ASHA workers being Overworked and Underpaid

Context

Recently a study highlights the marginalization of ASHA workers for being Overworked and Underpaid. 

ASHA workers

• ASHA workers are volunteers from within the community who are skilled to provide data and aid people in getting access to services of various healthcare schemes of the government.
• They act as a bridge connecting marginalized groups with facilities together with primary health centers, sub-centres and district hospitals.
• The position of these network health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.

Eligibility for ASHA workers

• ASHA needs to primarily be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years.
• She ought to be a literate woman with due preference in selection to those that are certified up to 10th standard anywhere they are involved and to be had in suitable numbers.
• This may be comfortable only if no suitable person with this qualification is available.

Roles and duties of ASHA workers

• Facilitating access to health care services.
• Building awareness about health care entitlements in particular amongst the terrible and marginalized.
• Promoting healthy behaviors and mobilizing for collective movement for higher health outcomes.
• Meeting health care needs in the area.

Challenges faced by ASHA workers

• Triple Shift: ASHA workers undergo a triple shift encompassing duties at home, in the community, and at health centers, leading to severe exhaustion and time constraints.
• Layers of marginalization: ASHAs face intersecting power dynamics of gender, caste, and informal economic system, exacerbating their marginalization within the system.
• Limited Autonomy: ASHAs have limited control over their time, price range, and properly-being, highlighting their lack of autonomy in the healthcare system.
• Erratic Meals: ASHAs enjoy erratic meal schedules and frequently receive the least priority in meals allocation within their families, reflecting broader gender inequalities in India.
• Violence Embedded in Role: Economic, bodily, and psychological violence is embedded within the ASHAs’ position, perpetuated by a system that fails to understand their contributions.
• Occupational Hazards Denied: ASHAs are taken into consideration as volunteers and denied recognition as ‘workers’. Hence risks such as extreme heat, further compromising their health and safety.
• Vulnerability to Health Issues: Poor ingesting habits, irregular meals, and lack of nutritious meals make ASHAs susceptible to malnutrition, anemia, and non-communicable diseases.
• Financial Strain: ASHAs regularly experience behind schedule wages and incur out-of-pocket expenses for process-associated fees, diminishing their potential to have the funds for healthcare for themselves.
• Lack of Status as Healthcare Workers: ASHAs aren’t accorded the reputation of healthcare workers, which underpins most of the challenges they face in the system.

Government Steps

• In the Interim Budget 2024-2025, the Central government announced to offer loose medical insurance cover for all ASHAs and Anganwadi workers and helpers under the Ayushman Bharat Scheme. 
• In 2018, the Ministry of Health and Family Welfare approved an ASHA advantage package deal, imparting coverage for accidents, deaths and incapacity.

Way Ahead

• A chronic, systematic funding to reinforce the ASHA program is inextricably connected to advancing India’s child and maternal health consequences.
• Without coverage adjustments, ASHAs stay framed as mere volunteers, neglecting their rights and welfare. 
• India needs to acknowledge ASHAs as full-fledged workers, supplying them with respectable pay and right care to ensure their physical and emotional health, ultimately benefiting women, kids, and society as a whole.

Source: The Hindu

UPSC Mains Practice Question:

Q.With reference to the National Rural Health Mission, which of the following are the jobs of ‘ASHA’, a trained community health worker? (2012)

1. Accompanying women to the health facility for antenatal care checkup
2. Using pregnancy test kits for early detection of pregnancy
3. Providing information on nutrition and immunisation.
4. Conducting the delivery of 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

c. 1, 2, 3 and 4

Ans: “a”

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