As India battles the COVID-19 pandemic resurgence, lakhs of the country’s all-female army of grassroots frontline health “volunteers”, called Accredited Social Health Activists or ASHAs, are going a one-day strike on May 24 to bring to the fore multiple issues they have been facing while assisting local health departments in battling the virus.
This is the second time – in addition to multiple protests – that ASHAs will be abstaining from their duties nationwide after staging a similar strike for two days last year, raising demands that still remain unheeded.
“We will be going on a one-day nationwide strike on May 24,” Surekha of All India Coordination Committee of ASHA Workers (AICCAW) told Newsclick on Thursday. Protests will be held at sub-health centres (sub-centres), primary health centres (PHCs), and district CHMO’s (Chief Medical Health Officer) offices across the country, she said.
Given the rising COVID-19 cases, the coordination committee said it would make sure that no large mobilisation or congregation of protesters takes place during the strike, Surekha added.
Attached to India’s National Rural Health Mission (NRHM), launched in 2005, the ASHAs are regarded as the first port of call for any health-related demands of deprived sections of the population, especially women and children in rural areas, who may otherwise find it difficult to access health services.
Their duties normally involve community development through healthcare awareness and increasing utilisation of the existing health services. There are nearly 10 lakh ASHAs across the country, as per government estimates.
Since the outbreak of the pandemic, however, the workload of ASHAs has increased manifold, with governments – Central and state –involving them in contract tracing COVID-19 patients, facilitating access to testing and vaccination facilities, along with spreading door-to-door awareness among other work.
“Their services are undoubtedly the most essential in today’s time. Yet, the hopes of ASHAs of even being recognised as a ‘worker’ remain shattered. It is an unfortunate irony,” says A R Sindhu, national secretary, Centre of Indian Trade Unions (CITU), who has been working among anganwadi and ASHAs.
Under the NHRM, ASHAs are envisaged as community health “volunteers”, not workers, and are entitled to task/activity-based incentives over and above a monthly fixed minimum “honorarium”, not wages.
This arrangement meant that when the pandemic hit and restrictions were put in place against public movement, the incomes of these community worker-volunteers took a massive dip as routine recurrent activities of the ASHAs, for which there’s an incentive, were disturbed.
“We receive many such complaints where an ASHA worker says she has been working round-the-clock yet not earning enough for her family,” Surekha said.
Last year, the Narendra Modi government had announced an additional incentive of Rs. 1,000 per month for ASHAs engaged in country’s COVID-19 response and state governments had announced one-time allowance for ASHAs in their respective states.
However, the extension for the incentive announced by the Centre “for further six months” has been made “optional”, the coordination committee said in a press statement on Thursday. “The situation is so bad [currently] that even regular monthly remuneration is pending for many months in many states,” the statement added.
Meanwhile, the Centre brought ASHAs under the fold of Pradhan Mantri Garib Kalyan Package Insurance scheme last year. The insurance scheme, introduced for all healthcare workers, provides life insurance cover of Rs. 50 lakh in case of death due to COVID-19.
But to get the compensation is “very difficult,” on the ground, according to Surekha, who claimed that around “80 ASHA workers” across the country had succumbed to COVID-19 only in April-May this year but “not one of them has been paid compensation yet.”
Sindhu, also a coordinator of the Joint Platform of Scheme Workers Federations and Unions, said that the May 24 strike will be a “token programme”, where demands of all ‘scheme workers’, such as Anganwadi, Mid-day Meal, and National Health Mission (NHM) workers, among others, will be raised.
“We are demanding safety gear and vaccination on priority basis for all of them. What we are also demanding is to regularise them in the workforce immediately,” Sindhu said.
With women in majority among these scheme worker-volunteers, experts have long argued of the “undervaluation” of female labour behind their plight.