Ministry of Women and Child Development

Women Empowerment Panel Flags Poor Utilisation of Funds Under ‘Beti Bachao, Beti Padhao’ Scheme

The committee found that out of a total of Rs 446.72 crore released for the scheme during the period 2016-2019, a whopping 78.91% was spent only on media advocacy.

New Delhi: A committee on women empowerment has flagged poor utilisation of funds by states under the ‘Beti Bachao, Beti Padhao’ (BBBP) scheme and suggested that the government needs to focus more on education and health than on advertising the scheme.

Titled ‘Empowerment of Women through Education with Special Reference to Beti Bachao-Beti Padhao Scheme’, a report by the panel tabled in the Lok Sabha on Thursday said that since the inception of the scheme in 2014-15 till 2019-20, its total budgetary allocation was Rs 848 crore.

An amount of Rs 622.48 crore was released to the states during this period.

“However, to the committees’ dismay, only 25.13% of the funds, i.e. Rs 156.46 crore have been spent by the states, reflecting not up to the mark performance of the scheme. Even Comptroller and Auditor General of India (C&AG) had made references to the scheme’s implementation and very less spending by states in 2016-17,” the report said.

The committee also noted that despite funds left unspent with the states in a particular year, the Ministry of Women and Child Development has been releasing additional funds.

“The committee also finds that the nodal ministry (WCD) has no disaggregated information on the spending by the states or union territories on education, health and other interventions under BBBP,” said the report.

The committee recommended that the WCD ministry should immediately take up with the states and union territories, the issue of poor utilisation of the central funds and ensure proper utilisation of BBBP funds for the benefit of the girl child.

Also read: What’s Keeping Madrasa Girls Away From Education? Unpaid Salaries, Govt Neglect, Lack of Awareness

“The nodal ministry should release funds to the states/UT strictly on the basis of actual utilisation of earlier release and after proper scrutiny of expenditure/ utilisation of the previous funds. The nodal ministry must have a target-oriented approach for the states and must act in a time-bound manner,” it added.

In its report, the committee said that Rs 50 lakh per year is earmarked per district for utilisation under six different components – 16% for inter-sectoral consultation or capacity building, 50% for innovation or awareness generation activities, 6% for monitoring and evaluation, 10% for sectoral interventions in health, 10% for sectoral interventions in education and 8% as flexi funds.

“The committee finds that out of a total of Rs 446.72 crore released during the period 2016-2019, a whopping 78.91% was spent only on media advocacy. Though the committee understands the necessity to undertake a media campaign to spread the message of ‘Beti Bachao, Beti Padhao’ among the people, they feel that it is equally important to balance the objectives of the scheme,” it said.

Noting that over the last six years, through focused advocacy, BBBP has been able to capture the attention of the political leadership and national consciousness towards valuing the girl child, the report said now the scheme should focus on other verticals by making ample financial provisions to help achieve measurable outcomes related to education and health envisaged under the scheme.

“Since BBBP is one of the most important schemes of the government to improve child sex ratio in backward regions and ensure the education of the girl children, the committee recommends that the government should, hereafter, reconsider spending on advertisements under the ‘Beti Bachao-Beti Padhao’ scheme and should focus on planned expenditure allocation for sectoral interventions in education and health,” it added.

There is a national task force headed by the secretary of MWCD, a state task force headed by the chief secretary or the UT administrator and a district task force headed by District Collectors or District Magistrates to guide and monitor the intermediary targets of the scheme, the report stated.

“… the committee finds that there is a lapse in undertaking the required number of task force meetings and collecting monthly reports or statements of expenditure from districts on time. Such examples of non-compliance with the guidelines are clear indicators that the scheme is not being reviewed or monitored properly. Regular audits and real-time updation of activities are necessary to ensure compliance,” it said.

The committee also noted that the lack of functional toilets could be the reason for girls dropping out of school.

The report stated that 94.8% of schools out of 15,16,797 (co-ed + girls) have girls’ toilets. Out of the 94.8%, only 90.65% of schools (coed + girls) have functional girls toilets, it said. Kendra Vidyalaya Sangathan and Jawahar Navodaya Vidyalaya also have sufficient separate toilets for girl students, the report added.

“The committee also observes that composite grants under Smagra Shiksha are provided for conducive learning environment including the construction of separate girls toilets. Though the Unified District Information System for Education (UDISE) data claims the availability of 95.4 per cent toilets for girls in schools, their actual usability with running water and doors which can be secured from inside is what counts and not the data on paper about the existence of toilets,” it said.

Stating that lack of functional toilets in schools is a major reason for dropping out of girls, the report recommended that a timeline be finalised for constructing 100% segregated functional toilets for girls in government schools, and in convergence with Jal Shakti Mission, tapped water supply be ensured in them.

(PTI)

Despite Sex Worker Orgs’ Protests, Centre Lists New Anti-Trafficking Bill for LS Session

Sex workers’ organisations are apprehensive that the Bill criminalises prostitution without preparing a roadmap for rehabilitation, leave alone the cases of those who want to be in the profession of their own volition.

Kolkata: The Centre on Monday, July 12, listed the new anti-trafficking Bill, formally the Trafficking of Persons (Prevention, Protection and Rehabilitation) Bill, 2021, for introduction, consideration and passing during the coming session of the Lok Sabha that is scheduled to commence between July 19 and August 13.

This has come as a shock to several organisations of sex workers because the listing came just a day after organisations from 17 states signed a petition to the Ministry of Women and Child Development, urging the government to allow the public more time to comment on its provisions.

The ministry had on June 30 uploaded the draft bill and invited comments from all stakeholders by July 14. Organisations of sex workers strongly protested the government’s move to allow only two weeks for assessing various provisions of the 38-page document and discuss it with sex workers, who are likely to be affected by provisions of this Bill.

Following the Lok Sabha’s listing of business of Monday, the All India Network of Sex Workers (AINSW) sent another letter to the ministry to register their protest against the government’s plan to go ahead with the Bill without considering the opinion of the stakeholders.

“To our utter shock, the Lok Sabha Bulletin Part II published on 12.07.2021, lists the ‘Trafficking in Persons (Prevention, Care and Rehabilitation) Bill, 2021’ in the ‘Tentative List of Government Legislative and Financial Business expected to be taken up during the Sixth Session of Seventeenth Lok Sabha’ for ‘introduction, consideration and passing’. This gives the impression that the anti-trafficking Bill has been finalised and cleared for introduction in Parliament, even before stakeholders have had the opportunity to make comments and suggestions on the same,” the AINSW, which is an umbrella of organisations of sex workers from 17 states, wrote in a letter to the ministry on Tuesday.

