A Misconceived Approach

Context: The Medical Termination of Pregnancy (Amendment) Bill (MTP Bill) passed in the Lok Sabha last year, is marred with certain concerns.

Provisions of the MTP Amendment Bill:

• Setting up of medical boards: in every state and Union territory (UT), consisting of a gynaecologist, paediatrician, radiologist or sonologist and any other members as proposed by that state or UT.
  • Responsible for diagnosing substantial foetal “abnormalities” that necessitate termination of pregnancy after a 24-week gestation period.

Associated concerns:

• Weak healthcare infrastructure: to sustain the operation and functioning of medical boards in every state and UT and to constitute these boards with the requisite specialists.
  • India has only one doctor for roughly 10,200 people in the public sector (National Health Profile, 2017).
  • In places like Arunachal Pradesh, Meghalaya, Mizoram and Sikkim, there is a glaring 100% shortfall in the availability of paediatricians.
• Inaccessibility to medical boards: for pregnant persons, especially those living in rural areas.
• Violation of rights to privacy and dignity: By subjecting people to multiple invasive examinations in order to determine whether they can terminate their pregnancy.
• Poor public health expenditure (at 1.6% of GDP in 2019-20): lead to high out of pocket (OOP) expenditure (58.7% as per the National Health Accounts in 2016-17).
  • Results in “distress financing” of medical care by selling off personal or ancestral assets like land and livestock, borrowing from predatory moneylenders, etc.
  • Acts as a major cause of impoverishment: E.g. About 17.4% of the women from the lowest quintile in Mumbai slums financed their maternal care expenditure by borrowing money.
• Focus on privatization (prioritize profit and are non-accountable) leading to compromised welfare: instead of building infrastructural and professional capacity.
  • The National Sample Survey Organisation (NSSO)’s 75th report shows that less than 20% of the population is covered by health insurance in India.