1. PUBLIC HEALTH LAWS IN RELATION TOWOMAN AND CHILD DEVELOPEMENTDr. Ranadip Chowdhury2nd year PGTDept. of Community MedicineR.G Kar Medical College
2. CHARACTERISTICS OF PUBLIC HEALTH LAWS Responsibility of government as a right toprovide adequate health and health services to allcitizens. Public health laws protect community healthrather than individual‟s health. Public Health contemplates the relationshipbetween the state and the population. Public health laws deals with the delivery ofpublic services based on scientificmethodologies. The laws acts as important guidelines for thestate, community and individuals.
3. WHY PUBLIC HEALTH ACTS FOR WOMEN ANDCHILD DEVELOPMENTCertain positive things ( WOMEN DEVELOPMENT): Life expectancy increased Sex ratio increased Literacy level increased Median age of pregnancy increased Maternal mortality decreased Contraceptive prevalence increased ANC check-up increased Institutional delivery increased Exposure to mass media increased Women employment increasedBUT STILL… ILLEGAL ABORTION FEMALE FOETICIDE DOWRY DEATH INCIDENTS OF SATI IMMORAL TRAFFICKING
4. Certain positive things ( CHILD DEVELOPMENT): IMR decreased Vaccination coverage increased No. of children breastfed in one hr of birth increasedBUT STILL… Child labor Child abuse Early marriage of child Right to Education of children is beingcompromised.
5. LEGISLATION FOR WOMEN EMPOWERMENT &HEALTH The Medical Termination of Pregnancy (MTP) Act, 1971 The Maternity Benefit Act, 1961 The Family Court Act, 1984 The Dowry Prohibition Act, 1961 The Commission of Sati Act, 1987 The Immoral Traffic Act,1956 The Protection of Women from Domestic Violence Act,2005
6. THE MEDICAL TERMINATION OF PREGNANCY(MTP) ACT, 1971 This law provides the liberalized conditions forwomen to seek abortion and for doctors to do it.Following conditions are mentioned in the lawwhen a pregnant woman can speak the facility ofabortion: THERAPEUTIC SOCIAL HUMANITARIAN EUGENIC MENTALLY NOT SOUND
7. COMMENTS According to government estimates, 8.9 per cent of maternal deathsin India every year are caused by unsafe abortions. A recent international report had said that only two in five of theestimated 6.4 million abortions that take place annually in India aresafe. It should be noted that it is still illegal in India to acquire medicalabortion drugs without a prescription, although studies suggest thatover-the-counter sales of the drugs is common practice. Implementation of the MTP Act has been slow and geographicallyuneven. In one rural, community-based study in Vellore District of TamilNadu, it was found that 84 percent out of the 195 women knewwhere to get an abortion, but only 13.8 percent knew they wereconducted by doctors.
8. WHY PREGNANT WOMEN ARE GOING FORABORTION??? Financial reasons. Already having too many children or having too many female children. Becoming pregnant after too short a birth interval. Experiencing health problems during pregnancy. Becoming pregnant at an older age. Becoming pregnant soon after marriage. Suspecting husband‟s infidelity. Having an pregnant as a result of rape
9. WHAT CAN BE DONE??? Raise public awareness to both men and women wouldbe a logical first step. More efficient distribution of resources in existingmedical facilities. Remove or substantially reduce the extraneouspaperwork that discourages proper reporting by medicalproviders. Develop incentives for doctors to get specificprofessional training in the least invasive and safestmethods of conducting abortions. Work as advocates to make the public health systemaccountable to the millions of people for whom it issupposed to be designed, with a special consideration forthe rights of the poor.
10. THE MATERNITY BENEFIT ACT, 1961This Act is to protect and empower women asworkers. To prevent unfair employment practicesand exploitation of women in the labor marketand to safe guard the health and well being of themother and child it is essential provide maternityprotection to working women.