Also read: Why Sex Workers’ Organisations Aren’t Pleased With the Draft Anti-Trafficking Bill

The letter said that they were “pained to note” that the ministry inviting comments and suggestions on the draft anti-trafficking Bill was “nothing but eyewash” and that “the Ministry has no real intention of considering, let alone accepting, any views and suggestions given by stakeholders on the Bill.”

The letter also referred to a government of India directive from the ministry of law and justice, dated February 5, 2014, which makes every draft legislation required to be placed in the public domain for a minimum period of 30 days.

The listing describes the Bill as one that “proposes to prevent and combat trafficking in persons, especially women and children, to provide for care, protection, assistance and rehabilitation to the victims, while respecting their rights, and creating a supportive legal, economic and social environment for them, and also to ensure prosecution of offenders, and for matters connected therewith or incidental thereto.”

However, sex workers’ organisations are apprehensive that the Bill criminalises prostitution without preparing a roadmap for rehabilitation, leave alone the cases of those who want to be in the profession of their own volition.

“On Sunday, we wrote to the ministry explaining why more time was required for submitting our opinion and that two weeks was too short a period for discussion on a Bill dealing with many complex and sensitive issues. While we are yet to get a response to our letter, the Centre moved ahead with listing it for passage in the coming session. This is gross injustice with the community on which the Bill is going to have a deep impact,” AINSW national programme coordinator Amit Kumar said.

The ministry of law and justice directive that sex workers’ organisations referred to lists the decisions taken in the meeting of the Committee of Secretaries (CoS) held on January 10, 2014 under the chairmanship of the cabinet secretary on the pre-legislative consultation policy. It was a time when the UPA II government was still in power.

One of the decisions said, “The department/ministry concerned should publish/place in public domain the draft legislation or at least the information that may inter alia include brief justification for such legislation, essential elements of the proposed legislation, its broad financial implications, and an estimated assessment of the impact of such legislation on environment, fundamental rights, lives and livelihoods of the concerned/affected people, etc.” and that such details “may be kept in the public domain for a minimum period of thirty days for being proactively shared with the public.”

Another decision reads, “Where such legislation affect specific group of people, it may be documented and disclosed through print or electronic media or in such other manner, as may be considered necessary to give wider publicity to reach the affected people.”

Why Sex Workers’ Organisations Aren’t Pleased With the Draft Anti-Trafficking Bill

In addition to saying that the government hasn’t given enough time for them to send in comments, some lawyers believe the Bill attempts to criminalise sex work entirely.

Kolkata: On Sunday (July 11), the All India Network of Sex Workers (AINSW) wrote a letter to the Ministry of Women and Child Development seeking an extension of time for submitting comments on the Draft Trafficking in Persons (Prevention, Care and Rehabilitation) Bill, 2021, alleging that the government gave too little time for assessing the provisions.

On Monday, the Durbar Mahila Samannaya Committee (DMSC), Bengal’s largest organisation of sex workers which is also part of AINSW, will be sending a separate letter to the ministry and is scheduled to hold a press meet to protest the government’s attitude. If the request for an extension is not met, they will oppose the Bill, members of both organisations told The Wire.

In their letter to the ministry, AINSW, which is a network of sex workers’ organisations from 17 states in the country, with over three lakh female, transgender and male sex workers as members, wrote that they “regret to note” that while the ministry had taken over two years to draft the Bill, affected groups and communities were given less than two weeks to share their views and feedback.

“The Draft Trafficking in Persons (Prevention, Care and Rehabilitation) Bill, 2021 is a complex document that covers aspects of criminal justice and social support and rehabilitation for victims. It traverses provisions of other laws like the National Investigation Agency Act, 2008, the Maharashtra Control of Organised Crime Act, 1999, the Information and Technology Act, 2000, the Prevention of Money Laundering Act, 2002, which needs to be understood in the context of the Draft Bill. The short notice given by the MWCD for submitting feedback does not do justice to the complexity and importance of the subject,” the letter said.

The 38-page draft Bill was uploaded on the ministry’s website on June 30, when the government also gave “all the stakeholders” time till July 14 to “offer their comments/suggestions”.

Also read: How a Nagpur Police Raid to ‘Rescue Underage Sex Workers’ Criminalised an Entire Neighbourhood

“AINSW with their partners and other civil society organisations and members are concerned that the Draft Bill conflates trafficking in persons with sex work, which may have significant consequences for the community. Our members, partners would like the opportunity to examine the Bill and its clauses carefully in order to make comments and suggestions to the Government,” said the letter signed by as many as 80 organisations and individuals from across the country.

Amit Kumar, AINSW’s national programme coordinator, said that they would oppose the Bill if the deadline for submitting comments was not extended. They want it to be extended till August 13. DMSC spokesperson Mahashweta Mukherjee said that they would also reach out to political parties, urging them to raise the issue in the Rajya Sabha where the Bill is likely to be introduced.

The letter added that the “tight deadline” given by the MWCD does not allow them to communicate and consult with different groups and networks spread across the country, including in towns and cities that are still under lockdown or restricted movement orders due to the second wave of the COVID-19 pandemic.

“The Draft Bill is only available in English. To discuss the provisions of the draft Bill with sex workers and know their assessment of the provisions, we need to translate it into regional languages and distribute it among them. Lawyers need time for careful examination of the clauses and assess possible implications. Two weeks is no time at all,” said Protim Ray, a Kolkata-based doctor associated with DMSC.

The AINSW letter highlighted how sex workers have been “allies” in anti-trafficking efforts and how their “role and participation was considered necessary” by the Supreme Court of India in the Budhadev Karmaskar v State of West Bengal case. The apex court had appointed a panel to deliberate and make recommendations on the rehabilitation of trafficking victims who had landed in prostitution and DMSC had served on the panel.

“We hope that the principle of ‘Nothing about us, without us’, which was given effect to the Hon’ble Supreme Court in the panel, will continue to be followed by the Ministry in letter and spirit,” the letter said.

While most of the sex workers’ organisations have not yet been able to make an assessment of the draft Bill, some lawyers cited clause 23, headlined ‘Trafficking in Persons’ as a problematic one.

For example, it says, “the consent of the victim shall be irrelevant and immaterial in the determination of the offence of trafficking in persons if any of the means mentioned at (b) above is used to commit the crime.” The clause 23 (b) mentions: (b) By means of threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of authority or of vulnerability, or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person.”

This could mean even the sex workers who are willingly in the profession end up in jail, DMSC vice-president Bishakha told The Wire.

Also read: Anti-Trafficking Bill: What Meenakshi Lekhi’s Suggestions Got Wrong

Abhijit Datta, an advocate based in Howrah district of West Bengal who has started studying the draft Bill, said that it appeared to him that the government was trying to prohibit prostitution altogether.

