Governance

Anganwadi, ASHA work massively disrupted during COVID-19 pandemic: Survey

Workers reported increase in stress levels, study finds

 
By Taran Deol
Published: Thursday 21 April 2022

Early childhood development (ECD) activities, including schools, creches and Anganwadi Centers (AWC), were among the sectors that came to a grinding halt during the COVID-19 pandemic. 

Disruptions in the AWC-based nutritional services continued well after the strict lockdown of March 2020 ended, a new survey found. 

As much as 43 per cent of the households with pregnant or lactating women (PLW) faced challenges in receiving food from AWCs, the report said. “Around 47 per cent of households with a child between the ages of 15 months and 6 years received less or no food from AWCs.”

“There were pockets of households that reported an increase in their child’s weakness (6 per cent), with an increased concentration in rural parts of Uttar Pradesh, Bihar and Rajasthan, and in ‘below poverty line’ and Antyodaya (government food subsidy scheme) families,” the report notes.

The time spent by Anganwadi workers undertaking various nutrition-related activities decreased, with less than half — 47 per cent — of them having spent more time providing take-home ration to children / PLW and nearly none of them — 95 per cent — providing hot meals, according to the report published in April 2022. 

The survey was conducted between December 2020 and February 2021 and covered 10,112 primary, secondary caregivers and 2,916 frontline workers across 11 states: Andhra Pradesh, Assam, Bihar, Haryana, Madhya Pradesh, Maharashtra, Odisha, Punjab, Rajasthan, Tamil Nadu, and Uttar Pradesh. 

The study was done by Dalberg Advisors and Kantar Public, and funded by Bernard van Leer Foundation, Porticus, Echidna Giving and Dalberg. NITI Aayog provided technical support and  data was collected from the department of women and child development and the National Health Mission.

Accredited Social Health Activist (ASHA) workers and Anganwadi workers also reported an increase in stress levels, with the workload becoming unmanageable since the start of the pandemic, the report noted. It added:  

Nearly half of the surveyed ASHAs and 36 per cent Anganwadi workers reported working longer hours, and 34 per cent and 38 per cent, respectively, reported increased stress levels. 

Stress levels increased for more than half the frontline workers in Tamil Nadu (66 per cent), Andhra Pradesh (64 per cent) and Odisha (60 per cent) in January-February 2021, as compared to pre-pandemic levels. 

Meanwhile, the percentage of those who recorded an increase was smaller in Uttar Pradesh (18 per cent) and Assam (17 per cent) reported a rise in stress. There was also a difference in urban and rural frontline workers — with 9 per cent of the former feeling less stressed as compared to 15 per cent of the latter. 

In almost all states, ASHA workers and Anganwadi workers serve a larger population than what is mandated. Only Odisha followed the one ASHA worker per 1,000 residents guideline, the survey found. The average population an ASHA worker covers was 1,395 residents in the 11 states surveyed. 

Same goes for AWCs, where one centre is supposed to look after 800 residents but only Odisha and Assam follow this mandate. The average number of residents an AWC caters to in the 11 states is 1.124, according to the findings.

The reasons for increase in stress range from an increase in workload, risk of spreading COVID-19, stigma associated with COVID-19 to lack of protective equipment to delay in payment and job security. 

To address work and stress levels, the report suggested four key points: 

  • Providing increased engagement with and recognition from more senior government officials
  • Enhancing supervisor support to boost morale and alleviate fears
  • Recognising the efforts and contributions of workers through public messaging
  • Providing psycho-social counseling services to frontline workers in order to help raise social capital

The report also found that almost half the parents were not ready to send their children to AWCs at the time of the survey. “As states are reopening these facilities, it will be important to keep an eye on whether children are actually returning or not,” according to the authors. 

Where needed, community-level drives can help ensure that children are attending AWCs, they observed.

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