‘Our Movement Will Continue For ASHA Workers In Other States’: Sunita Rani

Between August 8 and August 19, over 20,000 ASHA workers (Accredited Social Health Activists) in Haryana had been on strike demanding higher wages, an increase in retirement age, and inclusion in the government’s healthcare cadre on a minimum wage of Rs 26,000. ASHA workers in Haryana began to be paid a fixed salary of Rs 4000 only in 2018, following a six-month long protest. But in the five years since, the workload of ASHA workers has increased exponentially while their remuneration has stayed fixed, as we reported here.

On August 19, 2023, after leading a 24-hour sit-in protest in all 22 districts of Haryana, the Manohar Lal Khattar government finally gave in to some of their demands – it announced an increase in  the fixed honorariums of ASHA workers from Rs. 4000 to Rs. 6100, and promised them a sum of 2 Lakhs after retirement. However, their other demands are still unmet.

In an interview with Behanbox, Sunita Rani, the general secretary of Haryana’s ASHA Workers Union, speaks about the partial fulfilment of the workers demands, the way in which the union operates, and the way forward for the movement.

Are ASHA workers satisfied with the decision of the Khattar government regarding pay hike and the increase in the amount they will receive upon retiring?

We are not satisfied with the decision. The corpus of work that ASHA workers do – from being a critical link between India’s rural community and the public health delivery system; thereby strengthening the public healthcare system, ensuring that healthcare services reach every individual – is a lot. It is significant, and commendable work for which an ASHA worker has a right to minimum wage. Further, this work is permanent in nature, meaning that India’s healthcare system will always need an ASHA worker to function smoothly. But our workers are not even considered permanent employees, volunteers paid an honorarium.
The Haryana government’s decision to increase the fixed honorarium of ASHA workers from Rs 4000 to Rs 6100 is a significant effort, as is the promise to give workers Rs 2 lakhs as retirement benefits. However significant, it is a small step. The state government tells us that its hands are tied and since ASHA workers come under the National Health Mission (NHM), a central government scheme, only the Centre can decide whether ASHA workers can be recognised as permanent workers, or be given social security benefits such as ESI, PF, etc. ASHA workers were recruited as volunteer workers in 2005 by the NHM. Between 2005 to 2023 things have changed, both socially and economically.
On average an ASHA worker in Haryana earns about Rs 9600 monthly — this is including the fixed honorarium and incentives earned based on tasks completed. However, they have to pay out of their pockets for data recharge, transporting pregnant women to health facilities, and buying and photocopying survey notebooks, as well as paying their own house rents – all of which amounts to Rs 3000 and more, leaving the workers with little less than Rs 6600.

How can state governments expect ASHA workers to work below minimum wage in these times? This is a question for all the state governments to grapple with, for which they should hold deliberations with the central government. 

Another important development to note is the reduction of the budget under the NHM. The share of the NHM in the total allocation for the health budget has decreased from 41.6% in 2022-23 to 39.7% in 2023- 2024. This is a problem –  and one which has to be addressed at the central level, because state governments can also do so much.

How was the union able to collectivise close to 20,000 ASHA workers?

It has taken us 14 years to mobilise such a huge number of ASHA workers. In 2009, we started creating our ASHA Workers Union, which we registered with the Haryana government in 2011. Currently, there are 16,000 ASHA workers in our union, but in our protest demonstrations around 20,000 show up. The rural healthcare system is a 3-tier system – at the bottom is the sub-centre, above that are the primary health centres, and then come the community health centres. We have created committees of ASHA workers within all three tiers who report to our zilla or district committee, part of our larger Haryana state committee. We have tried to ensure that we create a union based on a democratic system – this is why it doesn’t take us a lot of time to make decisions, sometimes we do it within 30 minutes. Digital zamana hain, humne ray banayi aur message likha aur aadhe ghante ke andar woh circulate hojata hain (this is digital age, we take a decision and circulate it within half an hour). This time, our ASHA workers were so vigilant they kept their phones with them at all times so they could be updated about all the decisions being made, and their committees would quickly make decisions and inform us.

We also mobilised the general masses about the current reality of our public healthcare system, the ways in which it needs to be improved and the working conditions ASHA workers have to endure – with no access to social security benefits, minimum wage, etc. They all came to our support, which is a significant achievement. The Haryana government has said that this is the first time they’ve witnessed an agitation on this scale by women workers.

It has also been empowering to see a government that unleashed every repressive mechanism to stop us from protesting, finally relenting. It is the same government that put ASHA worker union leaders under house arrest for attempting to reach the Haryana Legislative Assembly for a protest demonstration on August 28, 2023. Not only this, vehicles booked for the rally were also impounded and ASHA workers put into buses and dropped at far-off places to deter them from joining the protest march. Despite this, ASHA workers did not stop – they walked to the assembly and reached the premises to protest. It is only through the power of women and their collective strengths that we have been able to achieve this.

How does the union plan on taking the movement forward?

The Haryana government’s decision to increase the honorarium and retirement benefits is a welcome step. However, our movement will continue – for the ASHA workers in other states who still receive way less than what we have achieved in Haryana. In different parts of India, ASHA workers have been protesting for better wages – be it in Patna, Bandipora, Mumbai or Hyderabad. We plan to march to Delhi on October 30, 2023, and have a nationwide protest of ASHA workers from across the country.