“Section 370 IPC covers trafficking quite extensively and its scopes are being further extended in this draft Bill. While it will take more time to understand the implications of all the provisions, at present it seems that the government is not going to allow it even if an adult comes to prostitution willingly. This will be fatal and undemocratic. Besides, there is no detailed plan of how the sex workers are going to be rehabilitated properly when they are not allowed to be in sex work. To discuss all these issues, more time is a must,” Datta said.

Snigdhendu Bhattacharya is a journalist and author based in Kolkata.

NGOs Say Cops Answering National Helpline Will Dissuade Children From Seeking Help

The transfer of administrative control of the helpline from the Ministry of Women and Child Development to the home ministry would mean that police personnel, instead of social workers, would answer calls made to 1098.

New Delhi: As police officers are expected to soon handle the call centres of Childline 1098, the national helpline for children launched for rescuing and assisting those in distress, non-government organisations – which had so far performed this task – are concerned that the move may deter a number of children and others from calling for help.

As of now, the helpline receives nearly 10 million calls a year. However, the transfer of administrative control of the facility from the Ministry of Women and Child Development to the Ministry of Home Affairs may impact these numbers.

In March earlier this year, Union minister for women and child development Smriti Irani had announced that the round-the-clock helpline, which is run by the Childline India Foundation (CIF), the nodal agency of the WCD ministry, may move into the hands of the MHA. She said this would mean that police personnel, instead of social workers, would answer the calls made to 1098.

‘Move aimed at preserving data sensitivity’

Elaborating on the rationale behind the move, secretary in the ministry of WCD, Ram Mohan Mishra, had said, “We want the interface to be the state. The other reason for the move is to preserve data sensitivity. We have already held discussions with the MHA and it is in the process of setting up a portal.”

Also read: Rise in Child Marriages in the Lockdown: How the Centre Ignored Data of Its Own Nodal Agency

When the concern regarding police personnel having the inclination and training to handle such calls was posed to Mishra, he added that “we will build an ecosystem such that after a complaint is registered, the call can be handled by NGOs.”

However, the move has not gone down well with hundreds of NGOs who are linked with the scheme. Many of them have openly protested against meddling with a successful initiative.

Childline assists in rescue of nearly 300,000 children annually

The Childline 1098 has proved to be a great initiative ever its launch. While Childline 1098 was originally launched by Jeroo Billimoria, a professor at the Tata Institute of Social Sciences, Mumbai, in 1996 as an experimental project, the central government later institutionalised it in 1999 under the Ministry of Women and Child Development. The CIF, which was founded in 1999, was then entrusted with the task of establishing the Childline service across India and looking after aspects such as service delivery, finance, training, research, documentation and advocacy.

Representative image of school children. Photo: Maia Maia/Flickr, CC BY 2.0

The Childline is now a 24-hour helpline that covers 595 districts and 135 railway child helpdesks to help children in distress. Its reach and success can be gauged from the fact that between January 2018 and September 2020, which also covered the first six months of the COVID-19 pandemic in India, it received a total of 2.15 crore calls.

The Childline’s role is limited to addressing calls and ensuring action, including rescue. On average, it helps in the rescue of around 300,000 children across the country annually.

‘Police handling of complaints may lead to psychologic harm’

Meanwhile, various child rights groups have opposed the Centre’s move to place the Childline under the MHA. In a statement in mid-May, the All India Working Group for Rights of Children (AIWGRC) had cautioned that the shift in administrative control could lead to reduced use of the service by children and that it may also adversely impact them psychologically and cause them distress.

Also read: Abused, Married Off and in an Emotional Crisis: Children Bear the Brunt of the Lockdown

The statement, signed by representatives of various organisations, pointed out that the nature of calls received by Childline was not limited to complaints that required police intervention and recording. “Many are from children in mental distress and require immediate as well as long-term counselling and support,” it added.

Pointing out that a large number of these calls include requests for support for food, books, shelter and even scholarships, the group said these calls require experts who understand children and their psychology and are trained appropriately to protect and guide children.

‘Childline seeks to provide assistance within an hour’

Talking about this important role of the helpline, A.K. Tiwari, the media spokesperson at Salam Balak Trust, told The Wire that Childline India Foundation had set up its call centres zone-wise across the country. “So any child could call 1098 in the same zone and the call centre used to forward the matter to the concerned NGO for immediate action. We would record the call in our register. Then the volunteers and team members of NGOs go and help that child. Usually we would try and reach the child within an hour.”

On the nature of assistance provided by the NGOs and their team members, he said, “It could range from taking the child to a hospital if he is unwell, providing food or clothes, or bring the child to a centre if he is lost. Also children are provided protection if they have been threatened or assaulted.”

On how the changes would impact assisting children, Tiwari said: “The difference was that earlier NGO workers would be trained and deployed at the call centres too. And they would pass on the information to the district level childline. Now police personnel will sit in the call centres and man these like they do with the ‘100’ number. They would then direct the NGOs to the child in need.”

Also read: COVID-19 Crisis Will Push Millions of Vulnerable Children Into Child Labour

‘How is preserving data sensitivity a concern here?’

Asked about the claim that the change in the administrative structure was being suggested so that there was no breach of privacy of children from data pertaining to them, Tiwari said that it was hard to fathom how this is a concern when in these cases only those in need were being provided help.

Speaking from his experience in dealing with various situations involving children, Tiwari said the main concern was that people may not feel as comfortable as before to inform 1098 since the police would be manning these. “For example, if there is domestic violence taking place in a house or a child was engaged in child labour in a house, or if there was physical abuse against a child, a neighbour would earlier simply call up the helpline and inform them about what was wrong. But now with the police being involved, they may not feel that comfortable in lodging a complaint fearing they too would become a part of the case.”

Representative image of a mother and her child during the lockdown in Delhi. Photo: PTI

‘Children would even call up to discuss how they felt depressed’

Tiwari further said that till now a large number of children, who were emotionally distressed, would call and discuss their problems with the call centre staff. “They would for example discuss that they are worried or that their parents do not love them or that they were being ill-treated by a particular family member,” he said, wondering how comfortable they would be in discussing similar issues with police personnel.

However, Tiwari said, one thing that will not change is that the NGOs and police will continue to work together. He also spoke about how the monitoring of railway stations and setting up of helpdesks there result in the rescue of a large number of children.

Also read: Understanding the Implications of the COVID-19 Lockdown on Migrant Workers’ Children

“At the Old Delhi Railway Station, we have 20 staff members who remain at the platforms and keep an eye out for children who are lost or are being trafficked. They even stop people and question them if they find someone suspicious. Usually, the traffickers panic and run away when confronted. In a year, we rescue around 1200 to 1400 children each year,” he said.

