Updated: May 28, 2021 5:58:48 am
The identical blue jackets, worn over their clothes separate Nayantara Parashar and her colleagues from other women in their village, as they prepare to start work for the day.
At 8am, standing before the entrance of the sub-health centre in Parli village of Tonk district, Parashar, who is an Accredited Social Health Activist (ASHA) worker, adjusts her face shield while discussing with her co-workers the route they will take that day.
“We have been doing door-to-door surveys since the first wave of Covid-19 last year. At present, our task includes identifying those having influenza-like symptoms (ILI) and spreading awareness about vaccines,” says Parashar, a mother of four daughters, who is in her thirties and lives in Parli.
Parashar and four other ASHA sahyoginis stroll across the inner roads of Parli, urging villagers to wear masks.
Seeing the group approach, two maskless men travelling towards them on a motorcycle quickly make a U-turn. They emerge minutes later, wearing masks turn.
“We also have the task of distributing medicine kits and reporting any Covid-like symptoms among people we come across. There is a pulse oximeter we carry for this purpose, especially to check oxygen saturation levels of elderly people,” says Basanti Sharma, one of the workers accompanying Parashar.
Vidya Devi, a 47-year-old mother of three, is also part of the team. She highlights the challenges of carrying out door-to-door surveys before talking about the dissatisfaction among ASHA workers regarding the honorarium they receive from the government.
“The Rs 2,970 honorarium which we are presently receiving from the state is not enough, especially during this time of Covid. Throughout the pandemic, we have always been on the frontlines, doing door-to-door surveys, convincing people to take the vaccines, distributing medical kits. Many ASHA workers also tested positive for the disease and some even died. We have repeatedly raised this issue before the government but even though they increased our honorarium by 10 per cent after our protests, it’s not sufficient as several of us have to run our families,” says Devi.
Earlier this year, ASHA workers in the state protested with demands including an increase in their honorarium and to be paid wages equivalent to that of a highly-skilled labourer.
Back in Parli, the ASHA team casually strike up a conversation with those they come across while visiting homes. While the conversation is about everyday issues like the goings-on in the village and the weather, the team members tactfully drop in questions about the health condition of family members of the house.
“If you wear masks and sanitise your hands regularly, then you won’t get Covid-19,” Devi tells a young man at one of the houses.
After completing their rounds through the village, the team has to file a report at the sub centre on the work completed that day.
At present, ASHA workers performance-based incentives depending upon the activities they take part in for the health department in addition to the Rs 2,970 honorarium.
Mohammed Ajmal Khan, convener of the Rajasthan Pradesh ASHA Sahayogini Saathin Karamchari Sangh — an outfit raising issues impacting ASHA workers in the state — says this is not enough.
“This is very less, given the fact that it is on the basis of the ground surveys carried out by ASHA workers that the local administration is able to identify Covid patients or improve the vaccination figures,” says Khan.
“The ASHA workers should get at least an amount equivalent to the minimum wages which highly skilled workers receive. If this is followed, they will receive around Rs 8-9 thousand per month. At present, even after adding performance-based incentives they receive from the Health Department, on average they earn only around Rs 3,000-4,000 each month,” he adds.
Throughout the Covid-19 pandemic, the groundwork done by ASHA workers helped the state script a turnaround in improving its vaccination numbers.
However, on a per-day basis (calculated for 31 days), the present monthly honorarium for ASHA workers comes down to Rs 95.81 per day — significantly lower than the Rs 326 per day minimum daily wage fixed by the Rajasthan government for highly skilled workers.
In answer to a question in the state Assembly, the state department for women and child development had said rules similar to personnel working in state government services don’t apply to ASHA workers and work hours are not fixed for them — as is the case with labourers.
In January, Chief Minister Ashok Gehlot had written to Prime Minister Narendra Modi demanding that the incentives paid to ASHA workers be increased by the Central government. Mentioning that these workers are playing a significant role in extending the reach of health services at the community level, Gehlot had said in the letter that the full honorarium is being paid presently by the state government.
Gehlot had said that at present as against 55,816 posts of ASHA workers in the state, 52,248 ASHA Sahayoginis are engaged.
Additional director, ICDS, Ranjeeta Gautam said that after the increase in the honorarium of ASHA workers in April this year as per the budget announcement, she doesn’t have any knowledge about any subsequent plans for increasing it again.
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