11. COMMENTS According to this Act every woman is entitled topayment of maternity benefit for a total of 12 wksi.e. six wks before delivery including the date ofdelivery and six wks after delivery. (Does thisbreak up is necessarily helpful??) No woman shall be entitled to maternity benefitunless the woman worked for more than 80 daysin the 12 months immediately preceding thedate of her expected delivery. (SEC 5) In case of tubectomy, a woman shall be entilted toleave with wages at the rate of maternity benefit fora period of 2 wks immediately after operation.(Sec9) ( Is 2 wks leave is necessary aftertubectomy??)
12. THE FAMILY COURT ACT, 1984 The Family Act provides for establishment of familycourts by the state governments to promote reconciliationand secure speedy settlements of disputes relating tomarriage and family affairs. Family court deals with Decree for nullity of marriage Restoration of conjugal right Judicial separation Divorce Declaration of marital status of any person Matrimonial property matters Claim of maintenance Guardianship Custody of children Access to children Application for injunction in matrimonial matters.
13. COMMENTSADVANTAGES: Speedy Justice And Saving From The Lengthy CourtProcedures Justice At No Cost Solving Problems Of Backlog Cases Maintenance Of Cordial RelationsPROBLEMS: Absence of Lawyer Sustaining Rights Lacking
14. THE DOWRY PROHIBITION ACT, 1961This Act is to prohibit the giving or taking of dowry.In this Act dowry means any property or valuablesecurity given or agreed to be given either directlyor indirectly by one party to the other party to themarriage; or by the parents of either party to amarriage or by any other person ; at or before orany time after marriage but does not include doweror mahr in the case of persons to whom the MuslimPersonal Law (Shariat) applies.
15. COMMENTS If any person gives or takes or abets the giving ortaking of dowry not less than 5 years and withfine which shall not be less than Rs.15,000 or theamount of the value of such dowry, whichever is more If any person demands, directly or indirectly, from theparents or other relatives or gurdian of a bride orbridegroom, as the case may be, any dowrynot less than 6 months but which may beextend to 2 years and with fine which may extend toRs.10,000.
16. 01000200030004000500060007000800090002005 2006 2007 2008 2009Dowry Death 6787 7618 8093 8172 8383AxisTitleDowry Death in India
17. WHY IS THE PROBLEM?? Age at marriage Teenage pregnancy Literacy rate of women INDIVIDUAL Unemployed women LEVEL Exposure of women to mass media Unemployed men Per capita income Spousal violence FAMILY Women’s decision LEVEL Microfinance Alcohol use Sex ratio Crime COMMUNITY Crime against women LEVEL
18. THE COMMISSION OF SATI ACT, 1987This Act is to provide for the more effectiveprevention of the commission and glorification ofSati and for matters connected therewith orincidental thereto.
19. COMMENTS There are two different types of punishment for onewho attempts to commit sati (imprisonment fora term which may extend to six months with orwithout fine or both) and another who does anyact for the glorification of sati (imprisonment fora term which shall not be less than one year butwhich may extend to seven years and with finewhich shall not be less than Rs.5000 but whichmay extend to Rs. 30000) The State Government may remove any temple orother structure which has been in existence for notless than 20 years. (WHY 20 YEARS??)
20. A Case: Mrs Kuttu Bai, aged 65 years, was reported tohave thrown herself on the funeral pyre of herdeceased husband, Mallu Bai at Tamali Patna, ofPanna district, Kerela.(2009)There are many such cases were there in MP, BiharRajasthan.WHY? Lack of Education and awareness. Problem in practical administration of the law. Inattentiveness of the police.
21. THE IMMORAL TRAFFIC ACT,1956This Act is to provide in pursuance of theInternational Convention signed at New York on 9thday of May 1950 for prevention of immoral traffic.
22. COMMENTS Definition of child and minor is confusing with otherlaws. According to NHRC Report on Trafficking in Womenand Children, in India the population of women andchildren in sex work in India is stated to be between70,000 and 1 million of these, 30% are 20 years ofage. Nearly 15% began sex work when they werebelow 15 and 25% entered between 15 and 18years. A rough estimate prepared by an NGO called Endchildren’s prostitution in Asian Tourism reveals thatthere are around 2 million prostitutes in India. 20%among them are minors.
