The Reductions to India's Nutrition Program for Pregnant Women Puts the Health of Mothers and Future Generations at Risk

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Why have the benefits due to poor pregnant mothers under the "Right to Food Act" been reduced by the Pradhan Mantri Matru Yojana?

Written by Pravin J P Arapurakal, Aranmula, November 30, 2018
The Provisions of the Prime Minister's Program for Pregnant Women appear poorly implemented and inadequate? The insensitivity shown by government planners to the needs of poor pregnant women is outrageous and short sighted. After all, investing in healthy mothers cascades into the population on a grand scale, Impacting the lives of families and whole communities. 

Are one in two pregnant women in India malnourished? The Times of India in 2015 reported on a group called the Global Alliance for Improved Nutrition. The organization estimates that 50 percent of expectant mothers in India are anemic (*1).  

A young lady at the Delhi School of Economics inspired this piece: On November 29th, 2018, Ms Aditi Priya, an MA student at the DSE, wrote a piece in the Hindu castigating the nation's inadequate support for pregnant women. She particularly berates the Governmental Program for the inadequate support of pregnant women (Pradhan Mantri Matru Vandana Yojana (PMMVY), launched in September 2017.)  Her complaint? She feels that the PM's effort at supporting pregnant women reduce the benefits they were entitled to under the Food Security Act of 2013 and make them harder to access.

Study by researchers at JNU and IIT, Roorkee: Many others share Ms Priya's concerns. Devanik Saha writes in the Hindustan Times: "Maternal healthcare expenses push 46.6% of mothers in India into poverty – with the illiterate being especially susceptible – according to this December 2016 study by researchers from Jawaharlal Nehru University and Indian Institute of Technology, Roorkee. The expenses include childbirth, antenatal care and postnatal care expenses."

The Many Inadequacies of the Pradhan Mantri Matru Vandana Yojana: The Schedule of Implementation Guidelines of the PMMVY (129 pages!) is exhausting (but not exhaustive) . It attempts to clarify the discrepancies between the provisions in the PMMVY and the provisions in the Food Security Act as they apply to pregnant women. The introduction to the PMMVY refers to the provisions of the Right to Food Act but the PMMVY in a somewhat mean spirited way, supersedes the provisions of the Food Security Act as they apply to pregnant women. 

Here are the provisions of the PMMVY, with comments below each point (*2).

- Rs 5,000 deposited directly into mother's account in three installments
Previously Rs 6,000 was to be paid in two installments. Now Rs 5,000 paid in three installments with separate applications for each installment. This devotion to documentation is supposed to be supported by the local Anganwadi or Asha Worker. This three part process may save the nation some money if the women loses her baby but in practice it increases costs for both the recipient and the administration.

There is mention of an additional Rs 1,000 paid if the woman gives birth in an institution. (Yes, more paperwork for the couple and overworked government hospitals can be expected). Each application to be authenticated by both father and mother of the child with Aadhar, Ration Card etc. A total of four sets of paperwork for the government to play with over a 12 month period.

Benefits for pregnant women previously applied to all pregnancies. Now benefits are only available for the first pregnancy. Obviously one goal here is to incentivize family planning, but at what cost! 

If the woman's husband is not involved in the pregnancy the woman is no longer eligible under the scheme. (The Right to Food Act, recognized the woman as the head of the house, thereby enabling abandoned or single women to still qualify for benefits.) 

One silver lining is that the Prime Minister's scheme does make provision at least on paper for an early payment that must be applied for within 150 days of "LMP". Careful perusal of the Guidelines to the scheme informs us that the abbreviation means "Last Menstrual Period."

Right to Food Act also has a bearing on general family health as well as expectant mothers: When the "Right to Food" Act was passed on 12th September, 2013, many educated Indians saw it as a mixed blessing.  Most understood that the Indian population needed greater food security despite a growing percentage of GDP being spent on food subsidies. The issue of waste and corruption in the administration of the program remains a pressing concern. More efforts are needed to analyze the implementation of the Right to Food Act, especially with regard to vulnerable groups like pregnant women and children.

Percentage of GDP spent on food aid has increased, at least on paper: In 2017-18, a group called "Inclusive Media for Change (Im4change) calculated that the percentage of GDP spent on food subsidies over the last five years was less than 1%. (*3)   While this is far less than developed countries it is an improvement. In 2012 some .75 percent of GDP was spent on national federal food subsidy programs. When the Right to Food Act was passed in 2013 experts anticipated an increase and projected that 1.2 percent of GDP would be spent on this program annually as grain, storage and delivery costs rise. 

A separate Food aid delivery system invites corruption: Food aid, as long as it is being managed through a separate (and hence corruptible) storage and distribution network will result in waste and leak into the free market, dampening prices for farmers; In many western countries, food aid is provided through a card that carries a financial value so that beneficiaries can purchase food products from the open market. 

This reduces paperwork, waste and corruption. Benefits for expectant mothers could perhaps be the first program that the government channels through general retail stores who are prepared to deal with additional paperwork and reduced margins.

The provisions of the Right to Food (RTF) Act (*4) are generous, particularly for those who are extremely poor. If administered properly they will also impact expectant mothers: - However the confining of cash benefits meant specifically for pregnant and lactating mothers (now administered through the PMMVY) to the first child of each mother is a travesty.

The RTF Act provides legal guarantees to 50 percent of India's urban population and 75 percent of the rural population to receive: 
- 5 kg of cereals per month (wheat, rice & coarse grains for Rs 5, 3 and Rs. 1 per kg. 
- The poorest of the poor continue to be covered under the "Anthyodhana Anna Yojana" program with eligibility for 35 kgs of subsidized cereals a month. 
- One key step in the right direction was that the Act empowered women by 
         recognizing the oldest woman in each home as the head of the household for the 
         purpose of obtaining ration cards. (This has now been undermined by the PMMVY).
- The RTF Act also provides for meals or take home rations to children at risk. 

Expenditure estimated for the Right to Food program does not include similar programs at the state level where states like Tamil Nadu, Andhra Pradesh and Chattisgarh have ambitious programs of their own. Since the Act was passed by the UDF and is now being implemented by the BJP and its allies, implementation must be audited.

Regrettably, the Right to Food Act does not involve local bodies like Panchayats at the implementation level and has poorly defined redressal mechanisms. This has been addressed somewhat in the PMMVY by involving Asha or Anganwadi workers in the process. Vast amounts of black market grain swilling around the country are dampening open market prices, thereby discouraging future generations of farmers who are already turning away from farming at an alarming rate. 

It is possible that the PMMVY was cobbled together without considering all the implications which is why the effectiveness of these programs must be audited and recommendations sent to regulators in government. Let's hope that Ms Aditi Priya, and the Delhi School of Economics, follows up on the excellent beginning she made and hold the governments feet to the fire of public opinion. Even if less than 50 percent of the pregnant women in India are anemic, we cannot afford having lakhs of stunted malnourished children on account of the misplaced budgetary priorities of the government.

*1 Article by Sushmi Dey in the Times of India

*2 Provisions of Pradan Mantri Matru Vandana Yojana can be reviewed here:

*3 Percentage of GDP in successive years that is being spent on food subsidies.

* 4 Provisions of the Right to Food Act of 2013 can be reviewed here:


  1. Dear Pravin,
    Very pertinent and socially significant articles you present are appreciated. I personally have posted it to many other groups. Wishing you all the best

  2. Thanks so much....such policy does strike one as being penny wise and pound foolish

  3. Powerful writing, Looking forward for more articles Thank you ☺

  4. Thanks...imagine the number of poor pregnant women without husbands nearby, or women having their second or third child that this program defrauds.


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