On how so many children land up at the station, he said, “While many of them are being trafficked, a majority of them leave their homes due to poverty. Sometimes their parents send them away to find work. Some lose their jobs or run away when ill-treated by their employers. Then there are also cases of elopement or of children getting lost.”

NCPCR Wants Action Against an MP District Magistrate for ‘Suppressing’ Info on ‘Conversion’

This is after several district officials told the NCPCR that an inquiry had been conducted and there was no further information to provide.

New Delhi: In a ‘rare’ case of Central intervention, the National Commission for Protection of Child Rights (NCPCR) under the Ministry of Women and Child Development has written to the Madhya Pradesh government to take action against the district magistrate (DM) of Sagar for failing to provide information it had sought about a case of ‘religious conversion’ at a children’s hostel run by a Christian organisation.

The NCPCR intervention has come even after the sub-divisional police officer of Bina town, where the hostel is located, the district population officer (DPO) and assistant district prosecution officer (APO) of Sagar told the Central government entity this September that it had conducted an inquiry as asked, and has no further information to provide to it.

In June 2015, following an investigative report in Outlook magazine about 31 tribal girls from five districts of Assam allegedly trafficked by three RSS-affiliated organisations to Punjab and Gujarat reportedly in violation of several laws, the state commission for protection of child rights had written to NCPCR to take action on the matter. The report had stated that the girls, some as young as three, were forced to embrace Hinduism, speak Hindi and give up their customs.

However, the NCPCR didn’t intervene on the matter and the right-wing organisations instead lodged a criminal complaint at the Gauhati high court against the news magazine, its editor and the reporter for promoting “disharmony, of feelings of enmity, hatred between different religious, racial , language or regional groups, or castes or communities”.

The news about the NCPCR’s recent action has so far been reported only in the right-wing online news site, Swarajya, which has been subsequently picked up by the RSS mouthpiece, Organiser.

As per the Swarajya report, which terms the Central entity’s action ‘rare’, the NCPCR intervention in the case is based on a news report, published in the Hindi newspaper Patrika, in July. As per Swarajya, the news report in Patrika had said that nine girls were “rescued” from Euphrasia Bhawan hostel in Bina town by Sagar district administration. One of the girls allegedly said they were “forced to worship a particular deity”. The Patrika report also quoted Child Welfare Committee of Vidisha district, which took the girl’s statement, claiming that they “seemed to have been illegally kept in the hostel and it seems a case of religious conversion”. Since there was no CWC in Sagar at that time, the CWC at Vidisha had taken the statements of the girls.

Also read: Part of Witch-Hunt, Says Harsh Mander After NCPCR Raids Children’s Homes Associated With Him

The Swarajya report quoted the girl’s statement as, “…yahaan puja bhi nai karayi jaati thi naa hi mandir hai. Madam Christian prayer karati thi aur gale mein bhi kuch pehenti thi (the place had no temple, but we were made to recite Christian prayers. Madam would wear something around her neck too).”

On July 14, the NCPCR stepped in by taking cognisance of that news report. It sought an action taken report from the Sagar DM on the matter, but reportedly didn’t receive any reply.

“The commission subsequently issued summons on 17 August, directing the DM to provide information on 13 points. These included,

What action was initiated by the administration on the basis of statements of the children of the CWC;

Whether an FIR under sections 42, 75, 82 of Juvenile Justice Act was registered;

Why was this hostel open when all schools and coaching were closed on the orders of the government citing pandemic;

How many hostels are being run by the organisation running Euphrasia Bhawan hostel n Madhya Pradesh, and what is their source of funding.”

On receiving no reply from the DM, on September 15, it held a hearing with some officials from Sagar administration. “The officials told the NCPCR that they had completed their inquiry in the matter and there was no further information which could be provided to the commission. The officials included sub-divisional police officer of Bina, district population officer (DPO) and assistant district prosecution officer (APO) of Sagar.”

However, the commission “concluded that the Sagar DM had simply failed to provide information which was tantamount to suppressing information”.

On November 27, the NCPCR wrote to the state chief secretary Iqbal Singh Bains directing him to take action against the DM for “failing to discharge his duties”.

Breaking Down the Big Jump in Demand for Child Porn in India During Lockdown

Despite a crackdown in October last year, the consumption of child pornography content in India spiked by 95% during lockdown.

“Information for parents: during this lockdown, India topped in the world in loading child sexual abuse material on the net. It’s not a guess anymore as to where we are heading to,” read a recent WhatsApp message sent by child rights activist Archana Agnihotri to all her contacts. Agnihotri is the director of Delhi-based NGO Samadhan Abhiyan.

The nationwide lockdown to contain the coronavirus outbreak has exposed a dark underbelly of society – millions of paedophiles, child rapists and child pornography addicts have increased their activities online, making the internet even more unsafe for children.

A recent report released by NGO India Child Protection Fund (ICPF) revealed that the consumption of child pornography content in India spiked by 95% during lockdown. There has also been a steep increase in demand for searches like “child porn”, “sexy child” and “teen sex videos”, along with an increase in traffic on Pornhub from India between March 24 and 26, as compared to before the lockdown.

“A vast majority of individuals were interested in generic CSAM (Child Sexual Abuse Material) involving ‘school girls sex’ and the demand for content with specific age groups, sexual actions and locations was growing,” revealed the report, that studied trends from 100 Indian cities including New Delhi, Mumbai, Kolkata and Indore.

A number of NGOs came together at CP, New Delhi, to rally against rising cases of child sexual abuse.

Child porn network: the modus operandi

Last year in October, the Crime Bureau Investigation (CBI) along with German Police was moving ahead with a plan to blow the lid off a global paedophilia racket. That month, they nabbed seven Indians from different locations who were active members of an ‘international racket’ of child pornography operating on as many as 29 WhatsApp groups. The accused hail from Chennai’s Selaipur and Ibrahim Sahib, Amar Nagar in Faridabad, Pasonda in Sahibabad, Bhattacharya Paralane in Howrah, Chomu district in Rajasthan and Delhi’s Nirankari Colony.

Just two days later on October 13, some 2,646 km away from the capital, Kerala police, under the banner of ‘Operation P-Hunt 3’, arrested 12 people, including a minor, for uploading and downloading videos and photographs related to child pornography.

Both cases had two things in common. One, they operated on wide-scale social media platforms with strong end-to-end encryption – like WhatsApp and Telegram. Two, the crimes transcended national boundaries.

