Conditional Cash Transfer for Empowerment of Girl Child in Haryana

Haryana has been witnessing a steady decline in the sex ratio over the past three decades. Matters worsened with Haryana showing the lowest child sex ratio (0-6 years) in India (Census 2011). However, the 2011 Census data shows that in spite of worst sex ratio, Haryana has improved its child sex ratio in the last decade by 15 points from 819 girls per 1000 boys in 2001 to 834 girls per 1000 boys in 2011. In the last two decades, Haryana has initiated and implemented several policies to increase the value of girl child among communities and to change community’s attitude towards girl child.  One of the strategies in this line adopted by the Haryana state has been to provide financial incentive to girl child to ensure birth and development of girl child.

 

Haryana was the first to initiate a conditional cash transfer scheme for the girl child. This scheme was called Apani Beti Apna Dhan (ABAD) in 1994, which operated between 1994-1998, aimed to enhance the value of girls. Under this scheme poor households and disadvantaged caste groups, were offered a saving bond of Rs.2500 in the name of the daughter which was redeemable at a maturity value of Rs.25,000 when the girl turned 18, provided the girl was not married. Impact evaluations study of the scheme by Sinha and Yoong (2010) using NFHS data of three rounds found that the scheme had positive implications on girls’ birth and survival. However, the scheme had inconclusive effects on mothers’ preferences for a girl child. The first batch of ABAD beneficiary will turn 18 in 2014 and will be able to cash in their bond. Another evaluation of the scheme by Nanda et. al (2014) in its preliminary finding reveals that the scheme helped beneficiary girl to stay in school for longer time. According to the study “A larger proportion of girls who were part of the program (beneficiaries) remained in school than those who were not (non-beneficiaries)”.

 

Both the studies mentioned above have shown positive impacts of the schemes on development of beneficiary girls. But what is not clear from both the studies is whether it has improved social mindset towards girl child and whether it has contributed to an increase in the number of births of girl child. In addition to the ABAD scheme the Haryana government introduced a similar new scheme called Ladli in 2005 aiming to combat the menace of gender biased sex selection. The conditions of the Ladli scheme are such that it encourages families to have two daughters and assures a bond of Rs.25,000 which at the time of maturity (after attaining 18 years of the age of second girl child in family) becomes approximately Rs. 96,000. Since its inception 183,069 families have been included in the Ladli Scheme and so far the state government has invested Rs. 254.82 crores under the scheme (GoH, 2013).  Impact of the scheme against its expectations is a matter of study but the recent Census data gives hope of improvement.

 

Other than these two specific schemes to reverse declining sex ratio, Haryana government has been implementing various incentive based schemes for the development of girl child. Monthly stipend is given to school going girls of socially and economically disadvantaged sections under various schemes. Normally stipend amount is higher for girls as compared to boys in such schemes. Education is one the important indicator of empowerment and it remained core condition of every kind of conditional cash transfer schemes for girl child in Haryana.

 

School Education Data indicates that though there is marginal increase in girls’ enrolment in secondary schools in Haryana but the dropout rate of girls has decreased substantially. For Class I-X, the girl’s dropout rate decreased from 39.15 in 2007-08 to 16 in 2010-11. The retention of scheduled caste girls in school has improved much faster in this period. The dropout rate of scheduled caste girl students of Class I-X has decreased from 63.93 in 2007-08 to 16.4 in 2010-11 (MoHRD, GoI). The educational indicators are evident that survived girl children’s conditions are improving faster in Haryana. With improved health service delivery in the state, the survival rate of girl children has also increased in last one decade. According to Sample Registration System, female Infant Mortality Rate of Haryana has decreased from 70 in 2001 to 44 in 2012.  

 

Thus, the recent history of public policy interventions in Haryana to empower women and girl child resulted in improved social conditions. The social indicators for girls such as education, health, immunization, survival and fertility have improved in last one decade and  various studies in Haryana have attributed this change to both, conditional cash transfer schemes and other policy interventions. The larger goal of the conditional cash transfer scheme such as ABAD and Ladli is to influence social and cultural values of individual and community and hence end gender discrimination. There are no evidences and studies to claim that such policies are influencing human values and helping girls to have higher status in the society. Declining sex ratio is the outcome of complex social, religious, cultural and structural arrangements in our society. Any policy intervention to address this issue needs to be carefully designed and implemented. Thus, possibly greater involvement of people is required in policy planning and implementation to alter prevalent gender biased practices. It is high time to review such conditional cash transfer schemes to understand their impact in changing gender biased mindset of society.

 

Jeet Singh

Building a safe India for mothers

Photo Credit: UNICEF

The report by the Registrar General of India on maternal mortality which was released in December 2013 came as a respite in the face of India’s failure to achieve the targets under the Millennium Development Goals. Maternal mortality has significantly decreased in India over the past few years. India’s maternal mortality rate (MMR), or the rate of deaths among women during or after pregnancy, declined by 16 percent in 2011-12 from 2007-09, according to the Census data.

Although, the MMR dropped from 212 deaths per 100,000 live births in 2007-09 to 178 in 2010-12, India is lagging behind the target of 103 deaths per 100,000live births to be achieved by 2015 under the United Nations-mandated Millennium Development Goals (MDGs).

Moreover, international comparisons reveal a grim picture. According to the 2010 figures from the "World Development Indicators", South Korea has a maternal mortality count of 16, followed by Sri Lanka (35) and China (37). India is way below at 200, lagging behind even Nepal (170). The three regional countries that are behind India are Indonesia (220), Bangladesh (240) and Pakistan (260).

So what is preventing India from not even matching countries like Nepal in ensuring better health care facilities to expecting and new mothers? Lack of institutional delivery or delivery by skilled professionals, poor health budgetary allocation to health, discrimination against women and cultural attitudes that do not consider professional prenatal and delivery care are the major contributors to this sorry picture.

The NFHS data released by the Ministry of Health and Family Welfare in 2012 also revealed that with the existing rate of increase in deliveries by skilled personnel, the achievement for 2015 is likely to be only 62 percent which is still considerably short of the targeted universal coverage. High out of pocket expenses by pregnant women and their families on institutional deliveries like drugs, user charges, diagnostic tests, diet and C –sections prevented the poor from accessing health care centres leading to high mortality rates.

Janani Suraksha Yojana by the National Rural Health Mission was launched in 2005 as a response to this poor health infrastructure.  It provides for graded scale of cash assistance based on the categorisation of States as well as whether beneficiary was from rural/urban area. However, is merely doling out money to BPL families enough to reduce maternal deaths? Is this an effective policy approach to a complex issue like maternal mortality?

In the “high focus” states (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh), according to the NRHM document, the MMR is high because there are not enough rural hospitals and road connectivity is poor. If the objective is to reduce MMR in these states, an all-out effort has to be made in both these fronts: creating the health infrastructure in rural areas which is truly functional and ensuring road connectivity. There is a lack of a policy framework which can move beyond the idea of financial incentive and respond to the underlying hindrances to improved maternal health. There is a need to pilot solutions which address the intertwined factors which lead to high number of deaths among pregnant women or new mothers. It is the need of the hour that we have policies which are born from a better understanding of the ground reality rather than mere financial assistance.

There are quite a few successful approaches we can learn from. Unicef’s work in Madhya Pradesh is worth a mention. Along with the State Government, Unicef has upgraded maternal and neonatal health centres in several remote districts of MP.  A call centre was also established in the district hospital two hours away to make sure that the ambulance reaches women on time and takes them home again, once they’ve given birth. If there are problems with a birth, the ambulance can take the mother to a newborn care unit in the district hospital. The unit is equipped with incubators and can accommodate children born underweight and unwell.

Maternal and Prenatal Death Inquiry and Response (MAPEDIR) is yet another innovative tool which is being used by health experts, policy makers and communities. This innovation extends across select districts in Rajasthan, Madhya Pradesh (MP), West Bengal, Jharkhand, Orissa and Bihar. It seeks to kindle the community’s participation in probing why women died in pregnancy, delivery or soon after, with an emphasis on developing feasible solutions to the identified problems. The entire process includes identifying and investigating maternal deaths, sensitising the community, galvanising communities and health systems into action, and monitoring and adjusting interventions through continuing inquiries. The accumulated evidence can help communities understand the root causes behind these deaths so they can take effective local action and advocate for improved services to prevent future deaths.

The role of private sector and public-private partnerships in increasing availability and physical access to services for women in rural areas is another solution which can be considered.

Whatever be the approach, reproductive freedom lies at the heart of the promise of human dignity, self-determination, and equality. Every woman in India should have the right to access to best reproductive health care available. Only then can they participate with full dignity as equal members of the society.

 

Simi Sunny