The Pradhan Mantri Matru Vandana Yojana (PMMVY) is a national maternity benefits transfer scheme launched by the Prime Minister of India on 31 December 2017. It is a conditional transfer, aimed to incentivise nutrition and health-seeking behaviour and provide cash benefits to pregnant women in the country. Our evaluation assessed the key capacity gaps in the implementation of the PMMVY, and the level of preparedness of government systems to undertake the cash transfer.

This study focused on the operation of the scheme in the state of Madhya Pradesh, conducting enquiries at the state, district, block, and village level to paint a comprehensive picture of programme implementation and beneficiary experience. This study provides

• an operational snapshot of the scheme delivery and the capacity of government systems and officials to deliver this scheme;
• an understanding of the key challenges arising from digitisation of social protection schemes; and
• comments on state capacity needed to deliver on digitised schemes.

Challenges

Reducing maternal mortality and ensuring maternal health are key sustainable development objectives. While Madhya Pradesh has made important strides in improving maternal and child health indicators, recent health statistics reveal continued problems in maternal and child health.  Some of the factors contributing to poor maternal and child health are inadequate nutritional intake during pregnancy, low awareness of ante-natal care, limited access to reliable healthcare, and returning to labour intensive work shortly after childbirth.

The PMMVY, through its conditions and by using cash as incentive, is an attempt to address these challenges. Our previous evaluation of the Bihar Child Support Programme highlights the potential of conditional cash transfers in improving health and nutrition outcomes amongst beneficiaries of such transfers.

In addition, the PMMVY adopts the direct benefit transfer (DBT) model to transfer benefits with the aim of improving efficiency and reducing leakage within the scheme. The cash amount is credited directly into the beneficiary’s bank account upon verification of the conditions. The linked account must be in the name of the female beneficiary, with the aim of ensuring that the woman has greater control over expenditure decisions for the money. All scheme-related data are hosted on a technology platform, allowing for prompt uploading of data and the potential to guide implementation decisions for the scheme through real-time feedback.

Our approach

This study was divided into two workstreams, each tackling a different evaluation question. First, a process mapping of the governance systems identified system-level challenges focusing on the design of the programme, capacity challenges, and fund flow to the programme. Second, a community-level assessment was undertaken to identify challenges in beneficiary experience to access the programme.

For the process mapping workstream, we relied on key informant interviews with state-, district-, and block-level government officials. For the community assessment, qualitative field work was carried out in two districts (Vidisha and Jhabua). These were identified as low-performing districts by government data. Here, we relied on in-depth interviews and focus group discussions with beneficiaries, their husbands, non-beneficiaries, community leader, and other members of the community.

Outcomes

The results of this study offer important lessons for improving state capacity and easing access to social protection schemes. Lessons for improvement in operational efficiency of DBT schemes, identified by the evaluation, include the following:

• Efficient data entry could smooth the payment process. Accounting for the different capacities and roles needed for delivering digitised schemes (eg: data entry operators) would be crucial.  
• Better data access will help state-level officials track implementation of the scheme and help plan resourcing more efficiently.
• Streamlining the documentation process would help reduce the administrative lag and reduce the burden on frontline workers.
• An implementation planning period for the scheme, along with timely training of scheme officials, would help reduce inefficiencies in delivery of the programme. Allowing for adequate preparation time for the scheme, before implementation is important in ensuring that delivery bottlenecks are identified early and do not impact receipt of social protection benefits.