Cash incentives or policy misstep? debate grows over Punjab’s ‘Aaghosh’ Programme

LAHORE: Punjab Chief Minister Maryam Nawaz recently announced a new initiative focused on maternal and child health, under which mothers of children under two years old and pregnant women will receive Rs23,000 as part of a healthcare support programme. 

The Punjab government has initially launched this initiative under the ‘Aaghosh’ Programme in 13 districts to provide financial assistance to expectant mothers and those with newborns. 

At first glance, this initiative appears to be an attractive offer for those living below the poverty line in Pakistan. However, the online discourse surrounding it has largely focused on concerns over the country’s rapidly growing population. 

Social media users have also emphasised the need for long-term investments in improving healthcare facilities at government hospitals, rather than offering short-term financial incentives. 

According to 2023 data, Pakistan’s population has surpassed Rs240 million, making it the fifth most populous country in the world. 

What is ‘Aaghosh’ Programme’?

According to a statement from the Punjab government, the programme will initially be launched in Dera Ghazi Khan, Taunsa, Rajanpur, Layyah, Muzaffargarh, and Kot Addu, Bahawalpur, Rahim Yar Khan, Bahawalnagar, Bhakkar, Mianwali, Khushab and Lodhran. 

First-Time Registration Incentive

Pregnant women will receive Rs2,000 upon their initial registration at healthcare centres or Maryam Health Clinics. 

Regular Check-Up Allowance

Financial support will be provided for each medical check-up during pregnancy. After a free medical consultation at designated health centers, cash assistance could be collected from a registered agent. 

Per-Visit Cash Benefit

Expectant mothers will receive Rs1,500 for every health check-up, totaling Rs6,000 throughout their pregnancy. 

Childbirth Grant

A Rs4,000 cash gift will be awarded upon delivery at a registered healthcare centre. 

Postnatal Check-Up Bonus

Mothers will receive Rs2,000 if they bring their newborn for a medical check-up within 15 days of birth. 

Birth Certificate Registration Incentive

An additional Rs5,000 will be given upon registering the newborn’s birth certificate at the healthcare centre. 

Immunization Support

Mothers will receive Rs2,000 per visit, with a total of Rs4,000 for ensuring their child receives essential vaccinations. 

Social Media Criticism 

Since the announcement of the program, social media discussions have raised several concerns. 

Some users have linked the initiative to population growth, questioning whether such incentives will contribute to an even higher birth rate. 

A user named Taimoor posted: “Is the population growth rate too low that we’re now offering incentives for it?”

Others pointed out the high costs associated with childbirth in private hospitals. One user suggested: “Instead of cash payments, the Punjab government should at least provide free deliveries or cover half the cost in private hospitals.”

What Do Experts Say? 

Women’s rights expert Shabana Arif, speaking to BBC, acknowledged that while the Punjab government’s initiative is a welcome step, it must be viewed in the broader context of poverty and maternal health neglect in Pakistan. 

“Maternal mortality rates remain high due to a lack of healthcare access. In this regard, the initiative may encourage families to prioritize women’s health. However, there is a concerning aspect—offering cash incentives might push people to rush for check-ups, but at the same time, Pakistan’s population is growing at an alarming rate,” she said. 

Shabana Arif believes that this initiative could unintentionally promote more pregnancies. She cited an example from Sindh, where a similar program provided Rs1,200 per month to pregnant women for nutrition. 

“We observed cases where women who already had three or four children became pregnant again just to qualify for financial aid,” she said. 

She further revealed that in some cases in Sindh, three generations of women in the same household — grandmother, mother, and granddaughter — were pregnant at the same time. 

“It seems that some men saw this as an opportunity to benefit financially, diverting the money for other household needs,” she added. 

It is important to note that early marriages remain common in rural and traditional communities across Pakistan. 

“Mindset Shift Is Needed” 

Could this program encourage a rise in birth rates? 

Tasneem Ahmar, Director of Aks Research Centre, acknowledged that the initiative is a good step toward improving maternal and child health. 

“The selected areas are underdeveloped and impoverished, so this program could help address some of the challenges faced by pregnant women,” she noted. 

However, she stressed the need for a stronger healthcare system that reduces reliance on financial assistance. 

“Instead of cash payments, the government should ensure universal health insurance for the poor, particularly women, so that they receive proper reproductive and general healthcare without financial barriers,” she suggested. 

Also read: Sindh government achieves notable progress in health, education, agriculture, and digital transformation

Tasneem Ahmar warned that providing direct cash incentives per childbirth could inadvertently fuel population growth, which is already a pressing issue for Pakistan. 

“What we truly need is awareness, especially for girls and women about their health, and a massive effort to educate people—particularly men—about the consequences of uncontrolled population growth,”* she emphasized. 

Men Should Be Required to Accompany Their Wives for Every Visit” 

What measures could improve maternal and child health programs? 

Tasneem Ahmar proposed three key additions to ensure the program’s long-term success: 

1. Educating women about reproductive health.

2. Limiting the program to only two childbirths per woman. 

3. Making it mandatory for men to accompany their wives for every medical visit so they understand the challenges and complications associated with pregnancy and childbirth. 

Shabana Arif suggested an alternative to cash incentives, recommending that the government provide medical packages instead. 

“Instead of handing out cash, the government should provide essential medicines, supplements, and medical check-ups directly to pregnant women,” she proposed. 

She also recommended issuing food or supplement vouchers, ensuring that financial aid directly benefits pregnant women rather than being misused. 

“There’s a risk that men might take control of the money and use it for other purposes, defeating the program’s core objective,” she warned.