Janani Suraksha Yojna, under the broader umbrella of National Rural Health Mission was implemented all over India in 2005. This was considered to be an effective way of modifying the existing National Maternity Benefit Scheme. The main objective of JSY was to reduce the Maternal Mortality Rate, Infant Mortality Rate and increase the count of institutional deliveries and thus the concept of Village Health Worker was operationalized keeping in view the financial constraints a BPL family faces, the construct of incentivization was introduced for the beneficiary as well as the facilitator.
All what it started with was a clearly demarcated definition of Maternal Health and the responsibilities and Duties of the government based health services and what it should comprise of, but the field visits and the various perceptions about the expression made it more amorphous, more lacking boundaries and overlapping with different dissimilitude. The repetitive problems which caught my attention were related to inaccessibility to the various programmes and services in place which were either considered normal or never caught attention were something very gross leading to a major gap in the working of the whole system. This was one of the most intriguing facts about the tribes and the problems they are made to suffer from, the worst part being reasons for this at most places is not known.
Among the known existing inadequacies, dwelt the other set of nonfigurative societal norms which made maternal care in accessible to a poor, tribal female. Inadequate infrastructure; buildings in dilapidated state; age olden equipments which have not being repaired or replaced; unavailable laboratory facilities at the primary and secondary health centers; uninstructed referral units; non-existent conveyance facilities; etc are being talked about in almost every single evaluation report; what is actually missed out and side lined are the non-conceivable circumstances which make these facilities more farfetched for the actual donees.
The absolute unavailability of resources along with the circumstances created make the government programme launched a failure in terms of numbers. Due to lack of awareness about any of the schemes and programmes, females in this belt are not able to claim their rights to safe motherhood. The total absence of civil amenities like roads and conveyance facilities, overshadow the available knowledge; the unfriendly behaviour of the medical and non medical staff makes it an alien environment for the people; the illegal sum of money charged for the poor quality services, makes the incentives non appealing for the tribal people.
About 91% of the total population in Barwani is dependent on agriculture which is not taken to be a full time occupation by most owing to the unfavorable climatic conditions; clearly states a situation where the general per capita income of the rural population is less then Rs 300. Individual endowment, by a woman in the family is less than 30% of the household income. The low literacy rate especially for the females (ranges from 0% to 36%) degrades the possibility providing women an institutional basis for drawing on social capital.
Gender gap comes in the frame in terms of health of the female who holds a liability to society to heighten the labour force and also bears the responsibility of motherhood and channeling the values down the family hierarchy; thus is fixed in the reproduction- production nexus. At the same time the un- evaluated household work which is considered to be ‘women’s job’ makes inequality persistent in all roles of life. Ironically the roles played by a wife, mother and sister are hardly ever acknowledged in terms of health and healthy living in this society; neither is this realized by the state and nor in the policies hence framed for the benefit of the womanhood.
These preconditions hence claim for quality research and considerate humane touch in designing of policy which not only meets the superficial, practical needs but also should recognize the deep seated, strategic needs. The policies which assert on improving the indicators should go beyond to the level of empowering the females to make decisions for self good, allowing them to hold discretion for good and bad and above all recognizing themselves as equals in society with the same rights and responsibilities.
Where one half of the population is un-empowered, distressed, disabled and dissatisfied; the other half can never progress. So, let’s commit ourselves to empower each and every one of ‘us’ and then life will not be a contest where every day starts with the race to earn the day’s living and ends with the darkness of weariness; but a splendid journey through a valley of flowers…
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