Government must adopt a policy of incentives and disincentives to prevent teenaged girls from being forced into marriage and early motherhood. This will not only help reduce India’s alarming maternal and infant mortality rates but also stabilise its population
Union Minister for Health and Family Welfare Ghulam Nabi Azad was speaking on July 11, the World Population Day. As a part of the programme, villagers from some of the poorest districts in India were felicitated, simply for having done the right thing voluntarily: A daughter’s marriage at 19, the first child born two years later (instead of the habitual nine months) and the next arriving after an interval of more than three years, followed by sterilisation by one parent.
With two-thirds of girls in more than half the country married by their mid-teens, and producing several children thereafter, these award-winning couples had broken stereotypes, big time. News of their awards had already created huge excitement back home in their districts.
After the awards were handed out, there came the Health Minister’s observation that no reward ought to be given to people who only abide by the law. Awards should only be given for marrying after 25 or even later, he said. Indeed, if the Minister could offer incentives to the poor to delay marriages, it could be revolutionary. Let us for a minute look at the sheer force of the numbers.
Each year half of all the children born in India are born in only eight States. Rest of the country accounts for less than half the residual annual births. Therefore, concentrating on this group of eight prolific States makes perfect sense. Hypothetically speaking, if all teenage marriages in these eight States could be postponed, each year 18 lakh girls would get a chance to lead improved lives, instead of being thrust with premature cohabitation and child-bearing. And if perchance their marriages could be further delayed until they became 25, a fifth of the total births in the country could be delayed each year in eight States alone.
Before a controversy about feasibility erupts, the article only seeks to highlight how many girls can benefit by delaying their marriages. Admittedly, no Government has the right to order the timing of nuptials or births. But certainly a progressive Government can and should encourage, and even induce, poor people to postpone marriages (read child-bearing) for the sake of women and children’s health. It is very much the responsibility of Governments to make Herculean efforts to reduce maternal and infant mortality. And when teenage fertility is one of the fundamental reasons for the high level of pregnancy related deaths, this factor has to be confronted. Any measure that helps postpone early marriages should be unabashedly argued for as a public health strategy. Stated this way, it does not amount to governmental interference in family life.
What are the risks of early marriages? First, the opportunity to educate girls is aborted. Second, pregnancy starts when the girl is not capable of recognising its early symptoms, so endangering her own health and that of the unborn child by neglecting ante-natal care. Anemic and underdeveloped girl/mothers tend to produce underweight, malnourished children with poor chances of survival and growth. Infants born to 15 to 19-year-olds are nearly 80 per cent more likely to die during the first year of life than infants born to mothers who are 20 to 29-year-old. Delaying a woman’s first birth can reduce infant mortality of first born children by up to 30 per cent. When all this is widely known to health professionals, why should it be ignored to let century-old traditions to hold sway?
The solution really lies in compensating and rewarding delayed marriages. Imagine if every woman belonging to the lowest wealth quintile or possessing no education (virtually interchangeable) were to be given a National Rural Employment Guarantee kind of inducement, simply for staying unmarried until she is 19. Additionally, if the amount was to increase with each passing year that she remains unmarried until she is 24, the investment would lead to much happier and healthier outcomes for millions of poor women and children. In the name of public health, a National Rural Postponement of Marriage Scheme should be introduced which would do more for safe motherhood and child survival than all the tried and (failed) models we have seen so far.
Side by side Government must stop giving cash compensation for institutional deliveries to women, unless they are 19-year-old at the time of delivery. Everyone knows that today the age of the mother coming for delivery is never questioned because of the uproar it causes on grounds of discrimination. But if women start receiving greater benefits for staying unmarried the hullabaloo would fast subside.
This article is not intended to open a Pandora’s Box of crazy ideas; rather to highlight where the epicentre of the population problem lies. If the honourable Health Minister could use his immense political acumen to influence the Chief Ministers of the Hindi belt States to make his idea of a marriage after 25 a reward winning event for the poorest families, he could achieve what none of his predecessors have pulled off in 60 years.