ASHA workers and facilitators, considered the backbone of the country’s grassroots healthcare system, in an open letter to Union Health Minister JP Nadda, while thanking the government for inviting 250 of them for the Republic Day function, expressed anguish that they were still not recognised as “workers” and were deprived of social security and other benefits.

The AWFFI open letter urged the government to provide a “dignified life and statutory rights”, not just “honour” and reminded the Health Minister that their piece-rated incentives, at around Rs 2,000/month, were last revised 10 years ago, in 2010.

“Isn’t it shameful for our republic which completed 75 years, that the ASHA workers who are working among the people even at the outbreak of pandemics and communicable diseases even without adequate safety gear, are not recognised as employees or workers but are considered ‘volunteers’ and get only piece rate wages called incentives and the assured incentives are only Rs.2000 a month. There is no social security for them, no health insurance and not even maternity leave! We would like to remind you as the minister and the health secretary that the piece rated incentives were last revised in 2010!”

Read the full letter below:

Open Letter to the Health Minister of India

To

Shri J P Nadda

Honorable Minister of Health and Family Welfare

Government of India

Sub:- ASHA Workers deserves a dignified Life with statutory Rights not only ‘Honour’

Dear Sir,

We, the ASHA Workers’ and Facilitators’ Federation of India (AWFFI), the largest trade union federation of the ASHA workers, as the representatives of them would like to thank you, the Health Secretary and the Government of India for inviting ASHA workers as special guests in the 76th Republic Day celebrations in Delhi to ‘honour’ our contribution. We also recall that around 300 anganwadi workers were similarly ‘honoured’ last year on Republic Day.

As per the statement by the Health Secretary, the Health Ministry of Government of India had invited 250 ASHA workers with their spouses from various States as special guests to join the Republic Day celebrations in Delhi, although the criteria for selection is unknown to us.

It is heartening that the Health Secretary acknowledged in the press briefing that the ASHA workers are the backbone of the health sector across the country and display the Nari Shakti (women empowerment). She also mentioned that the ASHA workers are doing incredible job for eradication of Tuberculosis (Tuberculosis Elimination Mission), not only that, the health system of the entire country is now mostly dependent on their efforts, especially in maternal and child care and combating infectious diseases. The selfless dedicated work of ASHA workers during the COVID-19 pandemic, received international recognition by WHO which honored ASHA workers of our country as ‘Global Leaders’.

You may also agree that the around ten lakh twenty nine thousand ASHA workers and facilitators working sincerely across the country deserves a dignified life with statutory rights not only ‘honour’. Isn’t it shameful for our republic which completed 75 years, that the ASHA workers who are working among the people even at the outbreak of pandemics and communicable diseases even without adequate safety gear, are not recognised as employees or workers but are considered ‘volunteers’ and get only piece rate wages called incentives and the assured incentives are only Rs.2000 a month. There is no social security for them, no health insurance and not even maternity leave! We would like to remind you as the minister and the health secretary that the piece rated incentives were last revised in 2010!

Don’t you think it is high time they must be recognised as workers, pay minimum wages and social security and pension as per the recommendation of the 45th Indian Labour Conference (ILC) back in 2013.  

We would like to bring to your notice that even the meagre remuneration for the ASHA workers and facilitators are pending for months in most of the states as the Union Government do not release the funds on time. Scores of ASHA workers sacrificed their lives and the lives of their dear ones during the Covid pandemic, most of their heirs are yet to get the death compensation; the ministry do not have even the record of the number of casualties.

Such ‘honouring’ programmes organized by the Government without addressing the fact that ASHA workers and facilitators are being deprived of their rightful dignity and entitlements will be ridiculed by the ASHA workers and the public.

We hope that your government will really honour the dedicated work of the ASHA workers and Facilitators and take measures to ensure a dignified life with statutory rights at work in the Union Budget 2025-26 which will be placed in a couple of days. ASHA Workers and Facilitators Federation of India is urging the Union Government to increase the financial allocation for the National Health Mission in the ensuing Union Budget 2025 and to take immediate measurers to regularise the ASHA workers and facilitators as government employees with all statutory benefits.

Madhumita Bandyopadhyay

General Secretary, AWFFI

Courtesy: Newsclick

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The Kolkata rape and murder case, a 31-year-old trainee doctor who was brutally raped and killed by a civic volunteer at the campus of Kolkata’s RG Kar Medical College and Hospital on August 9, 2024 is only one among the recent of horrific such crimes in a country that records 86 or 87 rapes every day. (Details can be read here) The young doctor was attacked while on night duty. Her body was found the next morning, bearing severe injuries to her eyes, face, mouth, neck, limbs, and private parts. The violence and brutality that the deceased had to suffer at the hands of the accused shocked the nation and led to widespread calls for vengeance and justice. Thousands of doctors and other medical staff had, thereafter, taken to the roads to protest the increasing instances of violence against medical professions, especially women, and to demand stringent laws providing for their safety.

The Supreme Court had, on following the nationwide outrage, taken suo-moto cognisance of the Kolkata rape and murder case, on a Sunday, August 18, and the bench of comprising Chief Justice of India DY Chandrachud, Justices JB Pardiwala and Manoj Misra heard the matter on August 20 and over the next days. The Supreme Court had reportedly said that “The reason why we have decided to take this suo moto matter is because this is not a matter related to a particular murder which took place in a hospital in Kolkata. It raises systemic issues related to the safety of doctors across India.”

In the first order issued by the bench on August 20, the bench directed the prompt establishment of a “National Task Force” (NTF) comprising of medical professionals to give recommendations –within three months–on the modalities to be followed all over the country to ensure the safety of medical professionals in their work spaces. The bench noted that several states such as Maharashtra, Kerala, Telangana, West Bengal, Andhra Pradesh, Tamil Nadu etc. have framed state laws to deal with violence against doctors. However, these laws do not address deficiencies in institutional safety standards. “Therefore, we must evolve a national consensus. There must be a national protocol to create safe conditions of work. If women cannot go to a place of work and feel safe, we are denying them equal opportunity. We have to do something right now to ensure that the conditions of safety are enforced,” CJI had orally stated during the highly publicised hearings.

It is essential to note that the said National Task Force will constitute a total of ten members (details below). The order provided that the NTF will be headed by Surgeon Vice Admiral Arti Sarin AVSM, VSM. Director General Medical Services (Navy). The other members of the task force are Dr D Nageshwar Reddy, Chairman and Managing Director, Asian Institute of Gastroenterology and AIG Hospitals, Hyderabad, Dr M Srinivas, Director of Delhi-AIIMS, Dr Pratima Murthy, Director, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Dr Goverdhan Dutt Puri, Executive Director, AIIMS Jodhpur, Dr Saumitra Rawat, Chairperson, Institute of Surgical Gastroenterology, GI and HPB Onco-Surgery and Liver Transplantation and Member, Board of Management, Sir Ganga Ram Hospital, New Delhi. In addition to this, the NTF will also include Professor Anita Saxena, Vice-Chancellor, Pandit B D Sharma Medical University, Rohtak, former Dean of Academics, Chief Cardio thoracic Centre and Head Cardiology Department AIIMS, Delhi, Dr Pallavi Saple, Dean, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, and Dr Padma Srivastava, formerly Professor at the Department of Neurology, AIIMS Delhi.