“The advancement in technology has worked both ways,” says Kailash Satyarthi, Nobel Peace Prize Laureate, who is an internationally-acclaimed child rights activist. On one hand, with the help of technology, many cases are being reported. “However, with it, the menace of child pornography is growing manifold, making the industry worth more than $8 billion alone,” he stresses.

After multiple demands made by Satyarthi and other activists, the Centre blocked many websites. But because of the dark web and other getaways, the move wasn’t successful. “A check has to be on the source” – so that no such content is uploaded on the web in real-time.

Also read: Putting a Ban on Porn Won’t Reduce Cases of Sexual Violence

In this regard, the Ministry of Women and Child Development has asked Internet Service Providers (ISPs) to remove and block websites containing extreme CSAM based on Interpol’s “Worst-of-list”. However, new websites keep emerging every day.

Jyoti Rathi, who is a member of the Delhi Commission for Protection of Child Rights (DCPCR), gives insight into how these groups/websites operate. “These groups have only one mandate: one has to share a minimum of two to three child porn every day to stay a member of the group,” she tells.

The problem is worsened by the fact that the circle of child pornography is interlinked with trafficking and prostitution. Victims are often stigmatised. Once a video of a child, especially a girl child, is out, she becomes socially unacceptable and falls into an inescapable trap.

Satyarthi adds: “Children who are lured are often trafficked and eventually sold for production of pornographic content.”

Though child pornography is rising at an unprecedented rate, Rathi tells that not many cases are reported. In India, sexual abuse and pornography is a taboo subject and many people do not report cases.

Long-lasting psychological impacts

Participants at ‘Run for Beti’, an awareness run.

The abuse can go on to impact the lives of children at physiological, psychological and social levels, and on sexual behavioural patterns.

Nirali Bhatiya, a cyber-psychologist based in Mumbai speaks of the direct impact such incidents can have on children and how they often become depressed, scared, guilty and embarrassed.

“‘The child is not what she used to be,’ said the mother of a child who was a vcitim,” Nirali said. Children who once face cyberbullying and, extortion find it very difficult to use any social media platform.

The psychological impact can include unusual or unexplained fear of people or places, nightmares, eating and sleeping disturbances, lack of trust in self and others, regressive behaviours and even suicide. The social impact can include sudden withdrawal, increased hostility, aggression and drastic changes in academic performance.

The crusaders of abuse

The Indian Institute of Technology (IIT) has developed a mobile application called ‘Meri Awaaz’ for DCPCR. The children-friendly application allows users to directly report abuse to the commission and keep their identity anonymous.

A number of other non-governmental organisations like Sakshi Foundation, Samadhan Abhiyan and Save The Child are working on daily interactive programmes with children.

This move comes in light of the fact that the commission does not receive too many complains of child pornography – a direct result of the lack of awareness concerning the ‘whom to’ and ‘how to’ report questions that arise.

All photos by: Bhumika Saraswati and Aaqib Fayaz

Budget 2020 Leaves us Wanting More to be Done on Malnutrition and Hunger

There is no sizeable increase for any of the schemes when it comes to allocations, while the continual wrecking of FCI’s finances don’t augur well for the future of PDS.

Despite the annual embarrassment of India scoring a poor rank on the Global Hunger Index, nutrition and hunger hardly merit a mention in the budget speeches of our finance ministers.

The last time there was anything related to tackling malnutrition among women and children was in 2014-15 – the first budget of the Narendra Modi government – where Arun Jaitley announced that a national nutrition mission would be launched.

Almost six years later, in Saturday’s speech, Nirmala Sitharaman highlighted the government’s efforts for mother and child nutrition and stated that she proposes to “provide Rs 35,600 crore for nutrition-related programmes for the financial year 2020-21”.

While this gave an impression that there has been some significant increase in the budgetary allocations for nutrition, as seen in media reports since Saturday, the question to be asked is whether there indeed has been any enhancement. Even more important, what does this budget hold as a vision for improving nutrition and food security for all?

Maternal and child nutrition

The National Food Security Act (NFSA) provides a basket of entitlements throughout the life-cycle and the government runs a number of schemes whose specific aim is make a dent on hunger and malnutrition. The most important of these is seen to be the ICDS (Integrated Child Development Scheme) which among other pre-school, health and nutrition services also provides supplementary nutrition to young children, pregnant and lactating women and adolescent girls. The POSHAN abhiyan, a flagship initiative of the present government and mentioned in the budget speech, is also focussed on the anganwadi services while it aims to achieve convergence with various other efforts that influence nutrition outcomes.

While the ICDS comes under the Ministry of Women and Child Development, mid-day meals in schools for children up to class 8 implemented by the HRD ministry is also included in the NFSA.

Also read: The Good, the Bad and the Impossible of the 2020 Union Health Budget

The combined allocation for these schemes in the present budget adds up to Rs 35,600 crore and we can safely assume that this is what the minister was talking about as there is also no new scheme or budgetary line related to nutrition, in the budget documents that have been put out. There are some existing schemes such as the scheme for maternity benefits, Pradhan Mantri Matru Vandana Yojana (PMMVY), which provides a cash benefit of Rs 5,000 to pregnant women for the first live birth which doesn’t seem to have been added.

Source: Budget Documents, 2020

Looking at the budget allocations for these schemes in comparison to last year, it is seen that there is no sizeable increase for any of these schemes. In fact, compared to the BE figures of 2019-20 assuming an average inflation of 4.5%, in real terms there is a slight decline in the budget allocated for anganwadi services, mid-day meals and PMMVY. However, compared to the revised estimates for last year, an increase is seen, the highest being 28% increase for anganwadi services.

Here, it must be noted that even the allocated amount for anganwadi services last year was understood to be inadequate by most experts. It has been argued for many years that if the anganwadi services are to adequately provide all the services that they are supposed to, there needs to be a huge boost in the investment into the scheme. In many parts of the country anganwadi centres continue to operate from dilapidated buildings or have no buildings, the teaching-learning material is not regularly replenished and most importantly, the anganwadi workers and helpers are paid meagre honorariums (central government contributes Rs 4,500 per month and in many states that is the amount that the workers receive, viz. not even minimum wages). For instance, the budget briefs by Accountability Initiatives finds that about 30% of the supervisory positions in anganwadi services are vacant, a quarter of the centres do not have toilet facilities.

Reduced revised estimates for these crucial nutrition schemes are also worrying because this means that these already under-resourced programmes have been suffering from lack of funds resulting in irregular and poor delivery. The PMMVY is another case in point, which by design excludes more than half the pregnant women by restricting benefits to the first child. Even the small set of women who are eligible have not been receiving their cash entitlements in time, as shown recently by the ‘Jacha-Bachcha’ survey.

