Who are ASHAs and Why Are They Protesting?
- Accredited Social Health Activists (ASHAs) are trained community health workers, primarily women, who act as a bridge between the community and the public health system in India. They are selected from the community, reside in the same area, and are tasked with improving the health status of their community by promoting health awareness, facilitating access to services, and providing basic healthcare.
- ASHAs (Accredited Social Health Activists) are a 26,125-strong workforce in Kerala under the National Health Mission (NHM).
- They have been on a day-night protest for over two months demanding:
- Higher honorarium in line with Kerala’s minimum wage standards.
- Retirement benefits and removal of restrictive payment criteria.=
Key Demands from ASHA Workers
- Honorarium increase to ₹21,000/month equivalent to Kerala’s daily minimum wage of ₹700.
- ₹5 lakh lump sum on retirement.
- Abolition of honorarium-linked performance criteria.
- Regularization of employment — shifting from “volunteer” status to formal workforce with fixed salary, pension, and social security.
The Government’s Position
- State’s Argument:
- ASHAs are a Union government initiative, hence the Centre must lead structural reforms.
- ₹636 crore pending from Centre under NHM for FY 2023-24 has impacted payments.
- Despite this, the State removed criteria-linked conditions but cannot afford a pay hike due to fiscal constraints.
- Centre’s Stand:
- Union Health Minister acknowledged the need for incentive revision in Parliament.
- However, no timeline or clear policy commitment has been made yet.
Current Impasse and Political Undertones
- The State has criticized the Kerala ASHA Health Workers’ Association (KAHWA) for protesting at the Secretariat instead of the Raj Bhavan.
- The movement has been labelled “anti-government” by some State officials.
- In the latest negotiation, the State rejected KAHWA’s interim demand for a ₹3,000 hike, proposing instead to form a study committee.
Structural Challenges and Policy Gaps
- ASHA workers remain outside the ambit of formal labor protections despite being central to public health delivery.
- The ASHA scheme, launched in 2005, still views them as volunteers — denying them fair wages and career security.
- Their role has expanded significantly (especially post-COVID), but policy evolution has not kept pace with workload and expectations.
The Need for Structural Reform
The ongoing agitation by Kerala’s ASHA workers highlights a critical fault line in India’s public health system — where frontline workers are overburdened, underpaid, and under-recognized. Immediate resolution demands:
