Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694833254987.pdf (India)
Research Note on Parliament’s Role in the welfare of Maternal, Newborn and Child Health Research and Information Division Lok Sabha Secretariat ----------------------------------------------------------------------------------------------------------------------------------------- The Note is only for the use of Members of Parliament.

It is largely based on published sources and is intended to serve as a background aid.

It is not for publication or reproduction in any form.
2 • The Partnership for Maternal, Newborn & Child Health (The Partnership, PMNCH) is an alliance of more than 1000 organizations in 192 countries from the sexual, reproductive, maternal, newborn, child and adolescent health communities, as well as health influencing sectors.

• The Partnership provides a platform for organizations to align objectives, strategies and resources, and agree on interventions to improve maternal, newborn, child and adolescent health.
The Partnership was formed in September 2005, bringing together 80 members from three organizations, which included the Partnership for Safe Motherhood and Newborn Health, the Healthy Newborn Partnership and the Child Survival Partnership, with the mandate to strengthen alignment and consensus building to support the achievement of the Millennium Development Goals (MDGs).
• The Partnership focused particularly on the importance of delivering the full continuum of care spanning sexual and reproductive health needs and rights of women and adolescents, pregnancy care, safe delivery, the first weeks of life and the early years of life.

PMNCH partners have catalysed tremendous progress over the last decade and continue to drive momentum toward improved maternal, newborn, child and adolescent health outcomes.
The Partnership is governed by a Board, and administered by a Secretariat hosted at the World Health Organization in Geneva, Switzerland.

• India has made massive and strategic investments under the National Health Mission for improvement of maternal health, as well being of mothers and newborn child is not only important in their own right but are also central to solving large broader, economic, social and developmental challenges.
India’s maternal deaths and infant mortality has declined significantly as a result of several government policies.

These achievements are a humble 3 beginning and a long and winding road is yet to be covered before a comprehensive, equitable and accessible healthcare system is made available to all.

This is where parliamentarians can play the role of bridging the remaining gap and see the priority actions to be taken.
Barriers/Challenges • Gender inequality, in biological, environmental and social terms, makes women more vulnerable to certain risks, leading to poorer outcomes.

• Lower levels of education, literacy, and income • Low control over exercising fertility choices and using contraceptives and access to safe abortion services • High Teenage marriages and teenage fertility rates in some parts of India.
• Low social status of women may increase their susceptibility to disease through a mechanism of dependency, vulnerability, and lack of opportunity • The barriers in accessing care—such as transportation, money, and stigma— which are raised higher for women • Though women provide the bulk of healthcare worldwide, both in the formal healthcare setting as well as in the informal sector and in the home, their own needs for healthcare are poorly addressed, especially among rural and poor communities.
• Women’s household roles impact their health -- such as exposure to smoke and women’s limited engagement in physical work.

These challenges do not have their solutions rooted in medical health but a holistic approach to public health and inter- departmental partnerships.

Initiatives to address the issues in India • The principle of gender equality is enshrined in the Indian Constitution in its Preamble, Fundamental Rights, Fundamental Duties and Directive 4 Principles.
The Constitution of India not only grants equality to women, but also empowers the State to adopt positive measures in favour of women.

Within the framework of a democratic polity, our laws, development policies, Plans and programmes have aimed at women’s advancement in different spheres.

From the Fifth Five Year Plan (1974-78) onwards, there has been a marked shift in the approach to women’s issues, from welfare to development.
The empowerment of women has been recognized as the central issue in determining the status of women.

• The National Commission for Women was set up by an Act of Parliament in 1990 to safeguard the rights and legal entitlements of women.

The 73rd and 74th Amendments (1993) to the Constitution of India have provided for 33.3per cent reservation of seats in the local bodies of Panchayats and Municipalities for women, laying a strong foundation for their participation in decision making at the local levels.
Some States have increased it up to 50 per cent.

• India has also ratified various international conventions and human rights instruments committing to secure equal rights of women.

Key among them is the Convention on Elimination of All Forms of Discrimination Against Women (CEDAW) in 1993.
The Mexico Plan of Action (1975), the Nairobi Forward Looking Strategies (1985), the Beijing Declaration as well as the Platform for Action (1995) and the Outcome Document adopted by the UNGA Session on Gender Equality and Development and Peace for the 21st century have been unreservedly endorsed by India for appropriate follow up.
Parliament and Parliamentarians role and Initiatives • Parliamentarians across regions are coming together more frequently to share their experiences with respect to institutional development.

An emerging international consensus on the norms and standards shared by 5 democratic Parliaments arose from such developments.

Decentralization, outsourcing and privatization have increased the number of private-sector and local-authority stakeholders, thereby making chains of accountability more diffuse.
Citizens place ever higher demands on governments and parliamentarians, with many now expecting the state to act as a buffer against rapidly changing international economic and political circumstances.

With the heightened complexity, challenges and expectations facing Parliaments, there is a commensurate need to scale up assistance to parliamentarians and target this assistance effectively.
• Law-making: The main task of a Legislature is to enact appropriate laws to translate the constitutional and national objectives of providing a dignified life to everyone, into reality.

As the highest discussion forum, the legislatures give directions to the national/state development agendas and establish relevant institutions for their effective implementation.

• Parliamentary Oversight: A key role of the legislatures is to exercise oversight of the Government’s functioning and achievements.
As regards development programmes and schemes are concerned, legislatures pro- active role in overseeing the execution of laws, developmental policies and strategic plans is paramount to ensure accountability and transparency in the functioning of the institutions of governance.

• Debates: Debates and discussions in the legislatures reflect different shades of opinion and varied dimensions of policies and programmes under implementation and the limitations in achieving the desired results.
While discussions in the Chambers and Committees help build consensus on the developmental agenda, starting from policy formulation and implementation 6 to monitoring, follow-up and feedback processes, legislatures always remain vigilant to the developmental priorities of the Governments.

• Financial Concerns and the Budget: Through the annual reviews of the proposed government expenditures, legislatures can ensure that adequate financial resources are allocated to the development related sectors.
Legislatures can also ensure that developmental priorities are reflected in the national and local budgets.

• Committees: Committees in the legislatures have come to play an important role in the parliamentary scrutiny of the Executive functioning.

The Committees with their access to expert knowledge, information and thorough study of the progress reports of the Government's developmental projects and schemes, have a significant role and say in the development process of the country today.
Given their focused and detailed deliberations on various sectoral issues, Committees hold the Governments to account, particularly on the developmental agenda.

• The committee on Empowerment of Women came out with a report on “Women’s Health Care: Policy Options” in Jan 2018.

It recommended various strategies to mitigate the challenges faced for ensuring better health care for women.
The approaches and strategies included synergy between the central and state policies, development of mechanisms for the monitoring of Rashtri Swasthya BimaYojana, fixed wages of not less than 3000 per months for ASHA workers, iron added fortified food for women for addressing the prevailing anaemia problem among women, amendment to increase the permissible period of abortion to 24 weeks and allowing abortion services to anyone by removing the condition of Marriage for seeking abortion and de-stigmatisation of mental health issues.
All the 7 recommendations subsequently made way into the new initiatives and programs like POSHAN Abhiyan for to ensure fortified food, comprehensive advocacy & IEC initiative for social acceptance of mental health issues and new health insurance scheme initiated by Government of India.

Further, the recommendation for the relevant amendment in MTP Act has also been processed.