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.