One in 10 children under the age of five do not have a birth certificate in India. This makes them invisible to the system, unable to avail of state benefits. But one district in Madhya Pradesh is trying to buck this trend, as development fellows Sohinee Thakurta and Smriti Gupta have discovered.
We met a 19-year-old-woman in an anganwadi (government preschool) in Chhatarpur, Madhya Pradesh, who had come with her one-year-old child and was pregnant with her second baby.
She did not have a birth certificate or any other document to prove her identity.
She was invisible to our system because there was no record of her.
This is the case with 10% of India’s new-borns, despite our move to a digital world.
A child who is not registered at birth is in danger of being denied the right to an official identity, a recognised name and nationality. It leads to a lifelong struggle to prove one’s identity and the inability to avail of the many schemes aimed at improving the life of both mother and child.
But does this affect all children equally? Children belonging to the poorest sections of society, scheduled castes and tribes and families with no formal education, are right at the intersection of all kinds of marginalisation. They are more likely not to have a birth certificate, putting them on a back foot from the time they are born.
“A child not registered at birth is invisible – non-existent in the eyes of the government or the law. Without proof of identity, children are often excluded from education, health care and other vital services, and are more vulnerable to exploitation and abuse,” said Henrietta Fore, former executive director at UNICEF.
A birth certificate registration provides a child legal recognition for existence, often being the first and the only evidence of legal identity for the child.
Children below the age of 18 do not have a voter’s identification card. And if they have not taken the Class 10 or 12 board exams, they do not have those certificates as well, making the birth certificate their only proof of place of birth and legal existence.
The process of obtaining birth certificates one year after the date of birth gets extremely arduous, which makes it inaccessible for the poor.
In a country where the rural literacy rate is 68.91% (according to the 2011 Census), having a birth certificate becomes imperative to avail public schemes aimed at providing better lives for children coming from the most vulnerable sections of society.
In the absence of documentation to prove birth, women and children, along with people belonging to SC/ST communities, the weakest members of society, suffer the most.
India faces a significant shortage of doctors, nurses and data operators at public facilities. Coupled with that, there is a lack of procedural knowledge among the registration functionaries, leading to low registration levels.
According to the Civil Registration System, birth certificates are issued free of charge by the Registrar for births concerned within 21 days.
But is 21 days a reasonable timeline?
Most vulnerable children live in remote areas with few delivery units, and families end up travelling around 80-100 km for institutional deliveries.
At the time of delivery, the government provides ambulances to pick up and drop the family at delivery centres free of cost. If the family doesn’t collect the birth certificate at the time of discharge (which is three days from the date of birth for normal deliveries), they have to travel again to the delivery centre, which costs Rs 1500-2000, acting as a disincentive for the family.
Also, there is no immediate demand for a birth certificate for any government welfare service. The awareness about the importance of registration among guardians is also low.
“The ownership of birth certificates may be low because parents in India tend to collect certificates at later dates when it is required for various purposes,” said Chandra Shekhar, professor, International Institute for Population Sciences, Mumbai.
But one district in Madhya Pradesh is trying to reverse the tide.
Chhatarpur is one of the 112 “Aspirational Districts” (most underdeveloped) in the country. It had an abysmally low rate of handing out birth certificates to beneficiaries at the time of discharge at the district hospital, which has nearly 7,500 deliveries a year and caters to a population of 17 lakh.
Around 30% of the deliveries in the hospital are from the adjoining districts of Sagar, Panna, Mahoba and Tikamgarh. This resulted in beneficiaries making multiple trips to the district hospital, incurring out-of-pocket expenditures, and missing their salaries as daily-wage labourers.
One of the major challenges faced by the staff while adopting this initiative was parents not deciding on the names of their children timely. Some parents wanted to consult pandits, while others wanted to check horoscopes before deciding on a name. The nurse-in-charge and data operators suggested counselling the expectant parents during ante-natal check-ups and spreading awareness through accredited social health activists (ASHAs) and anganwadi workers using Village Health Sanitation and Nutrition Day as an essential platform.
The district administration believes people should not be inconvenienced and made to run around government offices.
“We want to eliminate the middlemen involved. We don’t want other benefits dependent on this to be halted. This process saves people time, money and effort,” said Sandeep GR, the district magistrate.
Also, to avoid a significant communication gap between the delivery section, the discharge section and the birth certificate registration section, regular meetings were held to disseminate services promptly.
Finally, a group on a mobile platform was created for different sections to track the data daily. The data was analysed weekly to identify operational difficulties and address them.
Since the initiative has proved so successful, it is now being scaled up and applied to the different community health centres and primary health centres, benefitting around 61,000 people a year.
Smriti Gupta and Sohinee Thakurta are Aspirational District Fellows in Chhatarpur, Madhya Pradesh.
