On June 3, Chief Minister YS Jagan Mohan Reddy announced to increase the salaries of Accredited Social Health Activist (ASHA) workers to Rs 10,000 per month, raising hopes in the lives of nearly 42,000 female health workers across Andhra Pradesh. While the state government’s move was preceded by years of relentless struggles of workers demanding their rights, several workers’ leaders are sceptical about its implementation as several state governments have deceived workers with similar promises.
There are two components when it comes to the salaries of ASHA workers, a common honorarium and incentives for special functions they perform. In June last year, the previous Telugu Desam Party government under Chandrababu Naidu had promised a fixed salary of Rs 6,000. However, in reality, the health workers are paid only Rs 3,000 honorarium and separate incentives for individual work amounting to less than Rs 6,000 per month, which has left the workers disillusioned.
Across the country, ASHAs receive different wages for their health services in villages including escort services for healthcare programmes and construction of household toilets, under National Health Mission programme of the central government.
Also read: Despite Increase in Wages, Government is Failing its Health Workforce
While contributing with their health services in rural areas, ASHAs have led a continuous struggle of more than ten years for claiming their right for better wages, says C Dhanalakshmi, general secretary of Andhra Pradesh ASHA workers’ union affiliated to the Centre of Indian Trade Union. “On March 8, 2018, on the occasion of International Women's Day, ASHA workers led a state-wide strike and about 10,000 workers held a day-long protest gathering in Vijayawada,” Dhanalakshmi told NewsClick.
“Although the government has announced that Rs 10,000 would be a fixed salary unlike the previous system, but there is still no clarity on how the allowances will be paid,” she added.
“ASHAs held their agitations in numerous ways as their were deceived by the non-implemented promises of the previous governments. Alongside state-wide protests, ASHAs held public meetings once every three months at Mandal-level health centres, and at least once every six months at district collectorates raising their demands. The female workers attended duties wearing black sarees and black badges during protests,” added Dhanalakshmi.
“During Jagan Mohan Reddy’s prolonged ‘padayatra’ before elections, ASHAs gave him representations explaining their difficulties due to their meagre wages in different regions of the state, which perhaps prompted him to come up with the move,” says Suresh, member of Jan Swastha Abhiman (JSA) based in the state. JSA had stood in support of the ASHA movement and also submitted representations to the state government explaining the crucial role of the ASHAs in rural health service.
One has to wait and see the manner in which Andhra Pradesh government will implement its promise as several state governments have deceived the workers, says AR Sindhu of the All India Federation of Anganwadi Workers and Helpers (AIWFAH). “ASHA workers have been contributing for the betterment of the grassroot people of the country as their work is showing results. However, the wages paid to the ASHA and Anganwadi workers are in dire contrast to the price rise,” said Sindhu.
Also read: Telangana ASHA Workers Stage Protest, Demanded Fixing of Salaries
Recently on June 10, ASHA workers in Telangana led a state-wide protest as they were not receiving their honorariums for the last five years. Sindhu says that this is a country-wide problem and the central and state governments need to address this crucial issue.
There are nearly 10 lakh ASHA and Anganwadi workers across the country. Demanding economic security and better working conditions, the health workers have led numerous agitations across the country but are still enduring through lower wages and delayed payments.
Alongside the salary hike, Jagan Mohan Reddy’s government is also steering towards health sector reforms, as it appointed an expert committee to recommend an integrated plan for reviving the existing health system including – Public, Private, Ayush and Informal, aiming to provide Universal Health Care (UHC) services for all. Meanwhile, central government will begin a health project in the state titled as ‘Andhra Pradesh Health Systems Strengthening Project’ for which World bank is set to invest Rs 2,200 crore.
The state government spending on medical, public health and family welfare, as a ratio of total expenditure was 4.3% for 2017-18. Andhra Pradesh ranks eighth out of 21 large states in India on overall health performance on a National Health Index developed by the NITI Aayog.
Also read: Bihar ASHA Workers go on Indefinite Strike Demanding Better Wages and Social Security