ASHA Workers in India
Why in the News?
ASHAs (Accredited Social Health Activists) in Kerala have recently staged protests, demanding higher wages and retirement benefits.
Who Are ASHA Workers?
About:
ASHAs are community health volunteers introduced under the National Rural Health Mission (NRHM) in 2005 to provide essential healthcare services in rural areas. In 2013, NRHM merged with the National Urban Health Mission (NUHM) to form the National Health Mission (NHM).
ASHAs work alongside Anganwadi Workers (AWWs) under the Integrated Child Development Scheme (ICDS) to improve healthcare access.
An ASHA is typically a local woman (aged 25-45), preferably married, widowed, or divorced, with at least a Class 10 education. They are considered volunteers under NHM, receiving only task-based incentives, limiting their earnings.
There is one ASHA per 1,000 people, with 9.2 lakh ASHAs in rural areas and 79,900 in urban areas (as of 2022-23).
Key Responsibilities of ASHAs:
- Ensure antenatal check-ups and postnatal care, and educate mothers on breastfeeding and infant nutrition.
- Support immunization, tuberculosis (TB) treatment, malaria screenings, and disease prevention.
- Provide basic healthcare services, essential medicines, first aid, and report births and deaths.
Concerns of ASHA Workers:
- ASHAs receive low and irregular payments, ranging from approximately Rs 5,000 to Rs 15,000, with honorariums and task-based incentives that vary by state and are often delayed due to funding issues and Centre-State disputes.
- Despite their vital role during the COVID-19 pandemic, which earned them the WHO’s World Health Leaders Award in 2022, ASHAs continue to face challenges.
- ASHAs are not classified as government employees, so they are denied fixed wages, pensions, gratuity, provident funds, and medical insurance, although some states, like Andhra Pradesh, offer gratuity.
- The 2020 Parliamentary Standing Committee on Labour recommended formalizing their roles, but no action has been taken yet.
- ASHAs, largely women from marginalized backgrounds, also face gender-based discrimination in the workforce.
How Can ASHA Workers Be Empowered?
- Formalization: Recognizing ASHAs as government employees or at least contractual workers under the Code on Social Security, 2020, would ensure they receive essential labor rights and protections.
- Skill Development: Offering training programs would help ASHAs enhance their skills and transition into higher healthcare roles, such as Auxiliary Nurse Midwives (ANMs).
- Financial Security: In light of rising inflation, ASHA workers need financial security. A fixed salary, along with incentives, would ensure stability. Direct Benefit Transfers (DBT) could prevent payment delays, empowering them to focus on healthcare without financial strain.
National Health Mission (NHM)
The NHM aims to ensure universal access to quality, affordable, and equitable healthcare services, contributing to Sustainable Development Goal 3 (Good Health and Well-being).
Extended until 2026, NHM is implemented by the Ministry of Health and Family Welfare and assists States/UTs in providing accessible and affordable healthcare, with a focus on rural infrastructure, workforce, and service delivery.
Drishti Mains Question:
Discuss how ASHA workers contribute to achieving Sustainable Development Goal 3 in India.
UPSC Civil Services Examination, Previous Year Questions (PYQs)
Prelims
Q. With reference to the National Rural Health Mission, which of the following are the jobs of an ‘ASHA’, a trained community health worker? (2012)
- Accompanying women to the health facility for antenatal care checkup
- Using pregnancy test kits for early detection of pregnancy
- Providing information on nutrition and immunization
- Conducting the delivery of a baby
Select the correct answer using the codes given below:
(a) 1, 2 and 3 only
(b) 2 and 4 only
(c) 1 and 3 only
(d) 1, 2, 3 and 4
Ans: (a)
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