Context: ASHA (Accredited Social Health Activists) workers in Kerala are protesting for better wages and working conditions. Their work is critical for public health but remains undervalued due to its association with traditional gender roles.
Relevance of the topic:
Prelims: Key facts about Government Schemes, Welfare Programs, Social Issues
Mains: Can be used as an example in issues related to Health sector & Governance; Gender Issues in Employment.
Key Highlights of the Issue
- Gendered Assumptions: Women dominate state-run welfare schemes (E.g., Anganwadi, ASHA workers). Their work is considered an extension of domestic care, leading to undervaluation and low pay.
- Payment and Working Conditions:
- Despite WHO recognition (2022), ASHAs remain underpaid. Kerala pays ₹7,000 per month, among the highest in India, but still below the minimum wage for unskilled workers.
- Payments are often irregular due to dependence on central and state funding. Economic Survey (2022-23): India spends only 2.1% of GDP on healthcare, below the WHO-recommended 5%.
- No legal status as Workers: ASHAs are seen as "activists" rather than "workers", denying them labour rights. Despite their role in critical health interventions, they lack social security and job stability. ILO Recommendation (2018): Urged nations to formalise care workers, but India is yet to implement.
Demands of ASHA workers (in Kerala) include
- Formal worker status
- ₹21,000 honorarium
- ₹5 lakh as retirement benefits.
Benefits of Recognising ASHA Workers as formal workers:
- Financial Security : Regular wages instead of incentives. E.g., 63% care workers are Women (ILO Report 2021)
- Better Working Conditions: Formalisation would bring job security, healthcare benefits, and social security.
- Women Empowerment: Economic independence and dignity at work. E.g., Only 32% women earn their own income (NFHS-5 2021-22).
- Strengthened Healthcare System: Motivated workforce ensures better community health services. E.g., ASHA workers played an important role in COVID-19 response.
Way Forward
- Formalisation of ASHA Workers: Recognise them as public health workers under labour laws. Provide fixed salaries, job security, and social security benefits.
- Legal Recognition & Labour Rights: Implement ILO Convention 189 (Decent Work for Domestic Workers). Ensure EPF, ESI, and pension benefits.
- Timely and Increased Payment: Kerala Model: ₹21,000 minimum wage demand should be considered nationwide.
- Political and Social Awareness: Recognise unpaid and underpaid care work. NITI Aayog (2021): Recommended monetising unpaid care work to boost GDP.
ASHA workers are vital to India’s healthcare system but remain undervalued. As Amartya Sen highlights, true development expands freedoms, which includes fair wages and dignity at work. Formalising their roles, ensuring social security, and increasing healthcare investment will align with PM Modi’s vision of ‘Sabka Saath, Sabka Vikas’ and create a gender-inclusive, resilient public health system.