ASHA and Anganwadi workers are often regarded as the backbone of India’s public health system. As the most public interface of the government at the community-level, they are known for their tireless efforts in bringing health care services to the remotest villages in India. Even more so during the pandemic. Since the inception of the SGBV programme, ASHA/Anganwadi workers have become an integral part of our Talika Network.

Why are they crucial for Talika? How has their involvement impacted the network and community? What makes them a successful addition to the network?

Below we explore how ASHA/Anganwadi workers have become an indispensable part of the Talika Network and its activities in such a short span of time.

• Who are the ASHA and Anganwadi workers?

ASHA Workers (Accredited Social Health Activist) are an all-female cadre of community health workers formed by the Ministry of Health and Family Welfare (MoH&FW) under the National Rural Health Mission. Similarly, Anganwadi workers are constituted under the Integrated Child Development Scheme (ICDS) of the Ministry of Women & Child Development (MoW&CD), and oversee the Anganwadi Centres.

• How do they champion health rights amongst women?

They are primarily tasked with making available health-related services such as universal immunisation, antenatal/postnatal care, supplementary nutrition, etc. to women and children. Their contribution in the health sector was especially commendable during the Covid-19 Pandemic, as their tasks were expanded to include the dissemination of information about the virus, surveillance, and control of the spread, facilitating access to medicines, as well as vaccination duty which extended to even the remotest parts of the country.

• What has been their role with M.A.P?

Currently, M.A.P has employed 4 ASHA/Anganwadi workers on a part-time basis under our Support for Survivors of Sexual and Gender-based Violence (SGBV) Programme. These women are residents of the target settlements and are therefore familiar with the locality and the unique challenges specific to it. Most have over 8 years of experience of working with the community.

They primarily act as a communication channel between this community and the Talika Network, and are required to conduct health awareness sessions-- largely on reproductive rights and post-violence support and care, for the community. They also provide direct assistance and referrals on a case-by-case basis.

• Why is M.A.P working with them?

Even though they have come to occupy a critical role in the Network, interestingly ASHA and Anganwadi workers were not originally a part of the Network Plan.  

During the initial phase of the project, M.A.P drew inspiration from MSF’s Umeed Ki Kiran clinic model which employed ASHA workers on a part time basis. Further discussions with MSF also brought to light the need to have health workers from the target locations on board to be better equipped to provide health services/referrals to the communities they serve. This helped us further develop the health services aspect of our project. Moreover, over the months, our experience showed that having resource persons from the same locality, who have shared experiences makes it is easier for the target community to trust these ASHA/Anganwadi workers and confide in them or approach them.

• How were they selected?

When the M.A.P team visited these six settlements to undertake the needs assessment survey (READ: Survey 101: How to Conduct a Needs Assessment) it was through discussions with interviewees that community ASHA and Anganwadi workers were identified.

Once they were willing to work with M.A.P on the SGBV project, they had to be sensitised to the needs of the communities they were serving including where the migrants-- forcibly displaced or internal, had come from, and the problems they often face. Community visits helped in achieving this, and highlighted the pressing requirement for local support which would allow them to access services in cases where there was no documentation. Further, being largely employed in the informal sector meant exploitation by those they worked for. Women also were seen to not have access to health care. This added to their willingness to work with both communities.

• What is their relationship with the community like?

During joint sessions we noticed that the presence of ASHA/Anganwadi workers reinforced a sense of safety and familiarity within the community members, as they seem to be more comfortable and responsive during the training sessions held with them. Over time, through their dealings with their target locations, each of the 4 ladies has evolved their own ways of dealing with the community, becoming familiar faces in both.

• How have they contributed to Talika Network?

The ASHA/Anganwadi workers have played a significant role in the entire network building process (Read: Talika Network: NGOs and Focal Point Persons), in terms of communicating with the NGOs or Focal Point Persons. Since they are from the target locations itself, it has simplified our process of communicating with the service providers from these locations.

These community workers have portrayed exemplary initiative in making referrals to the NGOs and have connected with them in making essential services available for the community, for example, they facilitated the distribution of sanitary napkins in one of our settlements. Moreover, they have also played a crucial role in helping identify our focal point persons from the target locations, after verifying their backgrounds and interest in the position. Apart from larger aspects of mobilising people and building relationships, they have made a strong presence in smaller but significant day-to-day tasks like finalising meeting venues by availing common public facilities or Anganwadi centres.

 The fact that a significant portion of the outreach activities related to the project were still carried out during the pandemic and lockdown period is testament to their efforts and dedication. Most importantly, the part-time payment structure acts as a positive reinforcement and also aids in establishing accountability for all their actions. Additionally, they were extremely proactive in identifying persons in need of aid and assistance during the second wave (April 2021 onwards) of the Covid-19 pandemic.