Poshan abhiyan

The finance minister in her speech made a special mention of the Poshan Abhiyan launched in 2017-18 and repeated twice the achievement of equipping six lakh anganwadi centres with smart phones to upload the nutritional status of more than 10 crore households. While introducing smart phones to aid better monitoring as well reducing the burden of record keeping on anganwadi workers is a desirable objective, it also has to be seen in the larger perspective.

Also read: Budget 2020: Does the Govt Intend to Reduce Coverage Under the Food Security Act?

An analysis by the Accountability Initiative, shows that, “Information and Communication Technology enabled Real Time Monitoring (ICT-RTM) for the development and setting up of Common Application Software (CAS) and expenditure on components under behavioural change such as advocacy and Community-Based Events (CBE) together comprised 72% of total expenditure”. While these are also important components given the poor state of nutrition in the countries, it also shows that funds have not been forthcoming for the actual running of programmes on the ground.

Feeding the hunger

The PDS which provides subsidised foodgrains to 67% of the population (as mandated by NFSA) should also been seen as one of the schemes contributing to food security and therefore nutrition. In the current context, where unemployment is high, wages are low and food inflation has been increasing, many media reports show that the foodgrain that people are getting from the PDS is, for many poor households, the only source of assured food. The PDS provides only 5-kg of cereals per individual, which is not sufficient but often is what is keeping families from starvation. On the other hand, the foodgrain stocks at the FCI godowns have once again been burgeoning with the stocks of rice and wheat as of January 2020 being over 75 million tonnes whereas the buffer stock norm is 21.4 million tonnes.

In such a situation one would have expected an expanded PDS covering a larger number of beneficiaries and/or increasing the entitlement per individual. Further, given the data on poor diets in Indian households, in these times of rural distress, it would have made sense to also expand the PDS basket to include pulses and cooking oil as well as exploring ways of making fruits and vegetables available at stable and affordable prices.

However, the budget speech makes no mention of the PDS and the budget itself shows signals that this government is not interested in strengthening the PDS, rather all efforts seem to be towards undermining and dismantling it. The food subsidy which reflects the amount paid by the government to FCI for procuring foodgrains and issuing them at subsidised prices to the PDS has been reduced from Rs 1.8 lakh crore in 2019-20 BE to Rs. 1.15 lakh crore in the current budget. The revised estimate for 2019-20 was also a much reduced 1.08 lakh crore.

This indicates two things – first, the government is planning to continue to bleed the FCI by not paying up the entire subsidy amount. As it has been doing over the past few years where it is transferring a part of the food subsidy in the form of loans from the National Small Savings Fund (NSSF) (see figure 3 below). This only increases the interest burden in the long run while in the short term allows the government to get away with showing a lower expenditure burden and therefore a smaller fiscal deficit.

Source: Union Budget 2020.

*This part does not get reflected in the budget documents.
Source: Economic Survey 2019-20.

Second, this underhand manner in which is the FCI is being pushed into losses raises concerns that the government wants to move towards dismantling the FCI and the PDS, in line with the kind of privatisation efforts that have been announced in this budget, of the LIC for example.

An indication that this is the direction in which it seems to be thinking comes from the recommendation that Economic Survey makes: “The coverage of NFSA needs to be restricted to the bottom 20% and the issue prices for others could be linked to the procurement prices. A better alternative would be giving income transfers to consumers through Direct Benefit Transfers (DBT)” (p.86, Vol. 1, Economic Survey 2019-20).

Also read: Budget Fails Yet Again to Present a Roadmap to Increase Rural Demand, Double Farmers’ Income

The debate of replacing the PDS with cash transfers is an old one, that keeps coming up regularly – there are a number of reasons including the importance of PDS in ensuring basic household food security, problems of access, preference and inflation-indexing, the threat to the MSP system in the absence of PDS and so on which need to be considered. What would be more productive would be to discuss further reforms in PDS and procurement such as decentralised procurement, inclusion of millets, pulses and cooking oil, de-privatisation of fair price shops and strengthening mechanisms of transparency and accountability which would not only contribute to making the PDS a more efficient system but also increase its contribution to improving household food and nutrition security.

Wishing malnutrition away

Notwithstanding its positioning, budget 2020 in effect fails on many counts to respond to the nutrition challenge in India. The direct programmes which address the multidimensional nature of malnutrition including the ICDS, mid-day meals, PMMVY and Poshan Abhiyan are underfunded and at the same time PDS which contributes to basic food security is sought to be undermined.

The government seems to be oblivious to the situation of hunger in the country. It further seeks to create an illusion of plenty by arguing in the Economic Survey in its chapter on ‘Thalinomics’ that food affordability has increased in the last few years. This chapter is based on a flawed methodology where it compares food prices as a proportion of incomes of workers in organised manufacturing who comprise less than 5% workers in India and does not take into account that wages for the majority have been stagnating and unemployment is at its peak.

Dipa Sinha teaches at Ambedkar University, Delhi.

How the Centre Can Ensure Women Receive Maternity Benefits

Increased budgetary allocation is a welcome step, but key aspects of the Pradhan Mantri Matritva Vandana Yojana scheme need to be reviewed.

The Union Budget brought with it a 17% increase in this year’s allocation for the Ministry of Women and Child Development (MWCD).

Approximately 9% of the total allocation, which is Rs 29,000 crore, has been earmarked for the Pradhan Mantri Matru Vandana Yojana (PMMVY). The PMMVY is a Centrally sponsored conditional cash transfer of Rs 5,000 for pregnant and lactating women, being implemented since January 2017. This amount is meant to enable women over 18 years to rest and avail of better nutrition during pregnancy, and while breastfeeding their first child.

In India the argument often made regarding welfare provisioning is that there is no shortage of policies, however implementation is where the real problem lies.

Though this is largely true, in the case of the PMMVY, both design and implementation issues exist simultaneously.

Also Read: On Health and Nutrition, Budget 2019 is Lacklustre and Uninspiring

The National Food Security Act 2013 (NFSA) recognises the right of every mother to a maternity benefit of no less than Rs 6,000, that is to be provisioned via schemes framed by the Central government. Given this, the PMMVY should account for the universal right to maternity entitlements, and the minimum cash amount mandated by the NFSA. However, in fact, by limiting the cash provision to Rs 5,000 and restricting the benefit to the first live birth of women over 18 years, the PMVVY subverts the NFSA.

Last December, 60 experts had written to erstwhile finance minister Arun Jaitley, stating that a Central government budget of Rs 8,000 crore is necessary to ensure the right to maternity benefits of all women defined as per the NFSA. This estimate was based on the crude birth rate of 19 per thousand and the 60:40 PMMVY fund share ratio between the Central and state government.