23. WHY IS THE PROBLEM?? SUPPLY FACTORS Poverty Female Foeticide / Infanticide Child marriage Natural Disasters(floods, cyclones etc.) Domestic violence Unemployment Lure of job / marriage withfalse promises Domestic servitude Traditional / Religiousprostitution (Devdasi) Lack of Employmentopportunities DEMAND FACTORS Migration Hope for jobs / marriage Demand for cheap labour Enhanced vulnerability dueto lack of awareness Creation of need andmarket by sex traffickersfor „experimental‟ and„tender‟sex. Sex tourism Internet pornography Organized crime generatinghigh profits with low riskfor traffickers.•SUPPLY FACTORS• Poverty• Female• Foeticide / Infanticide• Child marriage• Natural Disasters(floods, cyclones etc.)• Domestic violence• Unemployment• Lure of job / marriagewith false promises• Domestic servitude• Traditional / Religiousprostitution (Devdasi)• Lack of Employmentopportunities•DEMAND FACTORS•Migration•Hope for jobs / marriage•Demand for cheap labour•Enhanced vulnerability due tolack of awareness•Creation of need and marketby sex traffickers for‘experimental’ and ‘tender’ sex.•Sex tourism•Internet pornography•Organized crime generatinghigh profits with low risk fortraffickers.
24. THE PROTECTION OF WOMEN FROM DOMESTICVIOLENCE ACT,2005This Act is an extremely progressive one not onlybecause it recognizes women who are in a live-inrelationship but also extends protection to other womenin the household, including sisters and mothers thus theact includes relations of consanguinity, marriage, orthrough relationships in the nature of marriage, adoptionor joint family thus, „ domestic relationships‟ are notrestricted to the marital context alone. In fact the Act hasgiven a new dimension to the word abuse whetherphysical, sexual, verbal, economic and harassment byway of dowry of demands and thus, under the new law.
25. COMMENTS Harassment by way of unlawful dowry demandson the woman or her relatives also comes underthis definition. (Importance of The DowryProhibition Act is hampered?) Is it justifiable that a woman would live underthe same roof with the man while fighting himin the court? Verbal Violence: Does the act say in way? According to NFHS-3 37.2% of the evermarried women experience spouse violence.Among the highest prevalent states of domesticviolence are Bihar, MP, Rajasthan.
26. WHY THE PROBLEM???CULTURAL CAUSES: Gender-specific socialization Cultural definitions of appropriate sex roles Expectations of roles within relationships Belief in the inherent superiority of males Notion of the family as the private sphere and under malecontrol Customs of marriage (bride price/dowry) Acceptability of violence as a means to resolve conflictECONOMIC CAUSES: Women‟s economic dependence on men Limited access to cash and credit Limited access to employment in formal and informal sectors Limited access to education and training for women
27. LEGAL CAUSES: Low levels of legal literacy among women Insensitive treatment of women and girls by police and judiciaryPOLITICAL CAUSES: Under-representation of women in power, politics, the media andin the legal and medical professions Domestic violence not taken seriously Notions of family being private and beyond control of the state Limited organization of women as a political force Limited participation of women in organized political system
28. LEGISLATION FOR CHILDPROTECTION & HEALTH THE PRE-CONCEPTION AND PRE-NATAL DIAGNOSTICTECHNIQUES ACT,1994 THE INFANT MILK SUBSTITUTES, FEEDING BOTTLESAND INFANT FOODS ACT,1992 THE JUVENILE JUSTICE ACT, 2000 THE CHILD LABOR ACT,1986 THE CHILD MARRIAGE RESTRAINT ACT, 1929 THE RIGHT TO EDUCATION ACT,2008
29. THE PRE-CONCEPTION AND PRE-NATALDIAGNOSTIC TECHNIQUES ACT,1994This Act was enacted for the prohibition of sexselection, before or after conception and forregulation of pre-natal diagnostic techniques forthe purposes of detecting genetic abnormalitiesor metabolic disorders or chromosomalabnormalities or certain congenitalmalformations or sex linked disorders and forthe prevention of their misuse for sexdetermination leading to female feticide.
