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Accredited Social Health Activists or ASHAs as popularly called are community health workers who are integral to India’s National Rural Health Mission rolled out in 2005. The aim of this project was to achieve ‘an ASHA in every village’. ASHAs are females chosen from within a locality, who are then trained towards promoting overall health and hygiene in their village. It is estimated that each ASHA looks after nearly a thousand families in her assigned unit. They are honorary volunteers who are entitled to monetary compensation.
The primary responsibility of an ASHA is micro-level care-giving. Her role includes bridging the gap between villagers and health services, raising awareness about health schemes and entitlements especially among the poor and the marginalised and promoting hygienic practices. It is every ASHA’s responsibility to mobilise collective action towards wellness. They are the interface of their assigned unit to our country’s health care system. ASHAs are also the localised facilitators of any health scheme introduced by governing bodies. They even facilitate vaccination, immunisation, access to contraceptive methods and child care programmes.
The primary challenge faced by many ASHAs today is untimely payment and inadequate wages. To worsen things, they suffer a pay cut if they take more than 10 days off. At present they receive RS 75 for immunisation, Rs.300 for escorting women to hospitals for child birth and Rs.1000 over the period of successful TB vaccination. During the Covid-19 pandemic, they are offered an additional Rs.1000. The roles of ASHAs have become manifold since the onset of the pandemic. Now they are additionally charged with screening, vaccination and spreading awareness of preventive measures such as masking and social distancing. They form an integral part of the frontline force whose tireless efforts and contribution are not appropriately compensated.
The absence of a proper transport system makes travelling difficult. ASHAs have to travel long distances to discharge their regular duties and the inconvenience causes wastage of time and human effort. ASHAs work only part-time and the allocation of duties should not impinge on their regular livelihood. But such inconveniences as improper infrastructure and uncooperative Panchayat bodies protract their volunteer hours to nearly full time.
It is irrefutable that ASHAs form the backbone of our rural health system. With the second wave of the pandemic ravaging rural India, these health workers risk their life as they battle Covid-19 on behalf of the government. They deserve much more than the current wages received. Moreover, the Code on Social Security, 2020 and The Code on Wages have failed to include ASHAs, denying them a guaranteed minimum wage. It is disheartening that these front line warriors, despite their mammoth contribution in the war against corona, are not recognised and duly compensated.