Despite this, the 2019-20 budget allocates only Rs 2,500 crore for the PMMVY. While this is more than the previous year’s budget, it is still significantly lower than the required amount.

In addition to the issues related to the design and funding of the programme, the conditions specified for receipt of the three instalments (see Table 1) rely heavily on the local-level government functionaries. While this approach would make sense in a situation of adequate training, incentivisation, and accountability, a qualitative study conducted by the authors in Manika block in Latehar, Jharkhand in June 2019 reveals this is not the reality.

Anganwadi workers, the ground-level functionaries of the program, stated that they have not received their salary since January 2019. Despite this, they are expected to shoulder a large part of the responsibility of implementing the PMMVY, as well as other state-run programmes at the village-level.

Information gaps regarding the PMMVY are widespread amongst anganwadi workers. For instance, most were uncertain about the cut-off point for submission of applications, what to do in the case of a miscarriage, or that an Aadhaar card application number is sufficient to register a beneficiary.

Conversations with anganwadi workers also revealed that sometimes they face challenges in registering women as they do not get Aadhaar cards, or open bank accounts despite repeated reminders. This situation is confounding and begs the question – why are women in situations of deprivation not enthusiastic about the PMMVY? It is difficult to identify a precise reason for this, however the complexity of, and the lack of clarity regarding processes is a likely factor.

Even when women have the necessary documentation to open a bank account, the process is intimidating and difficult. For instance we met a nervous young mother with her three-month old child at the State Bank of India, Manika branch.

They had made eight trips to open an account in order to apply for the PMMVY, but a bank employee rudely told her that no accounts were being opened for the next 15 days, without providing a reason for the same.

A PMMVY application is processed only if an applicant’s name is identical on her Aadhaar card and bank account. In this region, post-marriage many women change their surname from ‘Kumari’ to ‘Devi’, and subsequently update their Aadhaar cards to reflect this. As a result womens’ Aadhaar and bank account details often do not match. We met several women facing this issue and at a loss for a solution.

These cases illustrate the types of hurdles women face in procuring mandatory documentation for applying to the PMMVY. Given this it is hardly surprising that some stop trying.

Also Read: Eggs in Mid-Day Meals, Anganwadis Will Ensure Nutrition – and Gender Parity

Finally, payment delays are chronic. Owing to the highly centralised payment architecture, the local functionaries are not equipped to understand the reasons for delay. The non-payment of benefits has led to a reluctance on the part of anganwadi workers to submit PMMVY applications, because they are repeatedly questioned by applicants when they do not receive their entitlements. In this way the absence of timely payments is resulting in a disincentive to register future beneficiaries, and in turn further exclusion. Furthermore, it is serving to defeat the fundamental objective of the programme, i.e. enabling added rest and nutrition during pregnancy and after childbirth.

Given the reality of service provision, administrative inefficiencies, and awareness levels at the local level, this year’s increased budgetary allocation for the PMMVY is a welcome but inadequate step. Incidentally, the budgeted estimate for the PMMVY in 2018-19 was Rs 2,400 crore, which was revised downwards to Rs 1,200 crore, presumably due to underutilisation. To avoid a repeat of last year, there is an urgent need to review the approach, design, and the implementation of the PMMVY, to ensure it is inclusive and enables all mothers to claim their right.

Vanita Leah Falcao is a PhD student at King’s College London, London. K.C. Sachin is a student of public policy at Sciences Po, Paris. Sabhil Nath Painkra is a community worker in Latehar, Jharkhand.

On Health and Nutrition, Budget 2019 is Lacklustre and Uninspiring

The budget does little for the most vulnerable populations such as women working in the informal sector or their young children.

Just by looking at the numbers, the Budget for health seems promising. The total allocation for the department of health and family welfare (HFW) has increased by about 16%, which could be seen as a substantial hike considering there was hardly any year-on-year expansion during the previous term of this government. The total budget for the department for 2019-20 is Rs 62,659.12 crore, compared to the BE of Rs 52,800 last year. The budget for health is also not highly different from what was presented in the interim budget.

While many hoped otherwise, some issues that plague the health sector have still not received adequate attention.

In the recent electoral campaign, health was among the major issues raised by the ruling party, with the BJP projecting health both as an achievement (with the launch of Ayushman Bharat) and as a priority for future. Further, considering that the Budget comes at the heels of the death of more than 150 children due to the ongoing encephalitis crisis in Bihar, there was expected to be a greater focus on health.

These deaths were entirely preventable and highlighted the failures of the public health system and the urgent need to strengthen the delivery of healthcare, especially at the primary level. The importance of paying attention to nutrition and sanitation was also underscored.

However, the present government’s strategy for health continues to be more biased towards the Pradhan Mantri Jan Arogya Yojana (PMJAY), which basically provides insurance coverage for hospitalisation. The big increase within the health budget has been for PMJAY, from Rs 2,400 crores to Rs 6,400 crores. On the one hand, it has been pointed out earlier that this is probably not enough even to cover the Central government’s share towards premium charges for PMJAY, on the other, the inappropriateness of such a strategy for the health situation in India has also been widely written about.

Also read: Why the Boost to Healthcare in Budget 2019 Should be Viewed With Caution

Concerns have been raised about the limited potential of PMJAY towards reducing out-of-pocket expenditure. It is also feared that the scheme will divert resources away from strengthening public health systems and towards the private sector.

What one hoped for was greater allocations towards the National Health Mission (NHM) and other interventions that would strengthen the public healthcare system. The health and wellness centres (HWCs), which are part of the Ayushman Bharat package, continue to get very little support with the budget increasing only by around Rs 350 crores from the revised budget for 2018-19 (from Rs 999.96 crore to Rs 1,349.97 crores) for rural areas and by Rs 50 crores for urban areas.

According to a press release from the health ministry, only 8,030 HWCs were operational by February 4. Under Ayushman Bharat, the plan is to set up 1,50,000 such centres – while it is understandable that this cannot be achieved in one year, such a meagre increase in the budget allocation indicates a very slow pace in which this expansion is envisaged.

Such a modest increase is not even enough to double the number of HWCs from 8,000 to 16,000. HWCs are the main intervention to improve access to primary health care, the lack of which was so sadly felt during the Bihar epidemic.

Therefore, although there is an overall increase in the health budget, the required urgency that needs to be shown in the health sector is missing. If the government is to reach its budgetary objective of spending at least 2.5% of GDP on health by 2022 (according to the NHP 2017), then the rate at which the allocations are increased also needs to be accelerated.