30. COMMENTS Criteria for conducting prenatal diagnostic test (ANYOTHER CONDITION AS MAY BE SPECIFIED BYCENTRAL SUPERVISORY BOARD) (SEC 4.3) No person shall conduct the pre-natal diagnosticprocedures unless (A COPY OF HER WRITTENCONSENT OBTAINED IS GIVEN TO THEPREGNANT WOMAN) (SEC 5.1)( NO PERSON SHALL COOMUNICATE TO THEPREGNANT WOMAN CONCERNED OR HERRELATIVES OR ANY OTHER PERSON THE SEXOF THE FETUS BY WORDS, SIGNS, OR IN ANYOTHER MANNER) (SEC 5.1)
31. The central supervisory board shall consist of- ( NORADIOLOGIST) (SEC 7) Appropriate authority for State Government andAdvisory Committee for each Appropriate authority. Child (0-6 yrs) sex ratio has been declined from 927in 2001 to 914 in 2011 census in India. States like Haryana(830), Punjab(846), J&K(859)are the worst.
32. WHERE IS THE PROBLEM Lack of proper monitoring. Too many authorizing board but lack of co-ordination between them. Lack of awareness among the population whodeserve most. If proper actions are taken against the violator; itis not properly publicized so that people furthernot to take any illegal step. Unethical practice among some doctors. ILLETERACY AND LACK OF DECISIONMAKING
33. THE INFANT MILK SUBSTITUTES, FEEDINGBOTTLES AND INFANT FOODS ACT,1992This Act is to provide for the regulation ofproduction, supply and distribution of infantmilk substitutes, feeding bottles and infant foodswith view to the protection and promotion ofbreast feeding and ensuring the proper use ofInfant foods and for matters connected therewithor incidental thereto.
34. COMMENTS 7.3% BREASTFEEDING children consume infant formula ascompared to 12.7% Non-BREASTFEEDING children0.74.43.121.76.227.31028.911.930.18.718.104.22.168.19.905101520253035(%)<2 2-3 4-5 6-8 9-11 12-17 18-23 24-35age in mmmonthsBF Non-BF
35. Market Analysis 2011 – the infant formulamarket growing rapidly and Asian market isfastest developing and is also the largest (53%) 55% of Indian children less than 4 months ofage are exclusively breast fed, 23%predominantly breast fed and 20% receivesupplements along with breast milk.
37. WHERE IS THE PROBLEM Lack of awareness False belief that infant feeding formula is muchsuperior than breast milk for child development. False belief that breast milk is not adequate forbaby‟s hunger. Lack of awareness regarding proper attachmentof the baby during breast feeding. Social belief. ILLETERACY AND LACK OF DECISIONMAKING
38. THE JUVENILE JUSTICE ACT, 2000It is the responsibility of state to look into theproblem of juvenile social maladjustment andmake special efforts to mobilize all possibleresources of the family, the community andsocial organization for rehabilitation andbetterment of juvenile future. Any juvenile, whois likely to be abused, exploited and inductedinto criminogenic life and is in need of legalsupport to be appropriately rehabilitated.
39. COMMENTS Neglected juvenile means-who is being abused orexploited. (Definition of abused??)Emotional Abuse and Girl Child Neglect Equal percentage of both girls and boys reportedfacing emotional abuse. In 83% of the cases parents were the abusers. 48.4% of girls wished they were boys.
