It is a long wait for better pay for hundreds of Accredited Social Health Activists (ASHAs) in Tamil Nadu. Starting with registration and follow-up of antenatal women, keeping track of immunisation of children to COVID-19 work in the last one-and-a-half years, the number of jobs they do has been increasing but their long-pending pleas for regularisation and better pay remain ignored.
Serving as one of the links with villagers in hilly and hard-to-reach areas, ASHAs have been demanding regularisation of jobs, fixed monthly pay of ₹18,000 and recognition for several years. Their monthly incentives range from ₹2,000 to ₹3,000, with some of them not paid on time in many districts.
Over the last one-and-a-half years, ASHAs were involved in COVID-19 work as well. The latest addition for ASHAs in a few districts are works under the State government’s flagship scheme – Makkalai Thedi Maruthuvam, a cross-section of them said.
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In comparison with other States, ASHAs are deployed in hill villages in Tamil Nadu, Vahidha Nizam, General Secretary of Tamil Nadu ASHA Paniyalar Sangam (AITUC) said, adding that there were 2,700 to 3,000 ASHAs working in hill and rough terrains.
“When the concept of ASHAs was introduced through the National Rural Health Mission, we opposed it as it took away the permanent nature of jobs. This meant that there will be no permanent workforce for rural healthcare and they introduced incentivisation. Ironically, ASHAs work 24 x 7 from monitoring pregnant women to ensuring institutional deliveries, postnatal care and child care. They take schemes of both the Central and State governments to the rural population, and should be a permanent workforce. What is pathetic is that they are not even recognised as a worker, and none of the governments are looking into this issue with seriousness,” she said.
An ASHA, who has been working since 2009, said a few years ago, the Central government announced a monthly minimum incentive of ₹2,000 for them but majority of them have not received the amount till date.
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Another ASHA in a southern district said they have not received incentives for June and July as officials said they do not have funds. “We have no fixed working hours. If a pregnant woman goes into labour, we have to take her to the nearest government hospital and follow-up. We get an incentive of ₹300 for antenatal registration, and another ₹300 if we motivate the pregnant woman to deliver in a government hospital. Again, an incentive of ₹300 is paid for 45-days postnatal follow-up and immunisation of the baby. But these incentives are not paid on time,” she said.
ASHAs were involved in COVID-19 work including Influenza-Like Illness survey and contact tracing of persons who test positive for COVID-19. “Only ASHAs were not listed as beneficiaries for the State government’s incentive for those involved in COVID-19 work,” she said.
Recently, ASHAs of Kolli Hills Block, covering Solagaadu, Pavarkaadu, Senthangkulam, Mullukurichi, Thenurpatti in Namakkal and attached to the association, submitted a petition to the Collector appealing to the State government to consider their long-standing demands. They pointed out that ASHAs were working in the State for the last 15 years but had no permanent jobs, no fixed pay and were considered as “volunteers”.
Noting that the incentives were pending for six months to one year in many districts, they demanded that the incentives should be paid by the 10th of every month.
Ms. Nizam added that they had submitted several representations to the State government. “We hope that ASHAs are among the health workers that the present government has assured to regularise,” she said.
“We have to go by foot to remote villages as there are no motorable roads with the risk of encountering wild animals. We continue to work despite the meagre pay. We continue to hold on to this job, hoping that our demands will be fulfilled one day,” another ASHA added.