Nutrition for women and children

A related issue is the allocations for the nutrition schemes for women and children. Health outcomes are closely linked to nutrition status and this is another area where the improvements in outcomes in India need to be better. Here again, what we see is a mixed bag – the allocation for the ‘Umbrella ICDS’ has gone up from RE of Rs 23,356.50 crore in 2018-19 to Rs 27,584.37 crore. Much of this increase is under the ‘anganwadi services’ (from Rs 17,890 crores to Rs 19,834.37 crores) and the National Nutrition Mission (from Rs 30,61.30 to Rs 34,00.00).

While once again, these are heads under which an increase in allocation was required, the amount is not enough. The increase in ‘anganwadi services’ will most likely be barely enough to cover the enhanced honorariums to anganwadi workers and helpers (which are still at very low levels) with not much available for improving the supplementary nutrition given to children or to improve the infrastructure in anganwadi centres, leave alone providing for additional workers.

Also read: Budget 2019 Is Ambitious on Healthcare. But More Can Be Done

Under the ‘Umbrella ICDS,’ two schemes which are critical both from the perspective of women’s rights as workers as well as improving childcare and nutrition – the Pradhan Mantri Matru Vandana Yojana (PMMVY) and the National Creche Scheme – continue to be neglected. The revised budget for 2018-19 for PMMVY was Rs 1,200 crore, a decline Rs 2,400 crore – which was the budget estimate, showing that the scheme has not taken off.

In 2019-20, once again the allocation is only Rs 2,500 crore, whereas a letter written to the finance minister last year by 60 economists recommended that the full-fledged implementation of this scheme requires Rs 8,000 crore in the Union Budget. The budget for the creche scheme has been reduced from Rs 128.39 crore to Rs 50 crore. So, although there are some overall increases, this Budget does very little for the most vulnerable populations such as women working in the informal sector or their young children.

It is time the government recognised that something drastic needs to be done for health and nutrition in the country, and these routine half-hearted efforts are just not enough.

Dipa Sinha teaches at Ambedkar University Delhi.

Why the Boost to Healthcare in Budget 2019 Should be Viewed With Caution

The government’s health insurance scheme has seen an increase of 166%. But a similar boost to health and wellness centres could have achieved much better outcomes.

In the Union Budget speech of 2019-20, the topic of health was nearly absent. Aside from a single line in the vision statement and a couple of paragraphs on Swachh Bharat, the customary focus on health and healthcare was missing.

Rs 62,659 crore has been allocated for the department of health and family welfare and Rs 1,900 crores for the department of health research – 2.3% of the entire budgetary outlay. The total proposed allocation for health of Rs 64,999 crore has risen from a revised estimate of Rs 55,949 crore last year. This, however, does not place us on track to reaching the National Health Policy commitment of increasing public health spending to 2.5% of the GDP.

There has been an absolute increase of Rs 8,357 crores for the department of health and family welfare – a 15% rise from the previous year. However, nearly half of it – Rs 4,000 crores – is being added to the Pradhan Mantri Jan Arogya Yojana – the Central government’s publicly-funded health insurance programme for the poor. This scheme alone saw a 166% increase from Rs 2,400 crore that was estimated in 2018-19 to Rs 6,400 crore. Take this out and the budgetary increase comes to only a modest 8%.

The total outlay on National Health Mission (NHM), which is the main vehicle of strengthening public health services and promoting better health outcomes, increases from previous year’s Rs 30,683 crore to Rs 32,995 crores – a 7.5% increase. This barely covers inflation.

Within this, for the first time, the allocation for health and wellness centres (HWC) has been earmarked and sees an increase from Rs 1,200 crore to about Rs 1,600 crore. However, at Rs 15 lakh per HWC – the current estimate of annual funds required for one centre – this would support only about 10,000 centres as against a target of 1.5 lakh – which is about 7% of the target. Considering that this the central strategy of universalising primary healthcare, the budget is much less than is required.

Also read | Budget 2019: Spearheaded by Ayushman Bharat, Swachh Bharat, Health Gets a Boost

Part of the reason that HWCs are not able to expand at the rates needed is the shortage of human resources for healthcare. But the budgetary outlay for this vital component of the NHM stagnates – and in real terms, declines.

Similarly, the increase in outlay for the National Urban Health Mission (NUHM) is also modest – only about 7.5%. Within this, in the NUHM budget of Rs 950 crore, about Rs 250 crore goes to HWCs, leaving very little for strengthening the other components of our weak urban public health infrastructure.

The National Rural Health Mission (NRHM) is also seriously under-funded, but as compared to NUHM, the increase in the outlays for the strengthening of health systems (Rs 11,882 crore) and for disease control (Rs 2,895 crore) have seen a modest 16% and 20% increase. The Reproductive and child health funds, however, have stagnated and in real terms, declined.

There are some positive developments. The outlay for the AIDS control programme has increased by 30%. Past budgets had cut into this and activists had been warning against diseases making a comeback. There are also increased outlays for mental health programmes and for trauma centres – though they still fall short of the required amount.

PMJAY

How should the public view the 166% increase in PMJAY? The jury is still out on whether it will lead to an increase in either health outcomes or decrease in catastrophic health expenditure. There are few studies that support it, but many that question the benefits of this scheme. This scheme transfers public funds to private hospitals for reimbursement of care that the hospitals should have provided for free to poor patients.

However, in practice, many private hospitals – if not most of them – also charge patients illegally. The net result may only be a transfer of public funds to private hands. Many would suggest putting in place better monitoring and regulatory systems for the private sector with terms of the contract before expanding the scheme.

If this is done, the major empanelled providers would be a modest but significant number of ethical and affordable/efficient private healthcare providers supplementing a majority made up of public providers.

However, if the aim is to use public funds to stimulate and support a growing healthcare industry, then clearly this funding will have less to do with making India healthy.

Also read | Budget 2019 Is Ambitious on Healthcare. But More Can Be Done

If a similar increase of funds had been made towards entire public health services, or even the government’s own scheme of health and wellness centres, one could have achieved much better health outcomes.

State governments can try to fill the gap, but in practice, due to fiscal constraints and also because of the way states respond to signals sent by the Centre, this is unlikely to happen.

But one wonders how those who have voted massively for this government would view the divergence from what the BJP’s election manifesto had promised.

There is, for example, a clear commitment in the manifesto to set up 150,000 HWCs by 2022. There is another clear commitment to increase undergraduate seats by 18,000 and PG seats by 20,000 within five years – and double the number of doctors and specialists that the country has by 2024. Would they ask looking at the budget speech how all of that can happen without a commensurate budgetary outlay?

It is important for the society as a whole to keep reminding the government of the promises that have been made, on the basis of which they were given the mandate to govern.

T. Sundararaman is former ED, NHSRC, and consultant, health policy and health systems.