The bench said the cabinet secretary and the home secretary to the Union government, secretary, Ministry of Health, chairperson, National Medical Commission and president, National Board of Examinations shall be the ex-officio members of the task force.

The bench has also directed that the NTF formulate an action plan under two sub-heads –Preventing violence, including gender-based violence against medical professionals; and providing an enforceable national protocol for dignified and safe working conditions for medical professionals.

The intervention of the SC and formation of the National Task Force has been hailed by many as a significant step towards ensuring the safety of the medical professionals as well as changing the scenario of impunity and lawlessness when it comes to committing violence against medical staff.

While it is certainly a step in the right direction, such a significant move has unfortunately excluded a large section of health care professionals hailing from the informal sector. Despite a wider definition by the World Health Organisation (WHO) on who constitutes health workers, it appears that this vast network of women health workers in urban and rural India may not figure at all, especially as their work situations are not structured and easy to find solutions for.

The order specifies that the medical professions being referred to in the order are only interns, residents, senior residents, doctors, nurses and all medical professionals. This further begs the question of The same brings us to the question of whether, by limiting the ambit of the NTF to the aforementioned medical staff, the Supreme Court has implied that the issue of violence against medial professions is an issue of concern or restricted to only middle class workspaces and urban areas, when predominantly informal workers in the cities and health workers in rural areas –such as Accredited Social Health Activists (ASHA workers) and Anganwadi workers and gender violence issues faced by them –will not be looked into by the NTF?

The World Health Organization (WHO) defines health workers as people who work to improve health, including doctors, nurses, midwives, and other professionals. The same also includes health sanitation workers. The WHO classifies health workers into five broad categories: health professionals, health associate professionals, and personal care workers in health services, health management and support personnel, and other health service providers. Despite this, the said order of the Supreme Court overlooks the equally critical and vulnerable segment of rural health workers, including Anganwadi workers and Accredited Social Health Activists (ASHA).

Who are India’s ASHA workers? Employed under the Ministry of Health and Family Welfare since 2005—over 10.52 lakh ASHAs (2022 figures) who are trained female community health activists from our village communities who are those that reach our communities on basic public health.[1] Besides Anganwadi workers and helpers are part of the union government’s “services’ programme though there have been demands for regularisation and de-casualisation of their work. They provide and reach early childhood care, pregnant women and lactating mothers, monitor children’s growth and –with healthcare professionals—also reach and provide health needs like primary healthcare, referral services and immunisation. Presently, India has close to 12,93,448 Anganwadi workers and 11,64,178 Anganwadi helpers, not an insignificant number.

These individuals, who are the backbone of rural healthcare, face not only violence but also systemic neglect, low pay, and lack of support, making their struggles invisible in the broader discourse. While formal sector medical professionals receive attention and advocacy, the plight of these rural workers remains largely unaddressed, highlighting a glaring disparity in how we value and protect different tiers of our healthcare system. With a significant section of the medical staff absent from even being considered by a task force established especially to consider the concerns raised by medical professionals. Can safety be ensured for those in the medical fraternity of India without ensuring that those who are the most marginalised, ignored and vulnerable are excluded from being granted protection?

Details of the Supreme Court order:

The Supreme Court observed in its order that Medical Associations have persistently highlighted the lack of workplace safety in healthcare institutions.  Noting that medical professionals, including doctors, nurses, and paramedic staff, have increasingly become targets of various forms of violence while carrying out their duties, the intervention of the Supreme Court thereafter outlines a solution. With hospitals and medical facilities operating 24/7, these professionals work tirelessly around the clock. The unrestricted access to all areas within healthcare institutions has further exposed them to potential threats. In moments of distress, patients’ relatives often hastily blame unfavourable outcomes on the perceived negligence of medical staff, exacerbating the vulnerability of those dedicated to saving lives.

Specifically referring to the difficulties faced by women, the order stated “Women are at particular risk of sexual and non-sexual violence in these settings. Due to ingrained patriarchal attitudes and biases, relatives of patients are more likely to challenge women medical professionals. In addition to this, female medical professionals also face different forms of sexual violence at the workplace by colleagues, seniors and persons in authority. Sexual violence has had its origins even within the institution, the case of Aruna Shanbag being a case in point. There is a hierarchy within medical colleges and the career advancement and academic degrees of young professionals are capable of being affected by those in the upper echelons. The lack of institutional safety norms at medical establishments against both violence and sexual violence against medical professionals is a matter of serious concern.” (Para 7)

According to the judges of the Supreme Court, the issue of safety of medical professionals goes beyond merely protecting doctors; rather it is to be taken as a matter of national interest to ensure the safety and well-being of all health providers. The court noted in its order that as more women enter the workforce in advanced fields of knowledge and science, it is crucial for the nation to guarantee safe and dignified working conditions. The constitutional principle of equality mandates this, leaving no room for compromise on the health, safety, and well-being of those who care for others. The bench then states that the nation cannot afford to wait for a tragedy, such as a rape or murder, before implementing real and necessary changes.

The order stated “The constitutional value of equality demands nothing else and will not brook compromises on the health, well-being and safety of those who provide health care to others. The nation cannot await a rape or murder for real changes on the ground.” (Para 7)

In the present order, the bench led by CJI Chandrachud identified several critical issues affecting medical professionals:

1. Medical staff on night duty often lack adequate rooms for rest, with no separate facilities for men and women.
2. Interns, residents, and senior residents are frequently subjected to 36-hour shifts in environments lacking basic hygiene and sanitation.
3. The absence of security personnel at hospitals is more common than not.
4. Medical professionals often face inadequate toilet facilities.
5. Housing for medical staff is often located far from hospitals, with insufficient transportation options.
6. Many hospitals lack properly functioning CCTV cameras for monitoring.
7. Patients and their attendants have unrestricted access to all areas of the hospital.
8. There is a lack of screening for weapons at hospital entrances.
9. Hospital premises are often dingy and poorly lit.

The bench has ordered the constitution of a ten-member National Task Force so that a national consensus can be reached—through thorough consultation with all stakeholders—on the urgent need to establish protocols addressing the issues being faced by the medical fraternity.

Through its order, the bench empowered the NTF to make recommendations on all aspects of the action-plan on preventing violence and providing an enforceable national protocol for dignified and safe working conditions, as well as any other aspects which the members seek to cover. The order further noted that “The NTF shall also suggest appropriate timelines by which the recommendations could be implemented based on the existing facilities in Hospitals. The NTF is requested to consult all stake-holders.” (Para 14)

The Ministry of Health and Family Welfare will provide all logistical support including making arrangements for travel, stay and secretarial assistance and bear the expenses of the members of the NTF, the order stated.

