by Women In Global Health (WGH) India
Report on Contributions and Challenges of ASHAs
“ASHAs are a part of the health system but are never given a seat at the decision-making table, very much like most women within our families and outside”
India’s response to COVID-19 relies heavily on the female Frontline Health Workers (FLWs) including Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), and Anganwadi Workers (AWWs). They have been involved in surveillance, home visits, distribution of ration, awareness generation about COVID-19 transmission and prevention, and facilitating access to COVID-19 diagnostic and treatment services.
Emerging reports have indicated that while there was a wider recognition of the role of scientists and doctors in COVID-19 response, contributions of ASHAs and AWWs were unrecognized. Central and State Governments issued guidelines to engage these FLWs in COVID-19 response, including the provisioning of financial incentives, Personal Protection Equipment (PPE) for the health workers, and health insurance benefits. However, there are challenges in the implementation of these guidelines on the ground. Moreover, the FLWs continued to face difficulties like stigma, violence, delayed and insufficient payments, and lack of proper PPE while performing their tasks. These challenges potentially hampered their performance and held wider implications for delayed and ineffective health systems response to COVID-19.
Women in Global Health (WGH) India hosted a series of virtual dialogues to focus on the experiences of different cadres of FLWs to amplify their contributions and raise the challenges they faced. The primary objective of the series was to create a common platform for various stakeholders to discuss issues concerning the effective engagement of ASHAs and AWWs in the COVID-19 response and recommend broad policy responses for improving their engagement. The first three dialogues focused on ASHAs and AWWs and subsequent policy responses to the challenges faced by them. The series was designed to gain perspectives from stakeholders located at different levels of health systems including community, state, as well as the national levels. Discussants included health workers, workers’ representatives, trade union representatives, civil society members, researchers, academicians, state and national level policymakers, and development partners. Each level of the health system was taken up in a separate dialogue and emerging issues from each level were then fed into the next level of the health system discussed in the series.
Please download the full report here
This report has been prepared by Sapna Kedia, Shubha Nagesh, Stuti Chakraborty, Deepika Saluja, Sumegha Asthana, Sneha Krishnan, and Preethi John. The views expressed are on the behalf of WGHI.