Why society owes Asha workers a debt

The unsung heroes of the response to the Covid-19 pandemic have most definitely been the millions of frontline women workers, especially Accredited Social Health Activists (Ashas) who have been working tirelessly at the community level. They have engaged in numerous activities, ranging from doorto-door surveys, contact-tracing, awareness campaigns and ensuring quarantine/isolation. This is in addition to their regular roles, ranging from accompanying pregnant women to health centres, keeping track of immunisations, making home visits for new- born care and following up on tuberculosis patients.

Recently, these workers have been in the news for their strikes, demanding better payment, regularisation, access to personal protective equipment and free health care. Who are these women and are their protests, in the midst of the pandemic, justified?

Currently, there are about a million Asha workers who have been crucial in the efforts to decentralise health care and strengthen the primary health system. Their contribution to the increase in institutional deliveries, immunisations and decline in maternal and infant mortality has been widely noted. While each Asha worker can easily spend six to eight hours working in a day, she is not paid a regular monthly salary.

Instead, the central government has an incentive-based system in which, at the end of the month, each Asha worker is paid based on the basis of the tasks she has completed on a pro-rata basis. Following protests, recently the incentives were revised such that each worker can earn at least ₹2,000 per month. Some other tasks that Asha workers undertake such as conducting awareness campaigns are not listed as activities they are given incentives for, but they still do so as a commitment to the community. In contrast, the minimum wage for unskilled workers suggested by a governmentappointed expert committee in 2019 is ₹9,750 a month.

The story of almost 1.4 million anganwadi workers is no different. Although they do get a fixed monthly pay, they are treated as voluntary workers who receive an honorarium and not a salary. While the central government contributes ₹4,500 per month towards their pay, a number of states top this up with additional amounts though these are low. Just as the Ashas, the anganwadi workers play an essential role. They are responsible for nutrition services, including distribution of supplementary nutrition, growth monitoring and nutrition counselling along with providing preschool education.

For the additional work that Asha workers are now doing due to Covid-19, they have been promised an incentive of ₹ 1,000 per month. However, reports from most states are that they have not received this yet.

Further, reports suggest that, in many places, Asha and anganwadi workers work without any protective equipment such as masks or gloves while going door-to-door for surveys and other tasks, and in the process, are getting infected with the virus. Moreover, in many places, these workers face stigma from the community, with people not allowing them to enter their homes and abusing them when they try to collect personal details related to travel.

The way frontline women workers in our country are treated also points to the gendered nature of work itself. Many of the tasks that these women perform are perceived to be an extension of the care roles that they play within the household. The unequal distribution of care work within the family and the subsequent undervaluation of such work is extended to the community and the State.

Expanding better opportunities with decent wages for frontline workers could also contribute to the revival of the rural economy by putting wages into the hands of many, and take us closer to achieving our health and nutrition goals. This is important at a time when employment opportunities for educated rural women are so few.