Every day, Malar (name changed) has to take an 8-km walk on an unmotorable stretch to reach a tribal hamlet. This has been her area of work for almost a decade. An ASHA (accredited social-health activist) worker, Ms. Malar neither minds the daily walk nor the distance; she carries out the many health-related tasks assigned to her. But what worries her is the poor pay and lack of recognition.
For hundreds of ASHA workers like Ms. Malar, it is a long wait for better pay. Even as their fight for minimum pay continues — their performance-based incentive is ₹1,500-₹2,000 a month — many of them have not received any amount in the last three to four months. The authorities have cited “insufficient funds” as reason for the same.
There are around 3,000 ASHA workers across the State. Their work in hilly and hard-to-reach areas include conducting follow-ups with pregnant women, including getting them registered for delivery at government set-ups, immunisation of children, checks on adolescent health, health education and community sensitisation. Presently, some of them are also engaged in COVID-19-related work, such as influenza-like illness survey.
“I have been working as an ASHA worker since 2010. I cover an interior tribal village that has no motorable road or transportation. So it is a 16 km walk to and from my house every day. My job includes identifying pregnant women, bringing them to antenatal clinics, their registration, taking care of the immunisation of children below the age of five, checking for adolescent anaemia, escorting pregnant women for delivery to government facilities, even during late hours, and visiting them for 42 days in the post-natal period. We continue to carry out these works but our demands have not been fulfilled,” Ms. Malar noted.
An ASHA worker in Kanniyakumari said, “We have not received pay for the last four months. When we asked, the office of the Deputy Director of Health Services told us that there were no funds. However, we have been working non-stop. We have been demanding a fixed pay of ₹18,000 a month but the government has not even considered our plea.”
An ASHA worker and district committee member of AITUC, B. Vasanthakumari, pointed out that earlier, incentives were granted for 32 tasks. “This has been brought down to nine, and in some districts, incentives are given only for seven to eight works now. In fact, ASHA workers in Kallakurichi and Villupuram have not received their monthly pay for the last seven months,” she said.
No takers for work
Another ASHA worker in Namakkal, on condition of anonymity, said that incentives for work, such as creating awareness on family planning and providing vitamin-A supplementation, had been stopped. “We have not received pay for three months. We have to take care of our family expenses. Whatever amount we used to receive is insufficient. As a result, many young girls are unwilling to join as ASHA workers or do not stay for long in the job,” she said.
G.R. Ravindranath, general secretary, Doctors’ Association for Social Equality, said the State government should fix minimum wages for ASHA workers and make their jobs permanent. “The incentives are not sufficient. The State government should fix a minimum wage of ₹15,000 to ₹20,000. They should be given special pay for COVID-19-related work,” he said.
A Health Department official, when contacted, said he would check on the issue of non-payment of incentives.