Recent research published in the Social Science and Medicine journal has brought to light the struggles endured by Accredited Social Health Activists (ASHA) in India. Surprisingly, over half of previous studies have concentrated on the health system’s perspective, neglecting the individual hardships of ASHA workers. This study included 59 ASHA workers across six focus groups, discussing their work-related stress factors such as workload, gender bias, caste discrimination, and problematic relationship dynamics.
Key Findings from the Study
The study revealed significant findings concerning the issues faced by ASHA workers. These issues range from caste discrimination, with several ASHAs being barred entry into homes of higher-caste citizens, to gender-based disrespect, where ASHA workers faced derogatory comments and behavior when interacting with men outside their family circle. Additionally, toxic workplace relationships were prevalent, with unhealthy interactions with superiors and staff becoming common. Added to this is the strife caused by balancing demanding jobs and domestic responsibilities, with some facing threats of divorce.
Required Support and Coping Mechanisms for ASHAs
The study recommends that with proper support and coping mechanisms, ASHA workers could potentially manage their work-related stress more efficiently.
Understanding the Role of Accredited Social Health Activists
Launched in 2005-06 as part of the National Rural Health Mission, the ASHA program was subsequently extended to urban areas with the National Urban Health Mission in 2013. The program serves as the world’s largest community health worker program, helping enable community participation in health. As of June 2022, there are over 10.52 Lakh ASHAs in all states/UTs of India (excluding Goa).
ASHAs act as healthcare facilitators within their communities, creating awareness about health issues, delivering important services related to maternal child health and family planning, and contributing to the National Disease Control Program. These women serve populations of approximately 1,000 in rural areas and 2,000 in urban settings.
ASHA Selection Process
An ASHA worker should primarily be a woman from the village she serves, married/widowed/divorced, preferably aged 25 to 45 years old. She should be literate and, ideally, educated up to the 10th standard. However, this requirement may be relaxed if no suitable person with the necessary qualifications is available. Despite their significant contributions, ASHA workers are not classified as government “workers” but hold an “honorary/volunteer” role.
Proposed Steps Forward
Several steps are proposed to support ASHAs, including establishing mentorship initiatives for emotional support and guidance, strengthening advocacy efforts to address caste and gender discrimination, fostering open communication with their supervisors, and educating families and communities about the importance of their work. It is also suggested to create flexible working arrangements to help ASHAs better balance their familial and work duties. A community-wide recognition of ASHAs’ contributions is also seen as a way forward, instilling pride and valuing their work.
Examining the Role of ASHAs through Previous Year Exam Questions
To understand the relevance and significance of ASHAs’ role throughout the years, it is helpful to review related questions from previous civil service examinations. For instance, in the 2012 examination, candidates were asked to identify specific responsibilities of ASHA workers. The options included accompanying women to healthcare facilities for check-ups, using pregnancy test kits for early detection, providing information on nutrition and immunization, and assisting in childbirth.