Dignity and Fair Welfare for ASHA Workers in Kerela

– Dr. Sreedevi R.S., Assistant Professor, Dept. of Economics

26th August 2026

ASHA (Accredited Social Health Activist) workers in Kerala play a critical role in the healthcare system, particularly in rural areas. They are community health workers who serve as a bridge between the healthcare system and the community. When the state faced a health crisis like Covid, and when the state commented on the planning and execution of the access to health care, it is the ASHA workers whose sincerity and commitment towards their job that needs to be appreciated.

The state being known for its accomplishments in health indicators needs to treat the workers who have been working hard day and night to ensure sound health of the people. In the primary health sector they are the point of contact for the public. They handle a variety of tasks which include palliative care, ensuring vaccinations, monitoring the health of young children, administering medication to pregnant women, and answering their countless questions. It is not easy to go and work with the people and interact with them on a daily basis. Mostly the ASHA workers will have to travel long distances to provide a service or to collect some information or to create awareness. In such cases their expenses will be more than what they earn. As these workers come from such a background where they cannot afford to be spending more than Rs.200 or Rs.300 for their daily expenses.

Importance of Protecting ASHA workers

It can be said that the state owes its credit towards achieving high HDI (Human Development Index) to these workers who work at the grass root level. Whenever there is a crisis, these workers are available; be it covid,wayanad landslide, the floods etc. Even though these workers are called voluntary workers, their work has gradually turned into a full-time job. They often get called for all the programs that happen in that locality. They also have to organise programmes which will help them to claim some incentives that are associated with the task assigned. These workers are the backbone of the rural economy not just in Kerala but in other states as well.

The honorarium that ASHA workers get in kerala is Rs. 7000 every month, which means

that their per day wages is Rs.225 which is less than the state’s minimum wages of Rs.700. Even the migrant workers are able to earn an average of Rs. 750 per day in Kerala. From this minimal amount they also charge a fine for missing ASHA meetings and centre duty. Apart from these charges the pay is never on time making it even difficult for these workers to make their ends meet. In a welfare state historically known for prioritising the needs of the marginalised and its people-centric policies, the protest by ASHAs has been continuing for more than a month. It is high time that the state focuses on the workers’ demands.

Labour welfare and women workers’ rights

With respect to labour laws and the core values of the people centered government it is quite an irony that the state does not stand with their workers to ensure their wellbeing. Moreover, the workers being women and denying their right to be recognised as workers is also a way in which the government goes against their empowerment. The state’s model of development is also praised through the women’s group such as Kudumbasree where it highlighted women’s employment and empowerment. But the responsibility of the state in protecting ASHA workers failed to recognise their work. Having achieved high literacy among the people of the state, it failed to acknowledge the work done by ASHA workers.

When women’s role in the care economy is highly discussed in academics with respect to ‘unpaid labour’, ‘burden of caregiving’ and ‘dual burden’; in such a case the social responsibility and community work is identified as a ‘third burden’ where the time taken to do these are outside of her duties and responsibilities at her own household. It can also be noticed that it is women from low income households that take up the third burden voluntarily to deliberate the state’s duties.

For getting the honorarium which is of Rs.7000, the ASHA workers have to perform some tasks that include preparing a ward health report; participating in a review meeting at the panchayat or hospital; conducting a monthly clinic for women, children, and adolescents etc. To organise these many events it requires some up-skilling and training which is already given to these workers. When the state expects the workers to be part of these many programmes it is quite rational for them to ask for better honorarium as things are getting expensive.

The dignity of the labour that is done by ASHA workers is not being recognised here. When they work with utmost sincerity and commitment, it is the responsibility of the government to protect the labour rights where they get paid for the work that they do. We should not forget their role in ensuring safety and access to health during the times of covid, floods, nipah outbreak and other emergency situations. These workers are a link between health services and community. When the state boasts about achieving high targets in terms of health indicators the work done by ASHA workers must not be forgotten. They help to create a database on the health status of the state by continuously interacting and collecting information on all kinds of diseases, palliative care, health programmes etc.

How to approach their demands

When the ASHA workers demand a higher honorarium of Rs.21000, what they are demanding is only the minimum wages of Rs.700 in Kerala. Fair wages is something that the labour seeks when he/she enters the labour market. We need to recognise their work and labour with dignity. These women conduct home visits, spreads knowledge and awareness on nutrition, health, hygiene and is a point of contact in times of emergency.

If we have to look at their working pattern, they do not fit in an 8 hour working time pattern; they work for 10 to 12 hours in a day with no formal employment status, no pension, no insurance, no set working hours, and no leave benefits. Less than 20% of their earnings come from the central government; where it is easy for the state to intervene and make provisions for their employment benefits rewarding and recognising their timely interventions within the community.

When these workers ask for a retirement benefit or a fixed working hours and incentives, what they are seeking is a formal recognition of their work and themselves as health workers. It is now that the state must show their concern and solidarity with women workers guaranteeing them all the benefits and protections they seek. If the state is able to stand with the workers for their demands and recognition, the state is also protecting the direct beneficiaries who are the people. The state should not silence them or should not neglect their demands, rather it should lend both ears to see and listen to their needs. Kerala ASHA workers are carrying a legacy forward where they are fighting for their equality, recognition and visibility. The state has seen many protests like the right to cover their upper bodies, pembilai orumai in Munnar, the right to sit ‘irikkal samaram’ etc., where the women fought for their social upliftment and labour rights. In this context, what they are fighting for is also for the social progress of the society, where the state will recognise not the outcome but also the people who have delivered it. Women coming together for a common cause is not new in a state like Kerala, therefore, it should not shy away from supporting them but should set an example for other states to learn from the massive movements that has taken place in our state before.