As a part of clarification of who all will fall under the phrase medical professionals, the order stated that “It is clarified that the phrase medical professionals used in this judgment encompasses every medical professional including doctors, medical students who are undergoing their compulsory rotating medical internship (CRMI) as a part of the MBBS course, resident doctors and senior resident doctors and nurses (including those who are nursing interns).” (Para 13)

The complete order may be read below:

It is pertinent to highlight here that previously, in the month of July of 2024 itself, the Supreme Court bench of Justices Sanjiv Khanna, Sanjay Karol and Sanjeev Kumar had refused to entertain a petition filed by the Delhi Medical Association (DMA) seeking measures to prevent violence against doctors by observing that legislations are already in place. Moreover, the bench had clarified that the petitioners were at liberty to approach the concerned courts in respect of particular instances of violence. Thus, within a period of a month, the Supreme Court went from dismissing the issue of violence against doctors and medical staff by observing it as individual cases to the same being a “systemic” concern, following the outrage in the Kolkatta murder-rape case.

The order may be read here:

“Systematic” exclusion?

Healthcare workers (HCWs) are individuals who deliver care and services to the sick and ailing. This involves team effort from doctors, nurses, laboratory technicians, pharmacists, ambulance drivers, medical waste handlers, Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), Anganwadi workers and several others. ASHAs, ANMs and Anganwadi workers form an integral part of the grassroots-level health workers under the National Health Mission.  As part of the government’s National Rural Health Mission (NRHM), a new group of baseline health workers called Accredited Social Health Activists (ASHA workers) was formed in 2005 to address health related demands of the rural population, especially women and children, who find it arduous to access basic health services.

In the ongoing conversations about the protection and recognition of healthcare professionals, the vital contributions of ASHA (Accredited Social Health Activists) workers, Anganwadi workers and sanitation workers are often marginalised, overshadowed by the focus on urban and elite doctors. These individuals are the cornerstone of India’s rural healthcare system, delivering essential services to some of the country’s most remote and underserved populations. Yet, despite their critical role, they are largely excluded from the protections, benefits, and honour that are routinely extended to their urban and formal sector counterparts. This exclusion highlights a deep-seated inequality within the healthcare system, where the labour of rural health workers is undervalued and their safety and well-being are neglected.

ASHA workers and Anganwadi workers, who are exclusively women, operate under some of the most challenging conditions imaginable. ASHA workers, for instance, are often responsible for covering large geographic areas, traveling on foot to visit households, educate families on health practices, and provide crucial services such as immunizations, prenatal care, and family planning. These tasks are physically demanding, and ASHA workers frequently face long hours without adequate rest or compensation. In some regions, they are expected to work for less than the minimum wage, a paltry sum considering the importance and intensity of their work. Anganwadi workers, who run rural childcare centres and play a pivotal role in early childhood development, face similar hardships. They manage not only the educational needs of children but also their nutritional and health needs, often without adequate infrastructure or support.

The vulnerability of these workers is further exacerbated by the lack of formal employment status. ASHA and Anganwadi workers are often classified as “honorary” or “voluntary” workers, which means they do not receive the same benefits as formal employees, such as health insurance, pensions, or job security. This classification leaves them in a precarious position, where they are expected to perform essential public health functions without the protections that should accompany such responsibilities. In addition, they are frequently exposed to violence and harassment, both from the communities they serve and from within the healthcare system itself. Instances of ASHA workers being attacked or threatened while conducting COVID-19 tracing or vaccination drives have been reported across several states, including Uttar Pradesh, Bihar, and Maharashtra. Similarly, Anganwadi workers often face neglect and abuse from families who do not fully understand or appreciate their role, yet they continue to work under these difficult conditions with little acknowledgment.

When it comes to the violence that Anganwadi workers and ASHA workers face, the data is scarce. However, even the minimal data shows that there is a severe problem. A 2016 mixed-method study involving 396 ASHA workers from rural Northern Karnataka found that 94% of participants had experienced violent incidents in the preceding six months. Similarly, a study conducted in Kashmir during the 2010 unrest, which focused on 35 ambulance drivers, revealed that 89% of those interviewed had faced more than one incident of physical harm, 54% had suffered physical assault, and 83% had experienced job-related psychological trauma. Despite the presence of a significant number of ASHA workers, Anganwadi workers and other informal medical workers and aides in India, there is a glaring lack of comprehensive studies investigating the violence they face. The scarcity of data highlights the profound gap in understanding and addressing the risks these essential workers’ encounter. These studies also provide that the violence that these workers face stems from failures at multiple levels. Grassroots and mobile workers, who operate outside of health facilities, lack any form of security, while those stationed at health facilities receive only minimal protection. Owning to a lack of research on this issue, more recent figures could not be quoted.

Despite these overwhelming challenges, ASHA and Anganwadi workers have been resolute in their fight for better working conditions and fair treatment. Over the years, they have organized numerous protests, strikes, and campaigns to demand higher wages, job security, and formal recognition of their roles. In 2020, thousands of ASHA workers went on strike across the country, demanding a fixed monthly salary of ₹10,000 and better protective equipment during the COVID-19 pandemic. Anganwadi workers have similarly taken to the streets, protesting against the inadequate wages and lack of support from the government. Their struggles have led to some victories, such as wage increases in certain states and greater visibility of their demands in public discourse. However, these gains are often piecemeal and do not address the systemic issues that continue to marginalize these workers.

The exclusion of ASHA and Anganwadi workers from the protections and accolades afforded to doctors and other medical professionals indulged in the formal sector is indicative of a broader systemic inequality within India’s healthcare system. While doctors and hospitals that are urban and in the formal sector receive government attention and resources, the women who provide essential healthcare in rural areas are left to fend for themselves. This disparity not only undermines the health and well-being of ASHA and Anganwadi workers but also threatens the overall effectiveness of India’s public health efforts. For the healthcare system to function equitably and efficiently, it is imperative that these workers receive the recognition, protection, and compensation they deserve.

In addition to this, the exclusion of informal sanitation workers from the protections and recognition given to other healthcare professionals further underscores the deep inequities within India’s labour force. These workers, often operating in hazardous conditions with little to no safety equipment, are responsible for some of the most crucial yet dangerous tasks in maintaining public health. They handle the cleaning of sewers, public toilets, and waste disposal sites, tasks that expose them to harmful pathogens, toxic substances, and life-threatening situations daily. Despite their critical role in preventing disease outbreaks and ensuring public hygiene, they remain invisible in the broader narrative of healthcare protection and support.

