ASHA Workers’ Struggle for Recognition

The year 2020, further disrupted by the COVID-19 pandemic, pushed health workers to the front lines of the state’s efforts to deal with the virus. The state response, while showing chinks in an already weak public health infrastructure, revealed the poor and appalling working conditions of health workers. Several states witnessed health workers protesting poor working conditions and ill-preparedness of state authorities. This not only hampered these workers from performing their duties but also jeopardised their health and safety. The Accredited Social Health Activists (ASHAs)—voluntary women health workers—have been at the forefront of these protests. In August 2020, more than 6 lakh ASHA workers along with anganwadi and midday meal workers went on strike, demanding a raise in pay, timely payment, access to better protective equipment, insurance, travel allowance, regular testing, and legal recognition that allows them access to worker benefits, especially minimum wages.

Their demand for recognition as workers strikes at the heart of the original design in the National Rural Health Mission (2005), where ASHAs were perceived by the state as an interface between the community and the public health system. Women were recruited as volunteers on honorariums to perform specific tasks central to the functioning of the public health infrastructure. Working long hours, ASHA workers are responsible for a range of tasks, which include disseminating health- and nutrition-related information, collecting and maintaining household health data, recording births and deaths, ensuring immunisation programmes reach beneficiaries, checking for communicable diseases, and providing home-based postnatal care and family planning services. For the last decade, ASHA workers have challenged this volunteer status designated by the state and questioned the politics inherent in such designation. ASHA workers claim that such a status seeks to subsidise the core functions and responsibilities of the state through their labour and at the same time ends up devaluing their labour.