Inclusive Maternal Welfare and SDG Alignment: A Comparative Policy Analysis of PMMVY and TNMRMBS

Abstract

Public health outcomes in the future will be significantly influenced by maternal health, particularly in developing countries, where systemic inequity prevents equal access to adequate care. To support its commitment to achieving external goals specified in the UN Millennial Plan for Sustainable Development by 2030, India has implemented many Conditional Cash Transfer (CCT) programs to improve access to prenatal care, promote institutional births, and encourage healthy child nutrition through maternity benefit payments. Two key maternal programs in India have similar objectives but are organized differently: (1) Pradhan Mantri Matru Vandana Yojana (PMMVY), a central government initiative that operates under “Mission Shakti (Samarthya)” and (2) Tamil Nadu Dr Muthulakshmi Reddy Maternity Benefit Scheme (TNMRMBS) the first state-led maternity cash transfer scheme to be established in India. Using a second data analysis approach based on official departmental policy guidelines, national household data collected via the National Family Health Survey (NFHS-4 and NFHS-5), and peer-reviewed research literature, this study compares and analyses differences in how each maternal welfare program was designed and implemented, including design elements, eligibility criteria, benefit levels (amounts and eligibility), sustainability, and global strategy alignment (focused on aligning with SDG 3 -Reduce maternal Mortality ratio and SDG 5 -Achieve Gender Equality). The findings show that Tamil Nadu has substantially reduced its maternal mortality ratio (MMR) from 73 per 1,000 live births in 2020-21 to an estimated 39.4 per 1,000 live births in 2024. Gujarat has already achieved the SDG target (MMR of less than/equal to 70) by 2030 and is one of the eight Indian states that have reached SDG targets and will do so by 2030.PMMVY has a broad scope, reaching more than 53.76 lakh recipients in FY 2023–24 and distributing 17,984 crore since its inception. In contrast, TNMRMBS has a higher benefit amount of 18,000 and strong community engagement/collaboration. The Discussion section also indicates that there are ongoing inequities across both informal sector workers and lower caste workers. The conclusion provides evidence-based recommendations for an integrated and equity-sensitive approach to designing policies to facilitate Universal Health Coverage (UHC). In the future, effective implementation of health schemes necessitates a primary focus on the role of frontline workers, specifically ASHA and AWW personnel, whose field-level engagement is vital for program success. To gauge real-world effectiveness, longitudinal impact assessments must be conducted to link cash transfer disbursements directly to maternal and neonatal health outcomes using robust coverage cascade frameworks. Furthermore, comparative analyses of central and state scheme integration models across various Indian states are essential to identify the best practices for co-branded initiatives. Central to this discussion is the critical task of digital exclusion mapping, which identifies the proportion of eligible women sidelined by Aadhaar non-availability, banking access limitations, and technology gaps faced by frontline workers, ensuring that digital infrastructure serves rather than hinders vulnerable populations.