Informal sanitation workers hail from the most marginalised communities and are trapped in a cycle of poverty and discrimination. They work without proper training, protective gear, or job security, making them extremely vulnerable to injuries, infections, and even death. The risks they take are immense; it is not uncommon for sanitation workers to suffocate or drown in poorly ventilated and hazardous environments such as septic tanks and sewers. One keeps hearing of there being numerous reports of sanitation workers dying due to asphyxiation while cleaning septic tanks, a task often performed manually in the absence of mechanized alternatives. Despite these dangers, they receive minimal compensation and are often denied basic rights like healthcare, insurance, and pensions. Their exclusion from national safety protocols and labour protections is a stark reminder of the systemic neglect faced by the most vulnerable workers in India’s public health infrastructure.

As India a as country continues to address the safety and well-being of medical professionals, we must also confront and correct the disparities that leave rural health workers vulnerable and marginalized. If our efforts to enhance safety and protection focus solely on more visible or privileged segments of the healthcare workforce, we risk perpetuating existing inequalities and leaving behind those who are most in need. Ensuring the protection and empowerment of ASHA workers, Anganwadi workers and informal sanitation workers is not just a moral obligation; it is crucial for the success of India’s public health system. Their work is indispensable, and their contributions should be recognized and valued as such. The time has come for a comprehensive approach that ensures their rights, safety, and dignity, aligning the nation’s healthcare system with its constitutional commitment to equality and justice for all.  For true progress, our reforms must extend beyond just some more visible and central urban centres and formal sectors to encompass semi-urban, non-formal and rural healthcare workers, such as ASHA and Anganwadi workers, and informal sanitation staff. By acknowledging and addressing the unique challenges faced by these essential yet overlooked groups, we can create a more inclusive and equitable system that genuinely safeguards all those who dedicate their lives to public health. Only through such comprehensive and compassionate measures can we hope to achieve a truly effective and just response to violence against healthcare workers.

[1] Despite long standing demands for being recognised as government workers, ASHAs are not instead classified as holding an “honorary/volunteer” position. They serve populations of approximately 1,000 in rural areas and 2,000 in urban settings.

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“Peacefully raising voice against ongoing exploitation is undemocratic these days. You will not only be entangled in the FIR and litigation for protesting but also can be terminated over false allegations to suffer,” said ASHA workers from Gwalior, Rajni Meena (39) and Menaf Khan (35), speaking about their termination.

ASHAs are community health workers employed by the Ministry of Health and Family Welfare as a part of India’s National Rural Health Mission to deliver doorstep health services to pregnant women and toddlers around the clock. Each ASHA worker draws a monthly payment of Rs 2,200 in Madhya Pradesh and incentives of over Rs 4,000 based on their performance.

When the COVID-19 pandemic hit the country, ASHA workers emerged as the strongest frontline health workers linking the community with the health system in the midst of the outbreak. Their efforts were recognised by the World Health Organisation. ASHAs were one of the six recipients of the WHO’s Global Health Leaders Award-2022 which recognises leadership, contributions to advancing global health, and commitment to regional health issues.

CM Shivraj Singh Chouhan too honoured ASHAs with kind words on several occasions for their contribution to controlling the pandemic. Yet, they are facing termination for a wage hike protest.

Meena and Khan – who have been working as ASHA workers since 2013 in Gwalior Urban – are among the 25 workers who were terminated. The reasons for termination were either being non-performers or that their names surfaced in an FIR lodged against 10 women for protesting at Chief Minister Shivraj Singh Chouhan’s Gwalior event on April 16, 2023, when they were not allowed to meet him.

Speaking to NewsClick, Manish Sharma, Chief Medical Health Officer, Gwalior confirmed, “Ten ASHA workers were sacked after their names surfaced in the FIR and 15 workers were terminated for negligence or non-performance.”

Menaf and Rajni are single mothers. Menaf has a 14-year-old son and Rajni is a mother of two teenage sons. After losing their jobs, both independent women are not only struggling to make ends meet but also worried about their children’s future. “One knows how society stigmatises single mothers. After termination, our struggle has worsened,” said Rajni.

Since 2018, around 84,000 ASHA workers in Madhya Pradesh have been facing challenges in their pursuit of a wage hike similar to their counterparts in states like Chhattisgarh, Telangana, and others. These states provide their ASHA workers with a monthly wage of Rs 10,000, in addition to incentives.

After several protests, strikes, and assurance from the government, when their demands were not met, a group of ASHA workers went on an indefinite strike from March 15, 2023, in Gwalior after taking formal permission in a bid to put pressure on the government.

When the state government and the officials did not pay heed to the strike, they sought permission from the Gwalior district administration to meet Chief Minister Shivraj Singh Chouhan, who was scheduled to visit the city on April 16 for ‘Ambedkar Mahakumbh’ to mark the birth anniversary of B R Ambedkar.

A day before CM Shivraj Singh Chouhan’s visit, a news report on a YouTube channel elated the protesters. In the news video, CM Chouhan, while addressing government officials, is heard saying that the government is going to fulfil the demands of Rozgar Sahayak, Panchayat Sachiv, Anganwadi workers, ASHAs, USHAs, Patwari and others soon.

The two-minute video news concluded with the claim that the CM is going to make big announcements in Gwalior including a wage hike for ASHA workers. A bunch of upbeat protestors turned up at the event the following day with prior permission, anticipating an announcement by the CM. But their balloon of excitement burst when CM Chouhan did not make any announcement related to wage hikes but promoted the recently launched Ladli Behna Yojana. The scheme which was launched for women voters ahead of the Assembly polls scheduled in November this year, offers Rs 1,000 a month to women aged between 23 to 60.

The protesters pleaded with the officials present to allow them to meet the CM to hand over their memorandum of demands. But this request was turned down. This allegedly upset the ASHA workers who raised slogans for a wage hike during the event. In the subsequent minutes, they were dragged out of the pandal, allegedly manhandled and booked for creating a ‘riot’ and behaving indecently at CM’s event.

“A group of women from Bhind district, distressed with penury created a ruckus when CM passed them over without listening to their demands. They were in plain clothes, unlike ASHA workers who were wearing uniform saree. The police mistook them as one of us and blamed ASHA workers for the whole episode,” explained Laxmi Kaurav, president of the ASHA/USHA State Shramik Sangh.

Over two dozen of the protesters received ‘show cause’ notices following the CM’s event. “Officials used this episode to quell the voices of ASHA workers who were on strike. They also sacked key protestors who were vocal with their demands,” Laxmi added.

The police booked 10 ASHA workers under Sections 147 (Riot) and 341 (wrongful Restraint) of the IPC on the same day. “Menaf Khan, who was at home because of fasting (Ramazan) was also wrongly named in the FIR. She was terminated without investigation which shows an attempt to target those who have been vocal about the wage hike demand,” lamented Rajni Meena, speaking to NewsClick. “She is among the best ASHA workers in the state. She has won many awards and appreciation from the government.”

Yet, the protest continued the next day. The FIR and show cause notices did not deter the protestors and it continued till May 15. After 62 days of protest, the ASHA workers called off the strike giving a window of over a month to the government. They submitted their demands including revoking the termination of ASHA workers at the CM House in Bhopal.

