After decades of service, ASHA, anganwadi, healthcare workers in Mumbai demand regularisation, better rights and social security

Mumbai: Thousands of program workers, including ASHA workers, anganwadi workers, mid-day meal staff and National Health Mission (NHM) employees, launched an indefinite sit-in protest at Azad Maidan on Sunday under the banner of the Centre of Indian Trade Unions (CITU), demanding regularisation of services, social security benefits and timely payment of wages.The protest, organised by the various unions affiliated to CITU, brought together frontline workers from across Maharashtra who said they have been treated as “temporary” employees despite running some of the state’s most critical welfare schemes for decades.“We want the same rights as other govt healthcare workers, nothing more than that,” said Megha Gosavi, an ASHA worker from Pandharpur protesting outside the Aqua Line Metro gate at Azad Maidan. “We get zero leaves throughout the year. We also have to work on Sundays. We don’t even have any fixed timings, we have to be ready 24 hours a day for work.”The unions pointed out that the Integrated Child Development Services (ICDS) scheme has completed 50 years, the National Health Mission 28 years and the Mid-Day Meal Scheme 36 years, but workers under these programmes are still treated as contractual or temporary staff without employee benefits.Anuja Saluke from Borgaon in Solapur said she did not receive her Rs 10,000 salary for the last six months. “How am I supposed to run my household when we don’t even get our meagre salaries for six months at a time,” she said.Describing the financial strain caused by delayed payments, Saluke said many workers survive on debt. “We have to borrow money from local moneylenders and once we get our salaries we pay them back, but more often than not we are not able to pay them off, so we borrow from a third person and the cycle goes on,” she said.Manisha Kashid, who has been working as an ASHA worker for the last 16 years, said that when she joined in 2009 she worked without pay for nearly five years. “In 2014, ASHA workers started receiving Rs 500 a month. In 2020 it became Rs 5,000 and in 2023 it rose to Rs 10,000,” she said.Kashid added that despite having prescribed duties, ASHA workers are routinely assigned additional responsibilities without compensation. “We are regularly drafted for programmes such as enrolling people for Ayushman Bharat cards, Aadhaar cards and data entry work for multiple schemes, but we are paid nothing for any of this work,” she said.She also highlighted the tuberculosis eradication drives conducted since 2022. “We have to collect samples from households and cover 20 houses a day. We were promised payment for that work, but we haven’t seen a single rupee in four years,” she said.Ardha Reparicher, another healthcare worker at the protest, said that although they are officially classified as part-time workers with five-hour shifts, they routinely work for 10 to 12 hours a day.“In addition to our work at the healthcare centre, we clean toilets, blankets and dispose of garbage,” she said. “Sometimes the places are so far-flung that we need to hitchhike our way to the destination. For many women, the men in the household also object to them getting into vehicles of unknown people, but we just don’t have any choice.”“Sometimes we walk long distances in the sun to reach our new postings while the medical officer zips by in his car on the way to the same posting,” she added.Kamal Sonavane from Solapur city said she has assisted in the delivery of close to 1,000 babies during her nine years as an ASHA worker, but receives only Rs 200 per delivery.“Our work begins just after the confirmation of the pregnancy. We coordinate with the hospital, we set the diet for the expecting mother, we make sure she takes the necessary supplements like calcium tablets, and during labour I take her to the hospital and after the delivery I clean the baby,” she said.Sonavane said the responsibilities continue long after childbirth. “Post partum, we check the growth of the baby, vaccinations, the booster shots they require. At the same time, we have to do data entry of details such as growth, age, height and weight for all newborns until they reach the age of five years. For all of this, I get paid Rs 200 per baby,” she said. “For all this work we want to be at least paid reasonably and have some form of social security.”The protesting workers have demanded a minimum wage of Rs 30,000 per month for eight hours of work, regularisation of all program workers, implementation of benefits such as provident fund, pension, gratuity, and timely disbursal of honorariums and incentives.Dr Nitin Ambadekar, director of health services, said there had been delays in salary payments last year because of a transition to a different online system. “The issue has now been resolved and the payments are being disbursed,” he said.Dr Ambadekar added that discussions were underway regarding the regularisation of 10,000 NHM workers.CITU state president Shubha Shamim said a meeting had been held with minister for women and child development Aditi Tatkare and senior health officials. “We were told that many of our demands require policy decisions, for which further meetings will be held with other departments and ministers tomorrow,” she said.“Till we have written assurances, our agitation will continue,” Shamim added.Kashid added that despite having prescribed duties, ASHA workers are routinely assigned additional responsibilities without compensation. “We are regularly drafted for programmes such as enrolling people for Ayushman Bharat cards, Aadhaar cards and data entry work for multiple schemes, but we are paid nothing for any of this work,” she said.She also highlighted the tuberculosis eradication drives conducted since 2022. “We have to collect samples from households and cover 20 houses a day. We were promised payment for that work, but we haven’t seen a single rupee in four years,” she said.Ardha Reparicher, another healthcare worker at the protest, said that although they are officially classified as part-time workers with five-hour shifts, they routinely work for 10 to 12 hours a day.“In addition to our work at the healthcare centre, we clean toilets, blankets and dispose of garbage,” she said. “Sometimes the places are so far-flung that we need to hitchhike our way to the destination. For many women, the men in the household also object to them getting into vehicles of unknown people, but we just don’t have any choice.”“Sometimes we walk long distances in the sun to reach our new postings while the medical officer zips by in his car on the way to the same posting,” she added.Kamal Sonavane from Solapur city said she has assisted in the delivery of close to 1,000 babies during her nine years as an ASHA worker, but receives only Rs 200 per delivery.“Our work begins just after the confirmation of the pregnancy. We coordinate with the hospital, we set the diet for the expecting mother, we make sure she takes the necessary supplements like calcium tablets, and during labour I take her to the hospital and after the delivery I clean the baby,” she said.Sonavane said the responsibilities continue long after childbirth. “Post partum, we check the growth of the baby, vaccinations, the booster shots they require. At the same time, we have to do data entry of details such as growth, age, height and weight for all newborns until they reach the age of five years. For all of this, I get paid Rs 200 per baby,” she said. “For all this work we want to be at least paid reasonably and have some form of social security.”The protesting workers have demanded a minimum wage of Rs 30,000 per month for eight hours of work, regularisation of all program workers, implementation of benefits such as provident fund, pension, gratuity, and timely disbursal of honorariums and incentives.Dr Nitin Ambadekar, director of health services, said there were delays in salary payments last year because of a transition to a different online system. “The issue has now been resolved and the payments are being disbursed,” he said.Dr Ambadekar added that discussions were underway regarding the regularisation of 10,000 NHM workers.CITU state president Shubha Shamim said a meeting was held with minister for women and child development Aditi Tatkare and senior health officials. “We were told that many of our demands require policy decisions, for which further meetings will be held with other departments and ministers tomorrow,” she said.“Till we have written assurances, our agitation will continue,” Shamim added.(Inputs by Eshan Kalyanikar)