Unfairly exploited

The prevailing attitudes that treat care work as low-value labour must be challenged through policy discourse and public awareness initiatives. The state must acknowledge that the efficient functioning of health and welfare schemes depends on these workers, and their rights and dignity cannot be compromised in the name of fiscal prudence or bureaucratic inertia

-  AMAL CHANDRA

In the vast and intricate public service delivery landscape of India, an army of underpaid and unrecognized workers sustains the foundational pillars of health, nutrition, and education. Accredited Social Health Activists (ASHAs), Anganwadi workers, mid-day meal cook-cum-helpers, etc., form the backbone of essential government schemes that reach millions of Indians, particularly in rural and marginalized communities.

Yet, these workers - overwhelmingly women, many from Dalit, Adivasi, and other vulnerable backgrounds - continue to suffer systemic neglect, facing precarious working conditions, inadequate compensation, and a fundamental lack of recognition for their labour.

Their plight is not merely a matter of economic injustice but one deeply intertwined with the caste-patriarchal structures that define India's labour market.

Recognizing them as formal workers with full labour rights is not just a policy imperative but a moral necessity, one that requires strong political will and a reimagining of the value of care work in our society.

ASHAs, introduced under the National Rural Health Mission (NRHM) in 2005, are the first point of contact between the rural populace and the public health system. Their responsibilities include maternal and child health support, immunization drives, tuberculosis and malaria control, and even, as seen during the Covid-19 pandemic, frontline health surveillance and contact tracing.

Despite being celebrated as the "foot soldiers of health," ASHAs remain classified as voluntary workers, receiving a performance-based honorarium rather than a fixed salary.