40. Physical Abuse Two out of every three children were physically abused. Out of those children physically abused in familysituations, 88.6% were physically abused by parents. 65% of school going children reported facing corporalpunishment. 50.2% children worked seven days a week.Sexual Abuse 53.22% children reported having faced one or moreforms of sexual abuse. Children on street, children at work and children ininstitutional care reported the highest incidence of sexualassault. 50% abuses are persons known to the child or in aposition of trust and responsibility.
41. THE CHILD LABOR ACT,1986The Child labor ( Prohibition and Regulation) Act isto prohibit the engagement of children in certainemployments and to regulate the conditions of workof children in certain other employments.It is illegal to employ children below 14 year fordomestic work or as domestic servant, or in dhabas(road sideeateries), restaurants, hotels, motels, tea-shpos, resorts, spas, and other recreationalcentres.
42. COMMENTS Every child employed in an establishment shall beallowed in each week, a holiday of one whole day. Every occupier of establishment in which a child isemployed shall, within a period of 30 days from suchcommencement send to the Inspector, a written noticeabout the child. (Sec9) According to UNICEF more than 10% of labor forceconstitutes children in India According to ILO 1/3rd rural children & 1/8th urbanchildren aged between 10 -14 yrs in India are at work. Child labor contributes 20% of India’s GNP. Number of child labor is equal to the number ofunemployed adults in the country.
43. WHERE IS THE PROBLEM??? The socio-economic backwardness. Poverty. Illiteracy. Unemployment. Demographic expansion. Deep social prejudices. Government apathy. Customs. Traditional attitude. Lack of school or reluctance of parents to send their children toschool. Urbanization. Industrialization. Migration.
44. THE CHILD MARRIAGE RESTRAINTACT, 1929 This Act is expedient to restrain the solemnization ofchild marriage. This act also applies to all citizens of India without andbeyond India.COMMENTS No woman shall be punishable with imprisonment.(sec7) Age of child marriage differs from The Juvenile JusticeAct, The Child Labor Act, The Railways Act. Recently a study by Boston University School of PublicHealth (BUSPH) found that 44.5 percent of women ages22 to 24 were married before age 18. More than one infive – 22.6 percent – were married before age 16, while2.6 percent were married before age 13.
45. A study conducted by UNICEF in South Asia exploredan interesting data that 55% of children of urban Indiamarried under 18 years in contrast to 26% of children ofrural India. AN INTERESTING CASERajasthan, India: The custom survivesof giving very small children away inmarriage.On the auspicious day of Akha Teej,the mass solemnization of marriagesbetween young boys and girls is performed.From the parents’ point of view, this is thetriedand tested way of organizing the passing on ofproperty and wealth within the family. Asmall but significant proportion of the
46. WHERE IS THE PROBLEM??? Early marriage as a strategy for economicreasons Marriage alliances and traditions Early marriage as a way to ensure the protectionof girls Control over sexuality and protecting familyhonour Gender inequality
47. THE RIGHT TO EDUCATION ACT,2008 This Act shall provide free and compulsoryeducation to all children between the ages 6-14through a law that it may determine. This bill while unable to legislate for the commonschool concept of the Kothari Commissionnevertheless defines a minimum school.
48. COMMENTS There should be 25% reservation of children fromdeprived sections from their neighborhoods. Only six out of 28 states and the seven Union territorieshave notified the Act. The six states areSikkim, Orissa, Manipur, Arunachal Pradesh, AndhraPradesh and Rajasthan. Challenge from Private School: The schools say theRTE law violates their fundamental right to a livelihood.They have objected to provisions such as the requirementfor each school to have a playground and the ban onexpelling students till class VIII.
49. WOMEN IN THE LABOR FORCE IN INDIA According to a recent survey women were 31.6%of all workers. Women are an estimated 38.2% of all economicallyactive individuals. Of women that work in the labor force, only 20%work in urban areas. Women earn 66% of men’s salary for equal work. 26.2% of women compared to 9.0% of men cited alack of role models as a barrier to advancement.
