Ratul Dhiman
The outbreak of COVID-19 pandemic has plunged the entire world into an unprecedented crisis causing immense loss to lives as well as livelihoods. In India the second wave which came into play in mid-April 2021 has vindicated its ugliest form by causing unparalleled havoc. The United Nations Development programme has described the COVID-19 pandemic as “the defining global health crisis of our times and the greatest challenge we have faced since World War II.” However, it brings a sense of respite that from the last few days, the infection as well as casuality rate is witnessing a downward graph. But still there lies a long fight against the pandemic to ensure normalcy.
This time, the second wave made inroads to rural India, which in turn caused much devastation and exerted excessive strain on already over-loaded healthcare infrastructure. The spirit of selfless service shown by all segments of frontline workers- doctors, para medicos, sanitary workers, police, administrators, essential service providers etc. deserves much appreciation. Since, vaccination process is under way, it is now expected that within a few months we would be in a position to attain requisite mass-immunization.
Our fight against the pandemic has made it very clear that it is essential to have strong yet compassionate, effective and organized institutions which are flexible enough to tackle extraordinary circumstances.
It won’t be an overstatement to make that in our endeavor to tame the pandemic at grass-root level, the community health workers – Anganwadi workers, ASHAs and Auxiliary Nurse Midwives (ANM) played a key role and they continue to do so.
Anganwadi workers are women volunteers who under Integrated Child Development scheme (ICDS) provide nutritional supplements to pregnant and lactating women and children below 6 years of age; educate at community level about health practices and family planning; undertake health-checkups; carry immunization drives and also provide informal education to the toddlers at the local Anganwadi centers. While, Accredited Social Health Activists (ASHAs) are the ground level health workers since 2005, who provide primary healthcare to women and children, both in urban and rural areas. The wide spectrum of services undertaken by ASHAs include- providing prenatal and postnatal care, providing health supplements and to implement community-level health programmes. Auxiliary Nurse Midwives (ANMs) constitute themselves a key pillar of the primary healthcare system in India who assist childbirth, and ensure maternal as well as natal health.
During lockdowns, these community health care workers performed additional field duties and duly ensured that the nutritional supplements are adequately provided to the needy; that the ration is delivered door to door and that the masses are following the requite SOPs and are taking good care of their health. Whereas, during the peak of the pandemic, when the regular healthcare checkups took a backseat, the ASHAs walked an extra mile to provide necessary care to the expecting and lactating mothers and to provide required medications to both mothers as well as their infants.
The disruptions that the pandemic brought with itself couldn’t stop these extraordinary women in fulfilling their obligations as community level health workers. It was only because of the resilience and tenancy of these hardworking and duty-bound health workers that the entire community based healthcare system as an institution was able to reorient it at the very ground level to equip itself to deal with the crisis brought by the pandemic.
However, there is another side of the story. Despite the significant role played by them these Anganwadi workers and ASHAs continue to remain as unsung warriors. Time and again these community healthcare workers had been constrained to come on the roads to raise voice for increase in the honorariums, timely payment of dues and for better coverage under social welfare schemes.
In this regard the directions issued by the Union government in February this year is a ray of hope. As per the Union ministry of Women and Child Development’s directions for the welfare of Anganwadi workers and ASHAs the states and UTs are commanded to cover them under schemes like Pradhan Mantri Jeevan Jyoti Bima Yojna (PMJJBY), Pradhan Mantri Suraksha Bima Yojna (PMSBY) and Anganwadi Karyakarti Bima Yojna (AKBY). They have also been provided with other incentives like scholarships for their children including for ITI courses.
In J&K the very institution of ICDS is being reimagined as now the Anganwadi workers are being provided with smartphones and are trained how to effectively carry forward their operations through digital modes.
Health being a state subject under seventh schedule of the Constitution, it becomes pivotal for states to take adequate measures to strengthen the system of primary as well as community level healthcare by reinforcing grass-root institutions of Anganwadis. Since, a new and comprehensive National health policy shall be required to be floated in post-COVID period, therefore it is desirable that Anganwadi workers, ASHAs and AMWs are given due space in the upcoming health policies.
For us all, it is imperative to respect these extraordinary women who essentially form the foundations of India’s healthcare infrastructure. It is important that we give them due acknowledgement, laud their efforts and also fully support them in their respective karambhoomi.
(The author is Student, The Law School, Jammu University)
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