UPSC CSE Relevance:
– GS Paper I: Role of women, issues relating to social empowerment
– GS Paper II: Welfare schemes for vulnerable sections, health sector governance, role of NGOs/SHGs
– GS Paper III: Human resources in health, inclusive growth
– Essay Paper: Gender justice, labour rights, public health system
For decades, Anshakalin Stri Parichars (ASPs) in Maharashtra have formed the backbone of rural health services, performing tasks ranging from sanitation to maternal and child care. Yet, their conditions remain abysmal. Despite their wide responsibilities, their wages have stagnated at ₹3,000 per month since 2016, with no job security, pensions, travel allowance, or protective gear. A 2023 Nagpur labour court recognised their right to protection under the Minimum Wages Act but left implementation to the State. Even today, the State promises only ₹6,000 a month by December 2025 — far below the wages of multi-purpose health workers.
The neglect is not incidental; it reflects a gendered and caste-inflected hierarchy of labour in India’s public health system. ASPs, largely poor rural women, predate ASHAs and anganwadi workers but remain the most invisible. Their plight mirrors that of ASHA workers nationwide, who since 2005 have served as the community’s first link to health systems but are officially classified as “volunteers”. They survive on meagre and delayed incentives, leading to repeated agitations for fixed honoraria, recognition as government staff, and social security.
Key Issues
- Underpayment: ASPs fixed at ₹3,000 for years; ASHAs dependent on small incentives.
- No benefits: No pensions, insurance, or job security despite high-risk duties (snakebites, accidents during travel).
- Systemic bias: Women’s skilled labour is undervalued due to gender and social background.
- Protests: Repeated sit-ins across Maharashtra (Kolhapur, Nagpur, Ratnagiri, Yavatmal) and in other States by ASHAs.
Structural Contradiction
India’s health system depends on women health workers for immunisation, maternal-child health, and disease surveillance in rural areas, yet refuses to recognise them as formal employees. What is framed as providing rural women “opportunities” for service is in practice institutionalised exploitation.
Way Forward
- Recognise ASPs and ASHAs as formal health workers with minimum wages and entitlements.
- Provide living wages, timely payments, pensions, and insurance.
- Ensure safe working conditions and travel allowances for rural duty.
- Integrate their rights into broader reforms in health governance and gender equity.
Conclusion
The struggles of ASPs and ASHAs expose the contradictions in India’s public health system. A structure built on the underpaid labour of women cannot be sustainable. Securing rural health requires first securing the dignity, wages, and safety of the women who keep the system running.