50. LEGISLATION RELATED TO OCCUPATIONALHEALTH FOR WOMEN PROTECTION Mica mines Labor Welfare Fund Act 1946 Limestone and Dolomite mines Labor Welfare Fund Act1972 Bidi Workers Welfare Fund Act 1976 Iron, Manganese, Chrome ore mines Labor Welfare FundAct 1976 It is compulsory to appoint a woman member in theadvisory Committee. The Factories Act 1948: Prohibition of employment of woman in hazardous occupations. Maternity leave for 12 weeks. Separate toilets and washing facilities for male and female workers. Provision of creches where 50 or more women are employed.
51. ESI Regulation,1950: Claims for maternity benefitbecomes due on the date of issue of medicalcertificate for miscarriage, confinement, prematuredelivery or pregnancy related illness. The Plantation Labor Act,1951: Working mothersare to be given time off, during duty hours, forbreastfeeding children. Provision of crèches where50 or more women are employed. The Mines Act, 1952: Prohibition of employment ofwomen in underground mines which is more risk tohealth. The Maternity Benefit Act,1961: MATERNITY BENEFIT TO BE ALLOWED ONSUBMISSION OF MEDICAL CERTIFICATE. CASH BENEFIT.
52. The Bidi and Cigar Workers Act,1966:Provision of crèches where 50 or more women areemployed. The contract Labor Act 1970: Provision of crèches where 20 or more women areemployed. Female employee (except midwives and nurses) shouldnot be required to work beyond nine hours between 7pmand 6am (2005 AMENDMENT BY SUPREMECOURT WOMEN CAN WORK NIGHT SIHFT IFSECURITY IS ENSURED) Equal Remuneration Act 1976: Payment ofequal remuneration to male and female workers. The Inter-State Migrant Workmen Act 1979
53. COMMENTS According to child labour laws, a young person can bein the labour market from the age of 14 years on, but theTrade Unions Act denies the right of membership of atrade union to a worker below the age of 18 years and theright of being an office bearer until the age of 21 years. There is hardly any regulation of conditions of work andno provision for social security of any kind for theworkers working in establishments employing less thanten workers. India does not have a publicly funded social securityscheme, with three exceptions The Payment of Gratuity Act (1972) The Employees Pension Scheme The employees‟ provident funds
54. According to NCEUS legislation concerning workingconditions “technically” covered 2.5-3.9% of the totallabour force; laws concerning wages and remuneration5.2-10.5%, with the relatively positive exception of theMinimum Wages Act (38.1%), and laws concerningsocial security covered 2.2-3.7% of the labour force. There is neither minimum income guaranteed nor specialemployment protection during sick leave in ESI Act. Health and safety legislation is rare, except for theFactories Act. No Public Health Acts in relation to sexual harassment inIndia. The Indecent Representation of Women (Prohibition) Act(1987) Art. 16 of the Constitution
55. TO CONCLUDE THAT ALTHOUGH THERE ARESEVERAL PUBLIC HEALTH ACTS INEXISTENCE BUT Lack of awareness, Lack of implementation, Corruption, Lack of infrastructure, Inconsistency Inadequacy
56. REFERENCE: Kishore J. National Health Programs Of India NFHS-3 Health and Development Challenges. WHO Boler T, Marston C, Corby N, Gardiner E. Medical abortion in india: amodel for the rest of the world? London: Marie Stopes International, 2009 Kohli N. Most unsafe abortions in India Hindustan Times NewDelhi, August 09, 2008 RetheeshBabua G, VeerrajuBabub B. Dowry deaths: a neglected publichealth issue in India. International Health 2011;3:35–43 Khan I . Child trafficking in india: a concern DOMESTIC VIOLENCE AGAINST WOMEN AND GIRLS. INNOCENTIDIGEST. Unicef.2000;6:7 Child Abuse: INDIA 2007. Ministry of Women and Child DevelopmentGovernment of India Naidu MC, Ramaiah KD. Child Labour in India - An Overview. J. Soc.Sci2006 13(3): 199-204