Recognise ASHA workers’ COVID-19 work, ensure their well-being: Report

Give due credit and recognition to the contributions of frontline health workers (FLWs) such as Accredited Social Health Activists (ASHAs) in the fight against the novel coronavirus disease (COVID-19) and ensure their physical and mental wellbeing, a new report has urged.

Engagement of Frontline Health Workers (FLWs) in COVID-19 response in India was prepared as part of the Women in Global Health (WGH) India Dialogue Series by WGHI, that is the Indian arm of the global movement, WGH.

ASHAs, the report said, had been working against all odds ever since the COVID-19 pandemic started.

“They manage pregnant women’s and lactating mothers’ access to health services for antenatal care, institutional delivery, postnatal care, immunisations, family planning services, nutrition, chronic care, to name a few,” it said.

“In addition to these, during the pandemic they are responsible for surveillance activities, awareness generation, screening of returning migrants, contact tracing and facilitating access to COVID-19 diagnostic and treatment services,” it added.

However, there had been no raise in their incentives or any compensation for the additional time, the report noted.

In fact, ASHA workers were not treated in the same manner as doctors despite the fact that both are in the frontline in the fight against the pandemic.

“ASHAs have not been supplied with adequate PPE as they perform contract tracing and interact with newly infected cases in the community. This poses a huge risk to them and their families, resulting in stigma and discrimination by the community for being high-risk COVID-19 contacts. This has also led to multiple cases of violence against ASHAs and their families,” the report said.

The workers were paying from their own pockets for purchasing gloves, masks and sanitisers. They also did not have access to priority or free testing. If tested positive for COVID-19, ASHAs were not receiving support for their treatment.

Solutions offered

The report offered a number of solutions to ameliorate the lot of the ASHAs. These include:

• Recognition of ASHAs’ work by the government and their communities through financial and non-financial incentives
• Development of institutional mechanisms for feeding ASHAs’ experiences, needs and class, caste and gender realities in policymaking
• Development and dissemination of clear and concise guidelines for ASHAs in a timely manner
• Establishment of a capacity building strategy, particularly in relation to use of technology and initiate supervision initiatives for ASHAs
• Development of support systems for ensuring the physical and mental well-being of ASHAs
• Initiation of broader health system reforms for ASHAs including strengthening policies for fair recruitment, retention, financial protection, leave management, protection against sexual harassment, physical and mental health protection and stigma prevention with clear accountability at all levels.
• Convergence with vertical programmes such as livelihoods, nutrition to complement the work of ASHAs.