Major issues of CHWs



When health care professionals discuss rights violations, they refer to the rights of the recipients of health care. As a norm they address the rights of the community when they work with health rights. However, there are other large scale violations of rights in health care that are rarely acknowledged. I refer to the violation of the rights of the health providers. 

Physical safety, exposure to occupational hazards like infections, risk of sexual harassment and lack of respect from the higher cadres due to the low status. These are the safety issues that call for the attention of not only the health care movement but also the women's rights movement, because by no coincidence at all, most of these overlooked workers are women.

Even the civil society is completely preoccupied in addressing the rights of the community and rightly so. However, where would the community, the health program and the health system be without the health providers? It is the multi-layers of health providers that make health care possible.

The most populous section of health providers are the foot soldiers. In India, these are the community health workers. These would mean in India, the Anganwadi workers, Ashas, Mid-Day Meal workers and other unregularised health workers. Is it an exaggeration to state that like doctors, health care cannot work without them as well? It is true that their domain of interventions is restricted, yet, would doctors visit each home in the village, give health care education or even take women to hospitals for deliver as Ashas do?

Health services are hierarchical structures and it is not surprising that the foot soldiers are often dominated and neglected within them. The community that they work for too are generally the recipients of their services, not the champions of their rights. Therefore, if the rights of this largest section of the health care providers are not addressed empathetically and vigorously by the public at large, the researchers, the activists, the teachers and the practitioners of the health care movement, then they are truly alone.

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