“We have submitted our memorandum in the presence of ACS Health Mohammad Suleman, Union Minister Narendara Singh Tomar, Jyotiraditya Scindia, Energy Minister from Gwalior Praduman Singh Tomar and others. Our demands seem to have fallen on deaf ears,” said Kavita Solanki, president of the Left-backed ASHA workers’ union.

ASHA workers claimed that they have not received their salaries or incentives since January 2023 and they are working without pay.

“The show cause notice mentioned laxity and negligence towards the work when we were on the strike. But the termination letter says that they were sacked for the fallout of the FIR,” Laxmi contended.

CMHO Manish Sharma admitted that the ASHA workers went on the strike with prior information.

“Can an employee be sacked over false FIRs?” asked Laxmi. “Dozens of FIRs under serious charges are lodged against IAS, IPS officers and senior bureaucrats. Yet, they enjoy their posts. But ASHA workers were made scapegoats for demanding a wage hike in the election year.”

Menaf and Rajni who are looking for private jobs to make ends meet are worried about their children. One has taken a loan from a relative to put food on the plates of their children and another has become dependent on their aged parents.

When asked about their termination, CMHO Sharma said, “We have already started the process to fill those vacant posts. The complaints were pouring in against them that they were not performing their duties properly lately.”

Speaking to NewsClick, Menaf said, “On the one hand, CM Chouhan claimed to have been empowering women with Ladli Behna Yojana and self-help groups and on the other hand, their erring officials have terminated Ladli Behnas for demanding a wage hike.”

Courtesy: Newsclick

The post ASHA Workers ‘Pay Price for Protest’: 25 Terminated, 10 Booked for ‘Rioting’ in Madhya Pradesh appeared first on SabrangIndia.

Kurukshetra: As many as 300 Accredited Social Health Activist (ASHA) delegates from 20 states across the country gathered here on Friday for a three-day conference that will see the formation of a first-of-its-kind national federation of all-female primary health workers, who have been on the frontline in combating the COVID-19 pandemic.

The conference, which saw the participation of leaders of ASHA workers’ and facilitators’ unions, affiliated with the Centre of Indian Trade Unions (CITU), on its first day, commenced with the demand for ‘better health for all by strengthening the country’s public health infrastructure.’

The women also sloganeered to intensify the struggle to turn National Health Mission (NHM) into a sustainable programme.

Envisaged first under the National Rural Health Mission (NRHM), which was subsequently extended also to cover the urban areas in 2013, ASHAs are community health volunteers acting as a critical link between the government’s healthcare system and the community. 

Their tasks include, among others, mobilising the community and facilitating people’s access to health and related services, spreading awareness, and even acting as care providers to pregnant women and children requiring treatment.

Currently, there are nearly 10 lakh ASHAs in the country. Bereft of the ‘worker’ status, under the NHM, the all-women volunteers are entitled to task-based incentives for more than 60-odd activities, as listed by the Central government. In addition, they also receive an incentive worth Rs. 2000 for a set of routine activities from the Centre; over and above this, the different State governments are also allowed to fix a monthly payment for the ASHAs.

On Friday, the leaders gathered in Haryana’s Kurukshetra, rued that even as ASHAs have been playing a crucial role in strengthening the public health system and more so, played an important role in assisting the government machinery to restrict the spread of Covid-19 in the country since 2020 – for which, they were also recognised by the World Health Organisation (WHO) – the long-pending demands of the ASHAs remain unaddressed.

“ASHA workers fought a vigorous fight against Corona (Covid-19) in the country and also fought for their rights during this time. For many years, ASHAs have been pressing particularly for regularisation of their services with regular salaries and due respect in view of their tremendous work,” K Hemalata, national president, CITU said while addressing the congregation during the first session on Friday.    

K Hemlata, national president of CITU, said that it is time that the struggle of ASHAs is intensified. Image clicked by Ronak Chhabra.

She added that it is time that the struggle for the same is intensified, for which a national federation of the ASHAs will now be formed.

Dr O.P. Lathwal, former Director of Health Services in Haryana, who was the chairman of the opening session on Friday, extended his support for the demands of the ASHAs. He also highlighted that the social health activist movement in the country “owes its birth to the efforts and campaign” by organisations like Jan Swasthya Abhiyan (JSA) and Peoples Health Movement (PHM).

“Moving forward,” Lawal said, “we must now combine ASHAs’ demands with the demands for people’s health which is the only guarantee for the success of their struggle. The ASHAs’ struggle must also focus on the social determinants of health such as food security with the expansion of Public Distribution System (PDS), safe drinking, water supply, sanitation, hygiene, housing employment and others.”

Jagmati Sangwan of All India Democratic Women’s Association (AIDWA) said that the fight of ASHAs is also the “fight of every other woman in the country for a respectable position in the society.” On Friday, other speakers at the conference included leaders of the All India State Government Employees Association, Sarv Karamchari Sangh – Haryana, and JSA, among others. During the first session, a resolution to oppose the privatisation of healthcare was also adopted.

Speaking to NewsClick on the sidelines of the conference, A R Sindhu of the existing All India Co-ordination Committee of ASHA Workers, said discussions will be held among the delegates for the next three days after which a joint demand charter will be adopted by the newly formed national federation, which is proposed to be named, ASHA Workers’ and Facilitators’ Federation of India (AWFFI).

“Currently, there is a national federation of anganwadi workers and mid-day meal workers. And now, a federation on similar lines for ASHAs is also going to be formed,” Surekha of Haryana ASHA Workers’ Union told NewsClick on Friday. Anganwadi workers are envisaged under Saksham Anganwadi and Poshan 2.0 scheme (erstwhile, Integrated Child Development Scheme), while mid-day meal workers are part of the PM Poshan (earlier known as school Mid Day Meal scheme).

Asked about future programmes, Surekha said that a call for a joint national campaign of all the scheme workers in the country is expected to be given at the end of the three-day conference. “We will be fighting together for our legitimate demands,” she said.

Courtesy: Newsclick

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The World Health Organisation (WHO) on May 23, 2022 awarded India’s Accredited Social Health Activist (ASHA) workers with the ‘Global Health Leaders’ title. However, while masses including Prime Minister Narendra Modi showered praises, unions asked when the Government of India will similarly award the workers with basic rights.

“ASHA (which means hope in Hindi) are the more than one million female volunteers in India, honored for their crucial role in linking the community with the health system, to ensure those living in rural poverty can access primary health care services, as shown throughout the Covid-19 pandemic,” said the WHO.

The global organisation acknowledged how ASHAs provide:

• maternal care and immunization for children against vaccine-preventable diseases

• community health care

• treatment for hypertension and tuberculosis

• and core areas of health promotion for nutrition, sanitation, and healthy living.

