Patna, Bihar

For close to a month now, healthcare services in rural areas of Bihar are disrupted as about hundreds and thousands of frontline women health workers, the ASHAs (Accredited Social Health Activist), are on an indefinite strike in the state since July 12 last month.

On August 3, thousands of ASHA workers from different districts of Bihar gathered in the Gardanibagh area of the state capital, Patna, to stage a protest and demonstration with their nine-point demands, including a fixed monthly salary of Rs 10,000, clearance of the COVID-19 incentive money, and enrolment under pension scheme.

Under the National Rural Health Mission, over one million ASHA workers form the backbone of the country’s healthcare system and provide health-related services, such as immunisation, health surveys, assistance in childbirth, nutrition and sanitation related information, across all the villages. Last year, the World Health Organization (WHO) conferred the Global Health Leaders Award to the ASHA workers of India for their contribution towards protecting and promoting healthcare.

But despite international recognition of their work, ASHA workers claim they have not got their due by the government in the country.

“I daily visit at least 30-40 houses on foot and receive a paltry amount for work. I receive an incentive amount of Rs 1,000 a month from the state government and Rs 2,000 from the central government. In addition, I get a commission for child births and vaccinations,” 35-year-old Mamta Devi, an ASHA worker from Chakrami village in Bhagalpur district, Bihar, told Gaon Connection. She was in Patna participating in the protest to demand a better salary for her work.

Talking about the demands of the protesting ASHA workers, the leader of Bihar State ASHA Workers’ Union, Shashi Yadav, said: “We have been on strike for nearly 25 days now. We have had discussions with several officials from the health department, but our demands have not been met.”

“The minimum remuneration that was promised by the Mahagathbandhan government should be increased to Rs 10,000 instead of the current Rs 1,000 stipend. We demand prompt payment of the pending Rs 1,000 per month for the financial year 2019-20 [April 2019 to November 2020],” Yadav told Gaon Connection.

Also Read: “I have to wait for nine months to be paid Rs 600 incentive for one delivery”

The protesting frontline health workers are also demanding the outstanding dues from the Ashwin portal be cleared before the start of the new payment system.

Due to the strike, vaccination activities in the state have also been affected, and several PHCs in villages have stopped providing healthcare services.

 “Further, all ASHA workers and facilitators should be paid a Rs 10,000 Corona allowance for their duties during the pandemic. The ASHA workers should also be included in the pension scheme,” she added.

The protesting frontline health workers are also demanding the outstanding dues from the Ashwin portal be cleared before the start of the new payment system. Ashwin Bihar is an app developed for ASHA and ASHA facilitators for the entry of their daily and monthly activities through which their monthly incentives are generated and the amount is credited to their bank accounts.

With over a lakh ASHA workers and facilitators on strike since July 12, under the banner of the ASHA Joint Struggle Forum, the protest has gained momentum in many regions of the state. The strike has had a significant impact on almost all primary healthcare centres[PHC], community healthcare centres[CHC], and referral hospitals across the state.

Due to the strike, vaccination activities in the state have also been affected, and several PHCs in villages have stopped providing healthcare services.

On July 26, the state government issued a letter to all district collectors informing ASHAs had to perform four basic functions and those disrupting work would be removed (see letter below).

 But, protesting health workers seem unfazed. “I have been an ASHA since 2006. I have to work in all weather conditions. I have to go whenever there is a child delivery. We have to visit homes, facilitate deliveries, and organise vaccinations,” said Sunita Devi, a 42-year-old ASHA worker from Supaul district. She was also in Patna participating in the protest.

“We have to submit detailed reports to the government officials, including the Aadhaar and phone numbers of the beneficiaries. The government also asks us to conduct surveys in the villages. Although the children we have helped deliver have grown up and are having a good life, nobody is thinking about the future of our children,” she added.

The contribution of ASHA workers in Bihar, from vaccinations to reducing the infant mortality rate, has been appreciated by organisations like the WHO and the Patna High Court.

Despite international recognition of their work, ASHA workers claim they have not got their due by the government in the country.

The anganwadi workers in Bihar have also come forward to support the demands of the protesting ASHA workers. On August 5, a large number of anganwadi workers under the banner of the Anganwadi State Servants Union also arrived in Patna to demand regularising their jobs. During this demonstration, they supported the protest by ASHA workers.

Key demands of the protesting ASHA workers in Bihar:

• Replace the government’s Rs 1,000 incentive with a fixed monthly remuneration of Rs 10,000.
• Promptly clear the outstanding Rs 1,000 for the financial year 2019-20.
• Provide Rs10,000 Corona allowance to all ASHA workers and facilitators for their COVID-19 duty.
• Clear all outstanding dues from the Ashwin Bihar portal.
• Enrol ASHA workers in the pension scheme.