India’s over ten-lakh-strong army of women public health workers (ASHA or Accredited Social Health Activists) have received a long overdue global recognition. Last week, the World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus honoured them for “their crucial role in linking the community with the health system”.
They were one of six recipients of the Global Health Leaders Awards, chosen personally by the WHO chief, “to recognise outstanding contributions to advancing global health, demonstrated leadership and commitment to regional health issues”.
A proud moment for India, indeed, as the ASHA workers have been working doggedly since 2005, when the National Rural Health Mission was enacted.
And though they started with assisting in maternal health and child immunisation, their role has since expanded to handling deliveries, tackling malnutrition, and aiding treatment of hypertension and tuberculosis. In fact, they became crucial in health promotion through nutrition, sanitation, and healthy living in rural areas.
During the Covid-19 pandemic, ASHA workers helped identify patients and provided them with treatment and support.
Unfortunately, these frontline workers face severe challenges at the workplace and in their personal lives, including gender bias.
They do not have regular remuneration and are paid through incentives, which require a diligent noting of every task completed. They also lack basic amenities such as maternity leave, social security, gloves, masks and restrooms when they accompany a patient to the hospital in a nearby town.
Research by voluntary organisation Karnataka Health Promotion Trust revealed that ASHA workers were demoralised by the malice they encountered in the community since they are called upon to work at all times of the day or night. They faced domestic violence over their late hours.
ASHA workers face workplace harassment from doctors and nursing staff of the hospitals to which they accompany patients.
Reforms are needed to uplift the ASHA worker’s status as a critical frontline worker — with appropriate monthly salary, working hours, leave, and skill upgradation. ASHA workers need to be given the pride of place in public health.
Only then would this global recognition make a difference to their lives.