The Accredited Social Health Activist Workers (ASHA) are more than 1 million female volunteers in #India, honored for their crucial role in linking the community with the health system and ensuring that those living in rural poverty can access primary health care services #WHA75 pic.twitter.com/pC4eWC8rzy

— World Health Organization (WHO) (@WHO) May 22, 2022

Many people including PM Modi celebrated this news and congratulated ASHAs for this title. In a tweet, he said that ASHAs are at the forefront of ensuring a healthy India. Their dedication and determination is admirable.

Delighted that the entire team of ASHA workers have been conferred the @WHO Director-General’s Global Health Leaders’ Award. Congratulations to all ASHA workers. They are at the forefront of ensuring a healthy India. Their dedication and determination is admirable. https://t.co/o8VO283JQL

— Narendra Modi (@narendramodi) May 23, 2022

Similarly, unions like the All India ASHA Workers Federation affiliated to All India Trade Union Congress (AITUC) too thanked WHO for rightly conferring the award. However, AITUC Secretary Vahida Nizam pointed out the supreme irony that despite such praise ASHAs still are not recognized as workers in India.

“No wages except the paltry sum of ₹ 2,000 per month and the meager incentives is all that they get. For decades, ASHAs’ demand for regularisation of their services and defined minimum wages has fallen on deaf ears,” said Nizam.

The union said that besides recognising leadership, contribution to global health advancement and commitment to regional health, this award vouchsafes the permanent nature of ASHA’s contributions. As such, the union government should announce an equivalent return of compliment to the workers, said leaders. The Federation demanded regularisation of ASHAs with ₹ 18,000 per month salary.

“We hope that greetings of admiration translate into reality of rendering justice to these ASHA workers. This is long overdue,” said Nizam.

Similarly, Delhi ASHA Workers Union General Secretary Shweta Raj thanked WHO for respecting “India’s hopes” and asked when the central and Delhi governments intend to honour these hopes. Like Nizam, she said that the real meaning of respecting ASHAs is indicated by giving due rights.

“ASHAs served the public by playing on their lives during the last Covid-19 wave. But in return, neither do they get proper salary nor have they been given the status of government employees. Even ASHAs are mistreated every day from dispensaries to hospitals,” said Raj.

Regarding Modi’s tweet, she said that until the governments give the workers their rights, the congratulatory remarks remain as pure rhetoric. The union demanded respectable salary, government employee status for ASHAs and an immediate stoppage to misbehaviour suffered by the women.

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Tired of empty promises, Varanasi’s Accredited Social Health Activist (ASHA) workers questioned why the ground-level reality differed starkly with the claims of the Bharatiya Janata Party (BJP)-led Uttar Pradesh government.

As Assembly elections draw closer, BJP and Congress campaigns refocus their attention on rural vote banks. Leaders recently focused on communities like the healthcare workers that dedicatedly worked for rural health amidst a global pandemic.

In mid-August, Ch“Our wages, money for conducting surveys, everything is pending. Still we continue our work. Some ASHAs went to the government office recently and they were told the department does not have funds anymore. Others say there is an issue with transferring money,” she had told SabrangIndia, asking, “So how come we are the only ones not getting money?”

Pending wages have become a persistent problem for ASHAs, anganwadi workers, and mid-day meal cooks across the state this year. Both ASHAs and cooks started their individual mass mobilisations to highlight these grievances to the government. The only difference is that while the cooks received at least partial payment, ASHAs are yet to receive basic security.

This is what another ASHA leader Priya Gupta said about the ruling regime’s administrative performance while talking to Dr. Muniza Khan who heads the research and outreach team of SabrangIndia’s sister organisation Citizens for Justice and Peace (CJP) in Uttar Pradesh.

While smartphones and tabs were promised to college youth, Gupta’s demand for physical protection during night duty is a long-forgotten woe of the women.

“What protection? We have no security be it from illnesses or physical harm. We only get our Rs. 2,000 when we complete all our work including surveys. Officials repeatedly tell us it’s our job but we want better wages,” said ASHA Mamta.

As per the National Rural Health Mission website, an ASHA cannot function without adequate institutional support. It directs self-help groups or women’s health committees, village Health & Sanitation Committee of the Gram Panchayat, ANMs and Anganwadi workers and ASHA trainers to assist these women.

Yet Mamta said that ASHAs receive no help from local authorities save for ANM and similar workers. Some ASHAs also suffered mistreatment during visits.

Some other ambitious statements about ASHAs on the website are:

“Every ASHA is expected to be a fountainhead of community participation in public health programmes in her village.

ASHA will be the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services.

ASHA will provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilisation of health & family welfare services.

She will counsel women on birth preparedness, importance of safe delivery, breast-feeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young child.”

Despite these elaborate responsibilities, ASHAs did not receive any medical benefits, said Mamta. She claimed the local administration had failed to give her proper vaccinations.

“The government should also think about us. What if we meet an accident on the way at night? Who will take care of our family? I am yet to see any of the positive effects of the ruling regime in my surroundings,” said Kevat, whose child recently fell ill.

Having worked as an ASHA for five years, she decried the government for ignoring their demands of proper wages and protective gear as though they were “making personal requests.” She argued that women in her field work much longer hours than men, because they answer calls of patients even at night.

During Covid-19, ASHAs also had the responsibility of delivering medical packets to at-home patients. For this, officials either gave them sanitisers or masks.

“Very rarely did we receive both,” said Kevat.

Having mobilised across the state to demand their dues, ASHAs have become a potential vote bank for the Opposition. Especially after some ASHAs said they were allegedly beaten by Shahjahanpur police, Congress leader Priyanka Gandhi Vadra promised them Rs. 10,000 honorarium if the party is voted to power.

However, Varanasi’s women remain unimpressed by these claims.

“Every leader says this. We have already seen this happen. We have read her assurances but at the end of the day, no party ever does anything. They only make empty promises,” said Mamta.

On Tuesday, the women continue with their daily routine. Mamta stayed at home figuring out her future after the passing of her husband. Kevat ran to the chemist to get medicine for her family while Gupta visited the nearby vaccine camp to fulfil her role as an ASHA.

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UP: Anganwadi workers, MDM cooks and ASHA workers non paid wages for months!

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As part of the government’s National Rural Health Mission (NRHM), a new group of baseline health workers called Accredited Social Health Activists (ASHA workers) was formed in 2005 to address health related demands of the rural population, especially women and children, who find it arduous to access basic health services.

The government guidelines laid down several responsibilities of ASHA workers which include creating awareness about health and its social determinants, mobilising the community towards local health planning, and increased utilisation and accountability of existing health services. This 2005 design recruited women as volunteers on honorariums to engage in tasks central to the functioning of the public health infrastructure, and promote good health practices.

Their role became even more critical in the Covid-19 pandemic era as they have been deployed to undertake additional work, like conducting door to door tests, monitoring the migrant workers, ensuring the adherence to Covid-19 protocols, as well as collecting data and reporting to the primary health centres across various states.

