ASHA Workers in India | 17 Mar 2025

Source: IE 

Why in News?  

Accredited Social Health Activists (ASHAs) in Kerala staged protests demanding higher wages and retirement benefits. 

Who are ASHA Workers? 

• About: ASHAs are community health volunteers introduced under the National Rural Health Mission (NRHM), 2005 to provide essential healthcare services in rural areas.  
  • In 2013, the NRHM merged with the National Urban Health Mission (NUHM) to form the National Health Mission (NHM). 
  • ASHAs work alongside Anganwadi Workers (AWWs) under the Integrated Child Development Scheme (ICDS) to improve healthcare accessibility. 
  • An ASHA is a local woman (age 25-45 years), preferably married, widowed, or divorced, with at least Class 10 education. NHM considers them volunteers, limiting their earnings to task-based incentives. 
    • ASHAs serve one per 1,000 people, with 9.2 lakh in rural and 79,900 in urban areas (2022-23). 
• Key Responsibilities of ASHAs: Ensure antenatal check-ups, and postnatal care, while educating mothers on breastfeeding and infant nutrition.  
  • ASHAs support immunization, tuberculosis (TB) treatment, malaria screenings, and disease prevention. Additionally, they provide basic healthcare, essential medicines, first aid, and report births and deaths. 
• Concerns of ASHA Workers: ASHAs face low ( approx Rs 5000-15000) and irregular payments, receiving only a nominal honorarium and task-based incentives that vary by state and are often delayed due to funding issues and Centre-State disputes.  
  • Despite their crucial role during Covid-19, earning them the World Health Organization’s (WHO’s) World Health Leaders Award in 2022, their struggles persist.  
    • They are not classified as government employees, denying them fixed wages, pensions, gratuity, provident funds, and medical insurance, though some states, like Andhra Pradesh, offer gratuity.  
    • The 2020 Parliamentary Standing Committee on Labour recommended formalizing their roles, but no action was taken.  
  • ASHAs, mostly women from marginalized backgrounds, also face gender-based discrimination in the workforce. 

How Can ASHA Workers Be Empowered? 

• Formalization: Recognizing ASHAs as government employees or at least contractual workers with job benefits under the Code on Social Security, 2020 would ensure they receive essential labor rights and protections. 
• Skill Development: Offer training programs for ASHAs to upgrade their skills and transition into higher healthcare roles (e.g., Auxiliary Nurse and Midwives). 
• Financial Security:  With rising inflation, ASHA workers need financial security. A fixed salary alongside incentives ensures stability, while Direct Benefit Transfers (DBT) prevent payment delays, empowering them to focus on healthcare without financial distress.