Besides giving prenatal and postnatal care to mothers and taking them to the Health Centres for institutional Deliveries as well as providing health care to the infants of these mothers, there are a number of additional tasks that are to be performed by the ASHA workers working under the NRHM.
This additional work does not fetch them any additional income. In a sense, this is some kind of forced or ‘involuntary’ work. Some of these tasks are:
1. Epidemic Control
ASHA workers have to undertake H1N1/Bird Flu/AIDS awareness campaigns, as
well as relief work in affected areas; for this they are not entitled to extra
remuneration. In States like U.P. and Gujarat they have had to conduct surveys
to identify people suffering from Swine Flu.
2. Family Planning
ASHA workers have to campaign for family planning methods and even
distribute contraceptives in rural areas.
3. Immunization
They are forced to carry out immunization programmes as well as administer
polio drops.
4. Administering ORS
ASHA Workers are made to do house-to-house surveys to administer ORS (Oral
Rehydration Solution) to children suffering from diarrhea and a
performance-based incentive of RS.1 per child is given.
5. Work During Natural Disasters
In States like Uttarakhand and Jammu and Kashmir, the ASHA workers were
having to do disaster relief work under the guidance of NDRFD (Natural Disaster
Response Force) and the Indian Army. They were given no extra incentive for
this.
Overworked and Underpaid The ASHA workers have to rush expectant mothers to
nearby hospitals at short notice. They have to spend from their own purse for
transportation and the honorarium is sent to their bank accounts after considerable
delays. For antenatal check-ups of expectant mothers, they receive a petty honorarium
of just Rs. 300, whereas they have to often make several visits in the later
stages, or if there are pregnancy-related complications.
These para-workers are paid a pittance in terms of honorarium, i.e., just
Rs.1000, on an average. For this they have to have a Class 8 certificate and
have to undergo special training, during which period they are not paid
anything. They are given cheap mobile phones and receive orders through SMS;
they are kept track of all the time. After a lot of protest, the Mamata
Banerjee Government of West Bengal increased the monthly honorarium from
Rs.1,000 to Rs.1300. The Left Front constituents have started organizing the
ASHA workers in different states and have demanded an honorarium of at least
Rs. 10,000 per month although interestingly they had never increased it during
their own rule in W.B. and Kerala; nor are they planning an increase in the
State of Tripura where they are in power.