But the workload of ASHA workers is not directly proportional to the remuneration they receive, and they continue to be seen merely as volunteer service providers. The enormity of injustice does not end here, as they don’t fall under the ambit of the Minimum Wage Act, and don’t enjoy the maternity benefits and other schemes offered to regular government employees.
 

Meagre wage

In a written answer provided by Bharati Pravin Pawar, Minister of Health and Family Welfare, on July 23 this year to the Lok Sabha, it was revealed that ASHA workers receive a fixed monthly incentive of Rs. 2,000 for undertaking routine and recurring activities. Further to incentivise Covid-19 duty, the government decided to add an additional Rs. 1,000 per month under India’s Covid-19 Health System Preparedness and Emergency Response Package.

Different states have different incentives for ASHA workers, but there have been several strikes since the onset of the pandemic demanding sufficient and timely remuneration. For instance, Uttar Pradesh sanctioned Rs. 750 per month from the state budget and the average ASHA payment in the State is Rs. 4,270 per month. CJP’s interaction with hundreds of these women across the state reveals backlogs in payment of wages and often, withholding of payment, too. Bihar provides Rs. 1,000 per month apart from the fixed price fixed by the centre, so ASHAs in Bihar get Rs. 3,000 per month, Himachal Pradesh ASHAs get Rs. 2,000 per month, Uttarakhand ASHAs get Rs. 5,000 per annum and Rs. 1,000 per month.

Besides the range of monetary incentives to the ASHAs, on June 25, 2020, thousands of ASHA workers united, at the call of the All India Coordination Committee of ASHA Workers (CITU), and held a protest at various states, including Jammu and Kashmir, Punjab, Assam, Haryana, Madhya Pradesh, Maharashtra, Odisha, Gujarat, Andhra Pradesh and Kerala for regularisation as government workers, for adequate Covid kits (gloves, masks, sanitisers), additional incentive of Rs.25,000 per month for all contract and scheme workers, Rs. 50 lakhs insurance cover to all frontline workers, etc.

The same answer provided to the Lok Sabha in July this year also revealed that out of 10,47,324 ASHAs, a total of 109 have died due to Covid-19 till April of this year, across the nation, but the numbers could be arguably higher.

Going by the government records, Uttar Pradesh, Tamil Nadu, Sikkim, Manipur, Meghalaya, Mizoram, Nagaland, Puducherry, Himachal Pradesh, Ladakh, Lakshadweep, Andamans, Arunachal Pradesh, Dadar and Nagar Haveli, Daman and Diu and Assam have not recorded a single death of the health activists.  
 

Covid-19 duty risks

In May this year, lakhs of Accredited Social Health Activists across the country reportedly protested and demanded their pending payments and protective gears like PPE kits and masks for themselves. The workers who have efficiently assisted the government in controlling the spread of the virus have raised their voices against inadequate facilities. Some workers have complained that they hadn’t been provided uniforms for the last three years and they are expected to travel door to door to check on home isolated patients but have not been provided for transport, food or water while attending duties and most were yet to be tested for Covid-19. 

According to a NewsClick report, in Karnataka, D. Nagalakshmi, state secretary of the All-India United Trade Union Centre (AIUTUC) backed ASHA Workers’ Union said that the 42,000 workers have been waiting for their “honorarium” – Rs 4,000 – for the past two months.

Justice from the Courts?

The Bombay High Court was one of the first courts to recognise the importance of ASHA workers especially in the fight to combat Covid-19 and had directed the government to pay Rs. 200 per day instead of the fixed Rs. 1,000 per month. The application was filed on behalf of the Nagpur Municipal Corporation Employees Union in Subhash Jainarayan Zanwar Vs. Union of India and others, PIL No.10 of 2020), wherein they brought to the notice of the court the pathetic condition of the Accredited Social Health Activists.

They complained that appropriate remuneration was not being paid to the ASHA workers and the basic equipment for protection/security were not provided and further, even refreshments and tea, as also water from time to time, was not available to them. The insensitive Nagpur Municipal Corporation had gone a step ahead and filed an affidavit in the matter stating that there was no legal provision to provide food and refreshments to the ASHAs!

Justice Manish Pitale had said, “This Court finds that the ASHA workers, who are at the forefront of the war against COVID-19 and who are performing special duties, including door to door survey of houses during such crisis, are being treated in a most unfortunate manner by the Corporation. Even if the amounts of 1000/- per month and 1500/- ₹ 1000/- per month and that ₹ 1000/- per month and that per month i.e. total of 2500/- per month is being paid to ₹ 1000/- per month and that the ASHA workers, it is hardly sufficient for survival of such workers… It is distressing that those at the forefront of the war against COVID-19 are meted out with such treatment by the public authorities including the Corporation.”
 

How far have our courts helped?

Negligent efforts have been taken by the judiciary and the government to recognise the status of ASHAs as workers under the Industrial Act to avail the benefits of the Minimum Wages Act. The Minimum Wage Act that prescribes a minimum amount must be paid to an employee by the employer, as mentioned above, does not apply to ASHA or Anganwadi workers.

A big blow to Anganwadi workers was in 2006, when the Supreme Court Bench of Justices SB Sinha and Markandey Katju had held that Anganwadi workers engaged under the Integrated Child Development Service (ICDS) Programme are not entitled to minimum wages as the Minimum Wages Act is applicable only to ‘workmen’ in the industries. The Bench said the ICDS programme would not constitute an “industry” within the meaning of the Act and Anganwadi workers were not industrial workmen. (State Of Karnataka & Ors vs Ameerbi & Ors, Appeal Civ. No. 4953-4957 of 1998). 

However, in State of Punjab and Others versus Jagjit Singh, Civ. Appeal No. 203 of 2013, the Supreme Court offered some relief for scheme workers where it ruled that all types of temporary workers and daily wagers are entitled to wage parity with the regular workers provided, if they perform similar work. Another important aspect of this judgment was that it had opined that a mere difference in nomenclature should not deprive an employee from being paid a similar wage that a permanent employee gets for the “same amount of work”.

Calling it “exploitative enslavement”, the court had said, “it is fallacious to determine artificial parameters to deny fruits of labour. An employee engaged for the same work, cannot be paid less than another, who performs the same duties and responsibilities. Certainly not, in a welfare state. Such an action besides being demeaning, strikes at the very foundation of human dignity. Any one, who is compelled to work at a lesser wage, does not do so voluntarily. He does so, to provide food and shelter to his family, at the cost of his self-respect and dignity, at the cost of his self-worth, and at the cost of his integrity. For he knows that his dependents would suffer immensely, if he does not accept the lesser wage.” 

