Updated: February 11, 2021 7:14:51 pm
They juggle household tasks and healthcare activities, and despite being inadequately paid, they still find deep satisfaction in their work. Meet Accredited Social Health Activists (ASHA) workers who can work up to 20 hours a week in their village of residence, a new study by KEM Hospital and Research Centre at Vadu has found. Owing to the workload of various activities, they often feel tired and exhausted, but nothing dampen the spirit of these ASHA workers.
“The sense of benefiting the community is overwhelming for them. ‘Pride of ASHA work’ give them satisfaction and happiness. They prefer to describe themselves as ‘ASHA workers’, a term closer to ‘community healthcare workers’ than ‘health activist’,” Dr Anand Kawade, principal investigator of the study that assessed the ASHA workers’ perspectives about their workload.
The study carried out by the RESPIRE collaboration (a global health research unit focusing on respiratory health in Asia and is funded by the National Institute of Health Research) has been published recently in the Human Resources for Health journal. According to the study, ASHA workers struggle to balance their work and home. Despite having pride in benefiting their communities and job satisfaction, increased range of activities make them feel tired.
The ASHA programme is India’s largest public-sector community health worker initiative, launched by the Centre in 2005 to provide accessible, affordable and quality healthcare to the rural population. ASHA workers serve as the key facilitators of India’s healthcare system in the rural stretches. These are voluntary workers, not employees, tasked with implementing a number of government health programmes at a village level.
There are currently more than one million ASHA workers in India. They act as a link between people and the healthcare system. The study used mixed-methods design in two primary health centres, one rural and another tribal (often remote), in Pune district of western Maharashtra.
The ASHA workers answered questionnaires focusing on the time spent at work and travel, their perceptions of workload and its impact on them and their family. They were also asked about their remuneration, job satisfaction and family support.
Besides answering these questions, eight workers took part in in-depth interviews which explored their workload and its effect on them and their family. Age, training, education, experience, work set-up, incentives and other occupations were highlighted as “influencing” factors. When interpreting prioritisation of their work, the volunteer status of ASHA workers was important.
The study has implications for advocacy and policy within India. Although the ASHA workers have positive attitude towards their voluntary work, this could be enhanced by providing them with predictable financial and non-financial incentives.