ASHA workers in Karnataka demand better incentives; here's why they are going on statewide protest from Aug 12

The ASHA (health) workers in Karnataka will go on a statewide three-day sit-in protest from August 12 demanding the Siddaramaiah government to enhance the monthly honorarium to ₹10,000 as assured by the government following their protest in January this year.

“ASHA workers in the state have been demanding a fair honorarium as they are currently drawing Rs 8,000 per month which includes the Centre’s share of ₹3,000. We urge the state government to enhance its share from ₹5,000 to ₹6,000. In fact, the government announced a hike of ₹1,000 to Anganwadi and midday meal scheme workers in the last budget,” said D Nagalakshmi, state secretary of All India United Trade Union Centre affiliated Karnataka State United ASHA Workers’ Association.

While the long-pending demand for recognition of ASHAs (accredited social health activists) as government employees and minimum wages remains to be fulfilled, the workers have raised concerns over job losses and poor incentives due to sudden change in policy and an inefficient ASHA-Soft – a pioneer e-Health programme for managing online payment and monitoring the performance of ASHA workers.

As per the National Rural Health Mission norms, the government needs to select one ASHA per 1,000 population and if the population exceeds 1,000 population, a second ASHA needs to be engaged in rural areas. In the urban habitations up to 50,000 population, selection of ASHA will follow the rural norms.

“The state government has removed 2,000 sugamakaras (ASHA facilitators) and 370 ASHAs aged 60 year and above without prior notice. Also, a new policy of rationalisation of workforce has increased our work area – from 1,000 population to 2,000 in rural areas and from 2,500 to 4,000 population in the urban areas,” said TC Rama, vice president of the Association.

In rural areas, the dearth of bus connectivity and poor wages hampers work, say ASHA workers. Also, and the glitches in technology and lag in updating the daily performance record of ASHA workers through the ASHA-Soft – a web-based system for the performance appraisal is depriving the workers of incentives.

Besides the routine work – line listing of households, maintaining village health registers, registration of birth and death, list of children to be immunised, ANC beneficiaries and conducting monthly meetings, ASHA workers are eligible for performance-based incentives for their services under the National Health Mission that includes monitoring maternal and child health, immunisation, family planning, adolescent health, national tuberculosis and leprosy eradication, malaria and other vector-borne diseases control, Lymphatic filariasis, acute encephalitis syndrome, elimination of kala azar, dengue, chikungunya, anemia, iodine deficiency, NCD screening, drinking water and sanitation work.

Hike honorarium by ₹1,000

The Association has urged the Karnataka government to enhance their honorarium by ₹1,000 with retrospective effect (from April this year), reinstate the ‘Sugamakara’ workers, provide post-retirement benefits, enhance honorarium by ₹2000 for ASHAs in urban areas, and increase the honorarium similar to the Centre’s recent hike in incentives.

“The performance linked incentives will depend on the online data entry for Reproductive Child Health services. The ASHA-Soft (RCH web portal) data needs approvals at multiple levels (Primary Health Community Officer, Medical Officer, Taluk Health Officer). But any discrepancy will lead to a cut in our incentive. We want the process to be simplified,” explained Nagalakshmi.

“ASHA workers face safety and mobility challenges as we need to attend to emergencies in remote areas and at odd hours. In Karnataka, the ASHA workers are roped in for election work, caste survey, during SSLC board examinations and village fairs and many survey which are outside our job description and it is often without any additional remuneration,” said Rathna, an ASHA worker.