Almost 5 years after this judgment, ASHA workers continue to fight for their identity, demanding for a permanent worker status and surely, the pandemic has exacerbated their needs. The 45th session of the Indian Labour Conference (ILC), had also recommended that all scheme workers should be recognised as ‘workers’ and not as ‘volunteers’ or ‘honorary workers’. It was also suggested that the Anganwadi workers and ASHAs be covered under life and health insurance and all necessary amenities should be extended to the women. But the action taken report presented by the government at the 46th meeting of the Standing Labour Committee rejected each and every one of these demands except the demand for insurance scheme coverage.  

In Oxfam’s Commitment to Reducing Inequality Report 2020, India ranked 154 in health spending, (fifth from the bottom). This infrastructurally reflects on the lack of enough amenities for the health workers that have been fighting tooth and nail to contain the pandemic. Despite being hailed as frontline workers and Covid-19 warriors, essential ASHA workers continue to work under unfortunate conditions.

According to ThePrint, a survey was conducted by Oxfam India and its partner organisation in Uttar Pradesh, Odisha, Bihar and Chhattisgarh, interviewing a total of 306 ASHA workers. The startling facts that emerged were that just 23 percent workers had received hazmat or bodysuits. 64 percent of them claimed to have received no incentives for the Covid-related responsibilities undertaken by them. Only 43 percent ASHAs had received their monthly honorariums on a regular basis, as of September last year.

Central government’s Pradhan Mantri Garib Kalyan Yojana that was meant to provide an insurance cover of Rs. 50 lakh per person to frontline healthcare workers, sanitation staff, paramedics and nurses, ASHA workers and doctors was known to only 38 percent ASHA workers across the 4 states.

Besides verbal applause and showering petals over hospitals through helicopters to motivate healthcare workers, the government should start with recognising the ASHA workers who have proved to be more than just volunteers, and to not look for interim measures to shore up the crumbling public healthcare system. Subsequently, inhumane working conditions, inadequate staffing, low compensation, unacceptable working, lack of basic amenities should be next on the agenda!

As India begins to recover from 15 months of a social and political crisis unleashed by mis-governance over the handling of the health emergency, will Indians learn lessons and join hands to campaign for better wage security and health conditions for our ASHA workers?
 

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The post Is India exploiting its ASHA workers? appeared first on SabrangIndia.

Many experts and reports analysing the socio-economic impact of Covid-19 have demanded fiscal support for India’s vulnerable and below poverty line (BPL) population amidst the Covid-19 crisis.

On June 17, 2021, this notion was reaffirmed when Confederation of Indian Industry (CII) President T. V. Narendran said, “There is an estimated fiscal headroom of up to Rs. 3 lakh crore that can be channelised towards direct cash transfers to vulnerable people, higher allocation for MNREGA, short-term GST rate cuts and lower excise duty on fuel.”

However, recent protests by India’s peasantry, ASHA workers and labourers indicate that these demands are still a distant dream, especially cash transfers.

An urgent need for cash transfers

In May, the Azim Premji University released the ‘State of Working India 2021’ report that recommended the union government carry out cash transfers of Rs. 5,000 (per month) for three months, in addition to food packages, to as many households using digital infrastructure, not limited to Jan Dhan accounts.

The same month, the Centre for Monitoring Indian Economy (CMIE) said that over 15 million jobs were lost. Employment fell from 390.8 million in April to 375.5 million in May. This means a loss of 15.3 million jobs, and the decline continues even in June.

“This is not as bad as the loss of 114 million in April 2020 but comes second only to that draconian month of a nationwide lockdown. The May 2021 fall in employment is higher than the 12.3 million fall recorded in November 2016, the month of demonetisation,” said CMIE Managing Director Mahesh Vyas in his report.

Already, the Pew Research Center on March 18 reported how India contributed over 75 million people out of the over-131 million estimated poor people calculated after the global pandemic.

The Government of India, for its part, on April 23 announced the restart of the PM Garib Kalyan Anna Yojana that provides five kgs of grain for free to priority households for May and June. However, the fiscal issue for India’s labour force remains.

How are the BPL groups faring?

Working at the very frontline of the Covid-pandemic, ASHA workers have been suffering due to dismal wages for years. On June 15, Maharashtra’s ASHA workers went on an indefinite strike refusing the pittance of Rs. 30 to Rs. 35 a day. The women’s group firmly demands a monthly salary of Rs. 18,000 for ASHAs and Rs. 22,000 for ASHA supervisors.

“We have been constantly working during the Covid-19 pandemic, raising awareness among people for hardly Rs. 30 a day. Now that the rains have begun, our work will increase because more people are likely to fall sick. But when we fall sick, not a single rupee of help comes from the government,” a ASHA worker supervisor from Maharashtra told SabrangIndia.

Similarly, the ‘No Country for Workers’ report by the Stranded Workers Action Network (SWAN) suggests monthly cash transfers of Rs. 3,000 for six months. SWAN volunteers had already helped 7,050 people avail money transfers from SWAN. However, around six percent of the people required an additional cash transfer due to the continued lack of external aid.

Citing one of numerous unemployment stories, the report said, “Asha and her husband are self-employed and have a nine-month old baby. They sell pani puri to earn a living but their income has dried up since New Delhi announced a lockdown. Left with only a meagre amount of dry ration, the couple has been desperately searching for ways to buy milk for their baby.”

Incidentally, SWAN volunteers received more distress calls from women during the second wave compared to 2020 due to the rising unemployment.

Limitations in delivering cash transfers

The State of Working India 2021 report found that the Public Distribution System (PDS), MGNREGA and to a lesser extent cash transfers helped in preventing widespread starvation. However, observations of 2020 also showed that there is an urgent need to make financial infrastructure accessible to the vulnerable sections of society. Further, there is a need to increase the amount of cash transfers.

Regarding the procedure of direct benefit transfer, there is also a growing discourse around the JAM trinity (Jan Dhan accounts, Aadhaar card and mobile phones). The need for zero balance Jan Dhan accounts, mobile connectivity and an administrative demand for Aadhaar card hinders the non-digital population from accessing money transfers.

For example, during the Covid-crisis, the PM-KISAN programme announced cash transfers of Rs. 500 per month between April and June 2020 for all women Jan Dhan account-holders. These accounts refer to the PM Jan Dhan Yojana (PMJDY) that can provide banking services to every unbanked adult.

However out of around 400 million Jan Dhan accounts, 205 million accounts were owned by women as of April last year. Around 326 million women live below the national poverty line, meaning that more than one-third of poor women would be excluded from the benefit, even if all female-owned PMJDY accounts belonged to poor women.

Moreover, in contrast to the ration-pension-NREGA system where lists of beneficiaries are publicly available, and beneficiaries are usually certain about their status of inclusion, not all women know if their accounts are PMJDY accounts.

Another issue is the final step where people have to actually access the cash. Surveys used in the report found that 26 percent of poor women live more than 5 km away from the nearest bank or ATM.

“Still, the potential coverage of a cash transfer programme undertaken via the Jan Dhan accounts, at 150 million, would be higher than any other programme barring PDS, if the cash did reach every BPL account holder and they were able to avail of it,” said the report.

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