Last Updated on November 21, 2023 by Neelam Singh
Nirmesh Tyagi from Meerut, Uttar Pradesh, has been working as an ASHA (Accredited Social Health Activist) worker since 2006. Initially focused on maternal care and child immunization, her workload escalated with the onset of the coronavirus pandemic. She now works tirelessly, from 5-6 am until late at night, sacrificing time with her family. Nirmesh highlighted the strain on ASHA workers’ married lives due to erratic hours and emergency labor interventions. The workload intensified post-pandemic, including infectious disease surveys, vaccination, and awareness programs, now documented digitally.
Despite their critical role, ASHA workers are paid meagerly—Rs. 2000 from the central government and Rs. 1500 from Uttar Pradesh government, with irregular payments and deductions for incomplete tasks. The challenges faced by Nirmesh echo across 1.6 lakh ASHA workers in Uttar Pradesh, prompting widespread protests for fair treatment. The Meerut ASHA workers’ association, ASHA & Sanginee Karmachari Sangh, organized a two-day protest in Lucknow, joined by around 10,000 ASHA workers, while district-level associations continue their advocacy.
The demands
ASHA workers are advocating for a more equitable fixed pay, expressing discontent over deductions for missed tasks that diminish their already meager earnings. Nirmesh cited an example where a failure to send campaign pictures to seniors results in a Rs. 500 deduction, highlighting the financial challenges they face. Despite rising living costs, their honorarium has seen minimal increments. During the pandemic, while the world stayed indoors, ASHA workers risked their lives on the ground, yet feel undervalued by the government. They emphasize the need for a fixed monthly salary of at least Rs. 15,000 and job permanency. Bhagvati from Ghaziabad, an ASHA worker since 2016, echoes similar sentiments. Beyond fixed pay, ASHA workers are also pressing for health insurance coverage from the government.
Security and transportation
ASHA workers face financial challenges related to travel, receiving no compensation for their expenses when moving between locations. Bhagvati suggests providing scooters to facilitate travel, especially as local transportation is often unavailable in villages, making extensive walking strenuous. Additionally, ASHA workers express concerns about personal safety during these travels, especially for female workers. Ombiri, another ASHA worker, highlights the risks associated with being a woman walking across villages, emphasizing the lack of respect and safety concerns. The absence of reporting mechanisms exacerbates the challenges faced by ASHA workers, who contend with potential dangers in isolated areas where crimes against women often go unnoticed.
The ASHA workers work all day and often during the night as mentioned above. “We need a fixed timing for work. We are women, our life is at risk when we are out at night,” said Nirmesh Tyagi.
Unheard voices
ASHA works have been praised at national and international level. However, on the ground they are struggling and protesting without getting their voices heard.
Late 2022, World Health Organisation (WHO) Director-General’s Global Health Leaders Awards has recognised ASHA’s work saying they play “crucial role in linking the community with the health system and ensuring that those living in rural poverty can access primary health care services.”
Even Prime Minister Narendra Modi was delighted about the recognition of ASHA workers by WHO. He even took to (then) Twitter (now X) and said that ASHA workers are at the forefront of ensuring a healthy India. Their dedication and determination are admirable.
Moreover, Uttar Pradesh chief minister Yogi Adityanath, according to news reports, also said that the ASHA workers are the backbone of the rural healthcare system.
However, their voices are falling on deaf ears. “We have been protesting in Meerut and Lucknow often for the last three years. We are meeting various authorities and officials for better pay and other benefits for ASHA workers. We have written to various people in power. But our efforts go in vain,” told an activist Aarifa Anjum, who works for the welfare of ASHA workers.
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