkhand and Bihar.
- In the 90:10 division States, the top three performers were Himachal Pradesh, Sikkim and Mizoram; and, the bottom three performers are Manipur, Assam and Meghalaya.
- Among the 60:40 division States, Orissa, Chhattisgarh and Madhya Pradesh are the top three performers and Tamil Nadu, Telangana and Delhi appear as the bottom three performers.
- Among the 90:10 division States, the top three performers are Manipur, Arunachal Pradesh and Nagaland; and, the bottom three performers are Jammu and Kashmir, Uttarakhand and Himachal Pradesh
- Among the 60:40 division States, Goa, West Bengal and Delhi appear as the top three performers and Andhra Pradesh, Telangana and Bihar appear as the bottom three performers.
- Among the 90:10 division States, Mizoram, Himachal Pradesh and Tripura were the top three performers and Jammu & Kashmir, Nagaland and Arunachal Pradesh were the bottom three performers
- West Bengal, Bihar and Tamil Nadu were the top three States amongst the 60:40 division States; while Haryana, Punjab and Rajasthan appeared as the bottom three performers
- In the case of 90:10 division States, Mizoram, Assam and Tripura were the top three performers and Nagaland, Jammu & Kashmir and Uttarakhand featured as the bottom three
- Among the 60:40 division States, the top three performers are Kerala, Andhra Pradesh and Orissa and the bottom three performers are Madhya Pradesh, Jharkhand and Goa
- In the 90:10 division States, the top three performers are Mizoram, Sikkim and Nagaland and the bottom three performers are Manipur and Assam
In a diverse country like India, where each State is socially, culturally, economically, and politically distinct, measuring Governance becomes increasingly tricky. The Public Affairs Index (PAI 2021) is a scientifically rigorous, data-based framework that measures the quality of governance at the Sub-national level and ranks the States and Union Territories (UTs) of India on a Composite Index (CI).
States are classified into two categories – Large and Small – using population as the criteria.
In PAI 2021, PAC defined three significant pillars that embody Governance – Growth, Equity, and Sustainability. Each of the three Pillars is circumscribed by five governance praxis Themes.
The themes include – Voice and Accountability, Government Effectiveness, Rule of Law, Regulatory Quality and Control of Corruption.
At the bottom of the pyramid, 43 component indicators are mapped to 14 Sustainable Development Goals (SDGs) that are relevant to the States and UTs.
This forms the foundation of the conceptual framework of PAI 2021. The choice of the 43 indicators that go into the calculation of the CI were dictated by the objective of uncovering the complexity and multidimensional character of development governance
The Equity Principle
The Equity Pillar of the PAI 2021 Index analyses the inclusiveness impact at the Sub-national level in the country; inclusiveness in terms of the welfare of a society that depends primarily on establishing that all people feel that they have a say in the governance and are not excluded from the mainstream policy framework.
This requires all individuals and communities, but particularly the most vulnerable, to have an opportunity to improve or maintain their wellbeing. This chapter of PAI 2021 reflects the performance of States and UTs during the pandemic and questions the governance infrastructure in the country, analysing the effectiveness of schemes and the general livelihood of the people in terms of Equity.
Growth and its Discontents
Growth in its multidimensional form encompasses the essence of access to and the availability and optimal utilisation of resources. By resources, PAI 2021 refer to human resources, infrastructure and the budgetary allocations. Capacity building of an economy cannot take place if all the key players of growth do not drive development. The multiplier effects of better health care, improved educational outcomes, increased capital accumulation and lower unemployment levels contribute magnificently in the growth and development of the States.
The Pursuit Of Sustainability
The Sustainability Pillar analyses the access to and usage of resources that has an impact on environment, economy and humankind. The Pillar subsumes two themes and uses seven indicators to measure the effectiveness of government efforts with regards to Sustainability.
The Curious Case Of The Delta
The Delta Analysis presents the results on the State performance on year-on-year improvement. The rankings are measured as the Delta value over the last five to 10 years of data available for 12 Key Development Indicators (KDI). In PAI 2021, 12 indicators across the three Pillars of Equity (five indicators), Growth (five indicators) and Sustainability (two indicators). These KDIs are the outcome indicators crucial to assess Human Development. The Performance in the Delta Analysis is then compared to the Overall PAI 2021 Index.
Key Findings:-
In the Scheme of Things
The Scheme Analysis adds an additional dimension to ranking of the States on their governance. It attempts to complement the Governance Model by trying to understand the developmental activities undertaken by State Governments in the form of schemes. It also tries to understand whether better performance of States in schemes reflect in better governance.
The Centrally Sponsored schemes that were analysed are National Health Mission (NHM), Umbrella Integrated Child Development Services scheme (ICDS), Mahatma Gandh National Rural Employment Guarantee Scheme (MGNREGS), Samagra Shiksha Abhiyan (SmSA) and MidDay Meal Scheme (MDMS).
National Health Mission (NHM)
INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)
MID- DAY MEAL SCHEME (MDMS)
SAMAGRA SHIKSHA ABHIYAN (SMSA)
MAHATMA GANDHI NATIONAL RURAL EMPLOYMENT GUARANTEE SCHEME (MGNREGS)