And while messages of congratulations have since poured in from the prime minister and health minister among others, female health volunteers continue to fight for higher pay, regular jobs, and even health benefits.
While sporadic protests were continuing in several states, thousands of ASHA from across the country took to the streets in September last year to fight for their demands.
Who are ASHA workers?
ASHA workers are volunteers from within the community who are trained to provide information and help people access the benefits of the government’s various health care programs.
They serve as a bridge connecting marginalized communities with facilities such as primary health centers, subsidiary centers and district hospitals.
The role of these CHVs was established under the National Rural Health Mission (NRHM) for the first time in 2005.
ASHAs are married, widowed or divorced between the ages of 25 and 45 from within the community. They should have good communication and leadership skills; Must be literate with formal education through eighth grade, according to program guidelines.
How many ASHAs are there across the country?
The goal is to have one ASHA per 1,000 people or per dwelling in mountainous, tribal, or other sparsely populated areas.
There are about 10.4 thousand ASHA workers across the country, with the largest workforces in the densely populated states – Uttar Pradesh (1.63 lakh), Bihar (89437), and Madhya Pradesh (77531). Goa is the only state without such workers, according to the latest National Health Mission data available from September 2019.
What do they do?
They go door to door in their designated areas to create awareness about basic nutrition, hygiene practices and available health services. They primarily focus on ensuring that women undergo prenatal screening, maintenance of nutrition during pregnancy, delivery in a health care facility, and provision of postpartum training in breastfeeding and supplemental feeding of children. They also advise women about contraception and sexually transmitted diseases.
ASHA workers are also tasked with ensuring and motivating children to get their vaccinations. Other than maternal and child care, ASHA staff provides daily medication to tuberculosis patients as part of the directly monitored treatment of the national program. They are also tasked with checking for diseases such as malaria during the season. They also provide essential medicines and treatments to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, folic acid tablets to prevent anemia, and birth control pills.
“Now, we are also testing people and getting reports of non-communicable diseases. Moreover, ASHA workers have been tasked with a lot of work during the pandemic. Ismat Ara Khatun, an ASHA worker from West Bengal and Secretary General of the System Workers Federation of India who led the protest said. National, “We are no longer volunteers.”
Health volunteers are also tasked with reporting any births or deaths to their primary health center in their designated areas.
How has ASHA helped respond to the pandemic?
ASHA workers have been a key part of the government’s response to the pandemic, with most states using the network to screen people in containment areas, test them, and transport them to quarantine centers or assist with home quarantine.
“During the first year of the epidemic, when everyone was afraid of infection, we had to go from house to house and check people for symptoms of Covid-19. Those with fever or cough had to be tested. After that, we had to inform the authorities and help “We also faced so much harassment because of the stigma around the infection that people didn’t want to let us in,” Ismat Khatun said.
Kavita Singh of Delhi, a former ASHA worker and member of the scheme workers union in India, added, “We had to go to the families with confirmed cases of Covid-19 and explain the quarantine procedures. We had to provide them with medicines and pulse oximeters. Every This is on top of our routine work.”
With the start of the Covid-19 vaccination campaign in January last year, they were also tasked with motivating people to get their vaccines and collecting data on the number of people who had not yet been vaccinated.
How much do ASHA workers pay?
Since they are considered “volunteers”, governments are not obligated to pay them salaries. Most countries do not do this. Their income depends on incentives under the various schemes that are provided, for example, when they guarantee birth in an institution or when their child is immunized. All this only adds up to between Rs 6,000 to Rs 8,000 a month.
“Her work will be so detailed that it does not interfere with her normal livelihood,” says the National Health Mission. However, with the prevalence of most health programs that rely on it, this is not the case.
“Even if we work for 24 hours, we won’t be able to complete all the tasks. We don’t get any benefits like pension or health insurance. If the World Health Organization recognizes our role, and if the government can call us veerangna (the hero), they rain us down,” Esmat said. With flowers, why not pay us fairly for all the work we do.
For some time now, ASHA workers have been demanding that they become permanent government employees and offer them benefits.
“If not, they should at least fix our basic incentives so that we get paid at least Rs 3,000 a month no matter what. All business is rated 0 to 12 and if I don’t get at least 6 I get paid 500 Only Rs instead of Rs 3,000. I don’t get any points, even if the woman goes back to her hometown to give birth to the baby,” Kavita said.
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She said Covid-19 has pushed them to their limits.
“During Covid-19, we were being charged only Rs 1,000 for all additional work. Since the stimulus was discontinued in March of this year, half of ASHA workers in Delhi have decided not to engage in Covid-19 related vaccination activities,” Kavita added.