Empowering ASHAs: A Call for Dignity and Rights
The National Human Rights Commission (NHRC) of India recently held a significant meeting focused on the empowerment of Accredited Social Health Activists (ASHAs). This hybrid meeting, titled “Empowering Accredited Social Health Activists (ASHAs): Securing the Right to Work with Dignity,” took place in New Delhi. It was chaired by Justice Shri V. Ramasubramanian, the NHRC Chairperson, and attended by various members, senior officials, experts, and ASHAs. The meeting aimed to address the challenges faced by ASHAs and to discuss ways to enhance their working conditions and rights.
The Vital Role of ASHAs in Healthcare
Justice V. Ramasubramanian opened the meeting by acknowledging the invaluable contributions of ASHAs over the past two decades. He highlighted their role in improving healthcare outcomes, particularly in reducing neonatal and infant mortality rates. ASHAs have proven that individuals without formal education can be trained to become skilled healthcare workers. However, despite their significant impact, many ASHAs feel that their remuneration does not reflect their contributions. This disparity raises concerns about the treatment of those who serve marginalized communities.
Justice Ramasubramanian emphasized the need for a collaborative effort between the Central and State Governments to address ASHAs’ welfare. He pointed out that public health and minimum wage issues fall under the jurisdiction of the States. Therefore, a unified approach is essential to create policies that improve ASHAs’ working conditions and living standards. He called for actionable measures to ensure that ASHAs can work with dignity and receive fair compensation for their vital services.
Addressing Challenges Faced by ASHAs
During the meeting, NHRC Member Justice (Dr) Bidyut Ranjan Sarangi underscored the critical role of ASHAs as the first responders to health-related issues in rural areas. They often assist pregnant women and children before any medical consultation occurs. This frontline position necessitates recognition of their contributions, along with adequate incentives and security. Justice Sarangi stressed that ASHAs deserve the right to live with dignity, which includes fair compensation and support.
The Secretary General, Shri Bharat Lal, set the agenda for the meeting by outlining three technical sessions. These sessions focused on the evolving challenges faced by ASHAs, the government’s role in protecting their rights, and strategies for ensuring their right to work with dignity. He noted that while the government has introduced various schemes for women’s empowerment, ASHAs still face issues such as low honorarium, excessive workloads, and insufficient resources. Their exemplary work during the COVID-19 pandemic has been recognized globally, including by the World Health Organization (WHO).
Recommendations for Improvement
The discussions at the meeting led to several key recommendations aimed at improving the status of ASHAs. Participants suggested granting ASHAs formal worker status, which would provide them with fixed monthly salaries, social security, pensions, and paid leave. Standardizing honorariums across states to align with minimum wage regulations was also proposed. Additionally, participants recommended replacing the current incentive-based payment structure with a fixed salary plus performance-based benefits.
Other suggestions included providing health insurance, maternity benefits, and accident coverage for ASHAs. Ensuring access to personal protective equipment (PPE), transport allowances, and clean rest areas during field visits was also highlighted. Furthermore, strict policies against harassment and violence should be enforced to guarantee safe working conditions for ASHAs. The meeting also discussed utilizing unspent funds from the Building and Other Construction Workers Welfare Cess Act for childcare, elderly care, and ASHA welfare. Establishing state-funded creches at primary health centers and community centers was suggested to support ASHAs who are primary caregivers at home. The need for structured career pathways for ASHAs to transition into higher-paying healthcare roles was also emphasized.
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