ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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High Risk without Recognition: Challenges Faced by Female Front-line Workers

An already overburdened, understaffed and under-resourced health system faced severe repercussions in the wake of the pandemic. Those at the forefront of health and nutrition service delivery at the community level are struggling due to increased work burden and low compensation received, particularly since most of them are not formally recognised as workers. In this article, we discuss the conditions of work of front-line women workers, especially accredited social health activists, anganwadi workers and their supervisors (Integrated Child Development Services supervisors, auxiliary nurse/midwife and ASHA facilitators) in the context of the COVID-19 pandemic. Based on interviews conducted with workers in Telangana and Bihar, we highlight how women front-line workers were overworked and underpaid even before the pandemic and continue to remain so even after.

ASHAs’ Health Services

The intrinsic commitment of the accredited social health activists towards the well-being of the community is unduly exploited by the state in the name of “volunteerism.” It is high time a wholesome definition of work is adopted to understand the inconspicuous contributions made by these front-line healthcare workers, who form a key link in the public health system in India.

Performance-Based Incentives of the ASHA Scheme

A study of Accredited Social Health Activists in Shahapur taluka of Maharashtra, a drought-prone adivasi-inhabited area, shows that the remuneration of ASHAs is a growing concern both for them, as well as their families. Recognising their contribution to public health services, the government should provide fixed payment to them, beyond which task-based incentives should continue to be given, though at a revised rate. The current system of remuneration is making it difficult for ASHAs to meet their family's needs and the community's expectations. Further, payment and reimbursement procedures need to be simplified.
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