ASHA workers cut their hair during a protest, demanding an increase in their honorarium, in Thiruvananthapuram, Monday, on March 31.
| Photo Credit: PTI
The story so far: For over two months now, a section of Kerala’s 26,125-strong community of Accredited Social Health Activists (ASHAs) have been on a day-night agitation on the streets demanding better remuneration and retirement benefits. While the agitation gained much attention and was also raised in Parliament, the issues raised by the ASHAs remain unresolved.
Why are they protesting?
ASHAs in Kerala are given a monthly honorarium of ₹7,000 and a fixed incentive of ₹3,000. Depending on the area where they work (for example, the tribal belt), they also get additional incentives. The payment of the entire honorarium and incentives are dependent on them fulfilling certain work-related criteria. The honorarium is paid by the State while the incentives are paid by the Centre and State at a 60-40 ratio. The State government claims that Kerala pays one of the highest honorarium to ASHAs, whereas the incentives given to ASHAs by the Union government for various services has remained the same from the inception of the scheme. Kerala Health Minister Veena George’s statement that almost all ASHAs in the State are drawing anywhere from ₹10,000- ₹13,000 a month was refuted by the ASHAs who pointed out that they received much less in reality because of the criteria linked to honorariums.
What are the long term demands?
In Kerala, which has one of the highest minimum wage structures, and where daily wages for various jobs range anywhere from ₹700-₹1,200, ASHAs earn less than ₹250 daily. Though their immediate demands were the release of pending amounts due to them, they also demanded that the criteria linked to the honorarium be removed. Their main demand is to hike the honorarium to ₹21,000 a month so that they receive at least minimum wage (₹700 daily). They also sought a lump sum of ₹5 lakh on retirement. The ASHA scheme, when conceived in 2005, envisaged ASHAs as health volunteers rather than as a regular workforce. Hence they receive no fixed salary, no pension or other social security benefits. ASHAs point out that they would forever remain on the fringes unless they were made into a regular workforce.
Also read | Agitation to continue till wages raised, Kerala govt withdrew from talks: protesting ASHA workers
What is the State saying?
The State Government has all along maintained that ASHAs come under the Union government and that it was entirely up to the Centre to change the fate of ASHAs by making fundamental changes in the scheme such as revising the incentive pattern and changing their employment status from non-paid “health volunteers” to a regular workforce. The State has also called out the Centre for refusing to give the cash grant it owed to the State National Health Mission (NHM) for the year 2023-24 — ₹636 crore — which has precipitated the current crisis and totally derailed the functioning of the NHM. Though the Government issued orders de-linking the conditions which were attached to the honorarium payment, it has refused to relent to the ASHAs’ demand for a hike in honorarium or retirement benefits, citing the State’s precarious finances.
Moreover, the State government is peeved that the Kerala ASHA Health Workers’ Association (KAHWA) which is leading the agitation is doing so in front of the Secretariat and not in front of the Raj Bhavan. It has tried to discredit the agitation, accusing KAHWA of leading an “anti-government” movement.
What is the current position?
The Union Health Minister has declared in the Rajya Sabha that the incentives for ASHAs would be revised, yet no timeframe has been fixed for the same.
During the last round of negotiations, the State Government put forth a suggestion that a committee be set up to study the issues of ASHAs, including the honorarium hike. KAHWA suggested that in the interim, ASHAs be given a hike of at least ₹3,000 — an increase of ₹100 per day — which was rejected by the State.
Published – April 16, 2025 08:30 am IST
