ASHA (Accredited Social Health Activists) workers in Bihar are on strike since 1st of December 2018. In Bihar, there are 93,687 ASHA workers. Way back in 2010 their strength was 71,350. This outrage has several demands one of them is a minimum wage of Rs, 18,000. The statewide indefinite strike has been called by the ASHA Sanyukt, Sangharsh Manch- platform of several unions and association of workers. On this issue, had hit the streets of Delhi and Bangalore in past. This time it is Bihar.
“We work diligently for the rural population but we are treated as slaves. We have not got our incentives. We don’t have a fixed salary. Don’t we deserve to be paid?” asked Seema Sahi, employed as an ASHA worker in Primary Health Center (PHC) since 2005. She added further until the state government and health minister accept our demand, we shall continue our strike. Even after submitting our request, the administration is non-responsive.
Vibha Devi another ASHA worker said, “I was threatened by the local administration and senior officials of PHC for protesting against exploitation. Moreover, the media people did not bother to highlight our demand. The PHC officials mock us every day on no coverage by the media.”
The Unfulfilled Promise– In the month of September, Prime Minister Modi had promised a hike in their monthly honorarium from the month of October. He said- the revised incentive will come into effect from October and it will reflect in their salaries from November onwards which would be Diwali gift for them. The declaration was- workers who drew an honorarium of Rs. 3,000 would get Rs. 4,500 and those who get Rs. 2,200 would get Rs. 3,500 but still it remains a distant dream. Additionally, the PM had also given the assurance that the workers would be brought under the social security schemes- Pradhan Mantri Jeevan Bima Yojana and Prime Minister Suraksha Bima Yojana. All these remain as broken promises till now.
Importance of ASHA workers:
ASHA worker is a link between the rural community and public healthcare. The ASHA scheme was a flagship government scheme under the National Rural Health Mission (NHRM). Being underpaid, an ASHA worker bridges the rural population and Primary Health Centers (PHCs). They carry out ten crucial functions such as-
- Create awareness and provide information to community.
- Counsel mothers on birth preparedness, safe delivery, feeding practices, immunization, family planning, RTI, etc
- Facilitate community access to health care and health facilities
- Accompany pregnant women and children to health facility
- Provide care for minor ailments
- Act as depot holder for ORS, IFA, DDK, Oral pills, condoms
- Provider of DOTS
- Newborn care and treatment of childhood illness (IMNCI)
- Inform birth and deaths, disease outbreaks
- Construction of Toilets for TSC (Total Sanitation Campaign)
According to studies, despite central government’s low expenditure in public healthcare, there was impressive progress in healthcare indicators such as Infant Mortality Rate (IMR), Maternal Maternity Rate (MMR) and Total Fertility rate (TFR) which was possible just due to exceptional die efforts of the ASHA workers.
Demands of ASHA workers:
The workers on indefinite strike have put forward 12 points demand and some of them are-
- Government employee status for ASHA workers;
- Minimum Rs. 18,000 monthly honorarium;
- 50 per cent reservation in nursing schools for eligible ASHA workers;
- After training ASHA workers to be given exemption in age limit and appointed as ANMs;
- 50 per cent BCM (Block Community Coordinators) posts for eligible ASHA facilitators;
- ASHA workers should get benefit of all high level committee recommendations including work terms and conditions and honorarium;
- ESI (Employees’ State Insurance), EPF (Employees Provident Fund) and social security for all ASHA workers.
On the 21st Day of protest, there was a big turnout by ASHA workers in Kaimur, Patna, Muzaffarpur, Darbhanga, Nalanda. Bihar State President of ASHA workers union, Shashi Yadav had shared the glimpse of outrage which took place statewide.
The anger of ASHA workers is legitimate as no incentive after hard work has hurt their self-esteem despite discharging duties on a daily basis. The scheme doesn’t have a dedicated set of budget. The funds for these workers are arranged on an ad-hoc basis which resulted in the pouring of anger, agony and pain of ASHA workers. Let this economic uncertainty end.