Kerala ASHA Protests: Demand for Higher Pay and Benefits Explained

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Opposition MPs from Kerala protested in Parliament, demanding higher honorariums and retirement benefits for ASHA workers. The leaders highlighted that ASHAs earn only ₹233 per day, often irregularly.
In response, Health Minister J P Nadda stated that the NHM Steering Group had approved increased incentives, which would be implemented soon.

ASHA stands for Accredited Social Health Activist.
ASHAs are community health workers who are part of India’s National Rural Health Mission (NRHM).
The Ministry of Health and Family Welfare (MoHFW) employs them.

The National Rural Health Mission (NRHM) launched ASHAs in 2005 as community health functionaries working alongside Anganwadi workers under the Integrated Child Development Scheme (ICDS).
In 2013, NRHM and the National Urban Health Mission were merged into the National Health Mission (NHM).

Serve as the first point of contact for marginalized communities, particularly women and children, for healthcare needs.
Promote awareness of good health practices and assist in accessing public health services.
Support maternal and childcare, immunization drives, family planning, and disease prevention programs.
Conduct periodic home visits and maintain health records.

Women aged 25-45, preferably married, widowed, or divorced.
Minimum education qualification of Class 10.
Selection involves gram panchayats, Anganwadi institutions, community groups, and self-help groups.

One ASHA is assigned per 1,000 people.
As of 2022-23, India had 9.2 lakh rural ASHAs and approximately 79,900 urban ASHAs.
The highest number of ASHAs are in Uttar Pradesh, Bihar, Chhattisgarh, and Madhya Pradesh.

Volunteer Status and Payment Structure
- Initially, ASHAs were considered honorary volunteers whose work was designed not to interfere with their livelihood.
- However, many now work full-time as they serve as the first point of contact for marginalized households.
- Despite this, the NHM still classifies them as volunteers, making them ineligible for fixed salaries beyond task-based incentives.
Monthly Incentives and Honorarium
- ASHAs receive a monthly incentive of ₹3,000, shared between the Centre and the state.
- Payment is tied to completing specific tasks and is often not fully disbursed.
- Kerala ASHAs get ₹500 for the Rashtriya Bal Swasthya Karyakram (early childcare scheme), but its applicability is limited in areas with low childbirth rates.
State-Specific Honorarium and Task-Based Earnings
- In Kerala, ASHAs receive a monthly honorarium of ₹7,000, funded by the state.
- Payment depends on completing 10 tasks, such as running clinics and maintaining ward reports, each valued at ₹700.
- Additional task-based incentives vary depending on different national health schemes and their applicability in specific areas.

Kerala Health Minister Veena George stated that the state offers the highest honorarium to ASHAs.
However, some states provide higher payments and additional benefits.
Sikkim: Paying ₹10,000 per month since October 2022.
Andhra Pradesh: Increased honorarium to ₹10,000 and introduced ₹15 lakh gratuity for ASHAs completing 30 years of service.
Karnataka: Raised honorarium from ₹5,000 to ₹10,000 (effective April) following an ASHA workers’ strike demanding ₹15,000 as a fixed monthly honorarium.