This week, the World Health Organization (WHO) honoured India's one million all-women ASHA (Accredited Social Health Activist) workers for their outstanding contributions to advancing global health throughout the COVID-19 pandemic. ASHA workers are an essential bridge between the public health system and communities. They deliver essential primary health services in the areas of maternal and child health, sexual and reproductive health, mental health, communicable and non-communicable diseases, nutrition and are often the most accessible health worker in rural areas. They are often on standby 24/7 and regularly work more than 8 hours a day.
“We don't know what WHO is but we are thankful for the recognition of our hard work,” said Archana Mishra, an ASHA worker and a member of Hind Mahila Sabha union in Uttar Pradesh.
“We don't know what WHO is but we are thankful for the recognition of our hard work”
“Will this award help us to put food on the table for our families?” asked Reshma Adagale, an ASHA worker and a member of Nagpur Municipal Corporation Employees Union in Maharashtra, when she learned about the award.
ASHA workers are treated as volunteers or activists rather than public health workers and are remunerated around USD 500-800 per year. With rising costs and increasingly market-driven economies, the honorarium is far below the living wage calculated around USD 3500-4000 per year.
“ASHA workers are predominantly women from marginalised backgrounds who are expected to work for minuscule allowances, not wages. The idea that they should work without living wages is built around the gendered assumption that women will naturally contribute unpaid labour caring for communities. ASHAs are doing their job at the expense of their own welfare, livelihoods and insecure futures. The best reward they could receive is to be recognised as public health workers and paid accordingly,” said Kate Lappin, the Regional Secretary for Asia and Pacific at Public Services International.
“ASHA workers are filling the gap caused by under-funding of India's public health system, particularly in rural and marginalised communities,” said Abha Chaturvedi, President, Hind Mahila Sabha.
“ASHA workers are the most visible face of the public healthcare system in our country. Will WHO exhort its influence on the governments to formalise this precarious workforce and ensure dignity by recognising them as workers?,” asked Jammu Anand, President, Nagpur Municipal Corporation Employees Union.
"Will WHO exhort its influence on the governments to formalise this precarious workforce and ensure dignity by recognising them as workers?”
In December 2020, PSI affiliated ASHA workers joined hands with CHWs in Nepal and Pakistan to develop a regional joint charter of demands and launched a campaign “Community health work is work”.
The key demands of ASHA workers include: recognition as public health workers with payment of a living wage and Social Security Benefits; occupational safety and health protection with provision of safe and decent working conditions; and a people-centred healthcare system with allocation of at least 5 percent of the GDP to healthcare as mandated by WHO.
Banaani DekaProject Organiser, India
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Download photos of ASHA workers: https://www.flickr.com/photos/psiispiska/albums/72157712778386477
About Public Services International: PSI is a global trade union federation whose affiliates represent 30 million working women and men who deliver vital public services in 154 countries in both the public and private sector. The majority of our members work in the health sector.