Pooja Devi Kol lives in Dabhaura, a small village in the central Indian state of Madhya Pradesh, and is expecting her first child in four months. Lately, she has been forced to divide her time between managing her pregnancy and filing multiple applications for state maternity benefits.

Courtesy of a 2017 scheme, introduced by the government of Prime Minister Narendra Modi, first-time mothers in India are eligible for payments totaling $68. The sum is roughly the price of a low-budget smartphone. But, for Kol, whose husband is a construction worker and earns a monthly wage of around $40, that is a significant amount of money. 

The couple plan to use the cash to purchase baby food and clothes for their child. The problem is that Kol, 19, does not have an Aadhaar biometric identity card, which makes the payments impossible to claim. She explained that she has applied for the card three times, assisted by a worker at her local Anganwadi rural childcare center. For undisclosed reasons, each attempt has failed. 

“I’ve gone to the Anganwadi and stood in line for hours several times, but my application keeps getting rejected,” said Kol. “It’s exhausting and I start feeling dizzy due to the long hours.”

Three hundred miles away, in the district of Niwari, Pragya Saur gave birth to a baby girl early last year. Since then, she has faced similar problems. She and her husband are both day laborers and earn a combined monthly wage of around $41. Neither has an Aadhaar card or a bank account. Saur went to the local Anganwadi center a few times but her efforts were futile. 

“I wasn’t successful at applying for it,” said Saur. “We can’t afford to go there multiple times, because that would mean losing our daily earnings.”   

Introduced in 2009, Aadhaar is a wide-ranging national identity scheme that provides citizens with a unique 12-digit number, linked to fingerprints and iris scans. At first, signing up was voluntary, but it quickly became clear that the aim was to bring all of India’s 1.3 billion population under its auspices. By 2017, the government claimed that 85% of people had been enrolled in the program. However, some people have fallen through the cracks, owing to a lack of a birth certificate or similar documentation necessary to process their initial Aadhaar application. As of 2019, an estimated 102 million people did not have an Aadhaar card.  

Aadhaar’s stated purpose was the targeted delivery of welfare services to large sections of India. Its initial remit was to increase transparency and to reduce waste and fraud. Evidence suggests that by 2017 it had helped to save the public purse almost $7.7 billion. Now, Aadhaar cards are vital for anyone who intends to access a vast range of support, from food subsidies to pensions and medical treatment.  

In 2015, the Indian Supreme Court ruled that Aadhaar can be used as a means of access to government benefits, but that people cannot be punished for not registering. However, given how much poorer Indians have to lose by not being part of the scheme, it is compulsory in all but name. 

Aadhaar has played a pivotal role during the current Covid-19 pandemic. Recently, the system was used in the distribution of $27.3 million in coronavirus relief funds to individuals across the country. 

Among those worst affected by Aadhaar are poor and marginalized women, like Kol and Saur. India accounts for 17% of the world’s maternal deaths and ranks in the worst 20 countries for infant mortality. Many of these fatalities are the result of poor postnatal care and nutrition. The idea behind Modi’s maternity benefit program was both simple and important: to provide compensation for lost earnings and guarantee nutrition and medical care for mothers and newborn children. 

The program requires both parents to supply their Aadhaar cards, which automatically rules out many single, unmarried or divorced women. It further filters out applicants who have never had an Aadhaar number, have lost their cards or whose biometric or demographic data needs to be updated. 

The claims procedure is also unwieldy, with the money disbursed in three instalments, requiring mothers to fill in multiple forms registering their pregnancy, an antenatal check-up and the birth of their child. Within three years of the program’s launch, the government claims to have registered 13.7 million women and distributed almost $700 million. However, according to one report, 33% of the Aadhaar-based payments have been credited to the wrong bank accounts.  

Reetika Khera, an associate professor of economics at the Indian Institute of Technology, studied the use of Aadhaar for maternity benefits across six states in 2019. She found that at a time when “women need rest, they were being made to run around to correct Aadhaar details, figure out where their money has gone and so on.” 

Aadhaar is also failing women in other ways. Those seeking abortions — already a stigmatized group in India — are now unable to do so without creating a data trail. When seeking a termination, every pregnant woman’s identity is linked to their ultrasound information, leaving them vulnerable to leaks. A fear of exposure has led many to resort to backstreet practitioners. 

“Digital systems seem to have replicated offline challenges and in several cases, added to the complexity,” explained Brindaalakshmi K, an independent researcher working on the areas of human rights, identity and technology. “The offline stigma of getting an abortion has not been broken and, without changing that offline thinking, the government has introduced these digital systems and a digital ID.”

In 2015, the Indian government made it mandatory for women seeking sonography and other pre-natal tests to share their ID, which inevitably ends up being the Aadhaar number. Historically, Indian society has favored male children and viewed girls as a financial burden. The initial idea behind this measure was to clamp down on sex-selective abortions, but the system has created additional problems. Now such services are inaccessible to all women without suitable identification.

Aadhaar’s grip on healthcare services in Indian society looks set to tighten. In August, Modi announced the launch of a National Health ID, which will further centralize the data of Indian citizens by digitizing their health records and potentially linking them to Aadhaar, though the government says Aadhaar is optional for the creation of an individual Health ID. The idea is to create a digital health ecosystem that will help people to access public and private care by connecting hospitals, diagnostics, telemedicine firms and insurance companies. 

By September 2020, 100,000 such IDs had been issued. The government has said that it will use them in the rollout of a Covid-19 vaccination. Experts, however, believe that the system will replicate the problems encountered by women seeking reproductive services, by linking identity to sensitive medical information.  

Aadhaar data breaches are not uncommon. In 2018, information related to the reproductive health of over two million women in the south Indian state of Andhra Pradesh, along with their Aadhaar numbers, was published online. This information included the details of the women’s pregnancy cycles, along with their telephone numbers and bank names.    

“The state has been collecting details of pregnant women for a long time. The idea behind tracking all this information by the government is to keep a check on the maternal mortality rate, for vaccination programs, birth certificates and to track any deaths due to any viruses,” said digital rights activist Srinivas Kodali. “It’s a legitimate state activity.”

He explained that the problem arises when decentralized databases filled with women’s personal information are linked with centralized ID systems like Aadhaar. It not only poses privacy risks but also adds to the stigma of women wanting to access reproductive healthcare. 

Meanwhile, the system cannot manage a simple task like allocating maternity benefits to women in small-town India. Saur has now given up trying. Kol, however, remains hopeful. She plans to head over to the local Anganwadi in the coming days to apply for her Aadhaar card yet again. “Maybe it will work this time,” she said.