The State, Gender, and Privacy in India: An Exploration through the Mother and Child Tracking System

印度的国家、性别和隐私：母婴追踪系统的探索

• 批准号: 2886130
• 金额: --
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2886130
• 关键词: State; Gender; Privacy; India; Exploration

Sarah Hodges (2006, p2) argues that reproduction is "always simultaneously a physiological as well as social act" highlighting that reproduction is often socially determined. Faye Ginsburg and Rayna Rapp, borrowing from Shelee Colen's work on West Indian childcare workers, define stratified reproduction as the local and global circumstances whereby 'some categories of people are empowered to nurture and reproduce, while others are disempowered' (Colen, Ginsburg, &Rapp 1995). In India, reproduction is stratified by class, religion and caste. The general onus of population control lies on the poor, who are often also the ones who have to interact with the state directly through welfare measures on matters of reproduction. The Hindu right wing's demands for population control have also served as a tool for Islamophobia in the country with (debunked) conspiracy theories suggesting that the Muslims (15% of the Indian population) produce multiple children to overrun the Hindu population (79% of the Indian population) to seize political power. Further, caste also acts as a determinant of reproductive healthcare access as evidenced by the poor maternal health outcomes and low utilisation of maternal healthcare services of Scheduled Caste Women. Since colonial times, in the context of reproductive healthcare policies, the state has been more concerned with the question of population control and demography rather than with discourses of autonomy for women. Women's access to reproductive healthcare facilities such as abortion continues to exist mainly within discourses of population control, sex ratios and maternal health (sometimes their 'right' to abortion simply a function of their husbands' refusal to use contraceptives) and not within discourses of autonomy and privacy (Menon 1995)In 2009, the Ministry of Health and Family Welfare (MoHFW) launched the Mother and Child Tracking System to function as a national database in India's reproductive health information ecosystem. It aims to leverage information technology in delivering healthcare and immunisation services to pregnant women and children up to the age of 5. Various state-level systems run parallel to it or are subsumed by it. It ostensibly aims to establish a two-way communication between the service providers and the beneficiaries. There are multiple ICT elements involved in the system: the database captures detailed information of the beneficiaries such as their unique IDs, names, location, contact details and caste; a maternal health card containing a unique 16-digit unique identification number encoding the health centre location and serial number of the woman/child; mobile-based SMS technology to "communicate with beneficiaries and grassroot level healthcare service providers as well as health and family welfare policy makers, health managers and health administrators at different tiers of the health care delivery system" (MoHFW Press Release 2013). A call centre, the Mother and Child Service Facilitation Centre, serves to verify the MCTS records and collects feedback on the provision of services. Through this system, the MCTS collects a wide range of information of not only the targeted beneficiaries (such as personal details of all pregnant women, the details of all the welfare schemes they avail, data of all visits from conception to 42 days post-partum), but also demographic details and contact numbers of all health workers in each facility. In the absence of a data protection framework, the collection of such a large assemblage of data exposes the participants to serious risks of data misuse and surveillance.Given the complicated social history and context of access and the nature of reproductive healthcare in India, it becomes necessary to investigate the implication of adding ICTs to the mix. An intersectional enquiry of such processes will help shed light on the interaction of the state and citizens in the context of technology-mediated welfare measures.

Sarah Hodges （2006, p2）认为繁殖“总是同时是一种生理和社会行为”，强调繁殖通常是由社会决定的。Faye Ginsburg和Rayna Rapp借鉴了Shelee Colen关于西印度儿童保育工作者的研究，将分层生殖定义为当地和全球环境，其中“一些类别的人被授权养育和繁殖，而另一些人被剥夺了权力”（Colen, Ginsburg, &Rapp 1995）。在印度，生育是由阶级、宗教和种姓划分的。控制人口的责任一般落在穷人身上，他们往往也是必须在生育问题上通过福利措施与国家直接互动的人。印度教右翼对人口控制的要求也成为了该国伊斯兰恐惧症的工具，（被揭穿的）阴谋论暗示，穆斯林（占印度人口的15%）多生孩子，以超过印度教人口（占印度人口的79%），从而夺取政治权力。此外，种姓也是获得生殖保健的一个决定因素，在册种姓妇女的孕产妇保健结果不佳和孕产妇保健服务利用率低就是明证。自殖民时期以来，在生殖保健政策方面，国家更关注人口控制和人口统计问题，而不是妇女自治的言论。妇女获得诸如堕胎等生殖保健设施的机会仍然主要存在于人口控制、性别比例和孕产妇保健的论述中（有时她们的堕胎“权利”仅仅是其丈夫拒绝使用避孕药具的结果），而不是存在于自主和隐私的论述中（Menon， 1995年）。卫生和家庭福利部（MoHFW）启动了母亲和儿童跟踪系统，作为印度生殖健康信息生态系统的国家数据库。它旨在利用信息技术向孕妇和5岁以下儿童提供保健和免疫服务。各种州级系统与它并行运行或被它所包含。表面上看，它旨在建立服务提供者和受益者之间的双向沟通。该系统涉及多个信息和通信技术要素：数据库收集受益人的详细信息，例如他们的唯一身份证、姓名、地点、联系方式和种姓；产妇保健卡，包含16位唯一识别号码，编码保健中心的位置和妇女/儿童的序列号；基于移动的短信技术“与受益人和基层医疗保健服务提供者以及卫生和家庭福利政策制定者、卫生管理人员和卫生行政人员在不同层次的卫生保健提供系统进行沟通”（卫生和家庭福利部2013年新闻稿）。母婴服务促进中心是一个电话中心，负责核实母婴服务计划的记录，并收集有关提供服务的意见。通过这一系统，MCTS不仅收集目标受益人的广泛信息（例如所有孕妇的个人详细信息、她们利用的所有福利计划的详细信息、从怀孕到产后42天的所有就诊数据），而且还收集每个设施中所有卫生工作者的人口统计详细信息和联系电话。在缺乏数据保护框架的情况下，收集如此大量的数据使参与者面临数据滥用和被监视的严重风险。鉴于印度获得生殖保健的复杂社会历史和背景以及生殖保健的性质，有必要调查将信通技术纳入其中的影响。对这些过程的交叉调查将有助于阐明在技术介导的福利措施背景下国家和公民的相互作用。