The State government on Wednesday announced its decision to implement a new scheme called the Community Based Health Incentive Scheme (CHIS), which seeks to increase the fixed incentive of ASHA workers from Rs 2,000 to Rs 3,000.
The decision was conveyed by the Minister in-charge Health and Family Welfare Ampareen Lyngdoh during a meeting held with a delegation of the Meghalaya Accredited Social Health Activist Workers Union (MASHAWU) at the Main Secretariat.
This came after ASHA workers has resorted to an indefinite strike for the past 17 days, which to a great extent disrupted health care services to over 7,000 villages. Earlier, the ASHAs were demanding the government to enhance their fixed honorarium from Rs 2,000 to Rs 5,000.
The ASHAs however have sought time to take a decision on the government’s offer to enhance the fixed incentive by Rs 1000.
After the meeting, Ampareen Lyngdoh informed that the State is annually spending about Rs 17 crores on fixed incentives @ Rs 2000 per month on the honorarium given to the ASHAs in addition to around Rs 22 to 23 Crores annual spending from NHM as performance-based incentives.
The fixed incentives for the ASHAs was initiated in April 2021 because about 70 % of villages in Meghalaya have a small population and therefore, in order to ensure equity and basic minimum financial support for all ASHAs, the state introduced the fixed incentive system (in place of existing performance linked schemes).
“A new scheme will now come into effect which will be named as the Community Based Health Incentive Scheme for ASHA. Under this scheme the fixed incentive of ASHAs will be increased from Rs. 2000 to Rs. 3000,” she announced.
Under this, the Village Health Councils (VHCs) headed by the headmen at the community level will be responsible for reviewing and evaluating the performance of ASHAs in fulfilling the specified health milestones, Lyngdoh added.
She also informed the Chief Minister of the State Conrad K Sangma has agreed in principle that an additional amount of Rs 1000 can be considered and added to the existing Rs 2000 fixed incentive from the State government.
Under the new scheme, the revised incentives for ASHAs will be based on ASHAs contribution and their efforts along with VHCs and Health Teams of PHC/CHC/Sub-centers to improve community-level health indicators. These include: Making all out efforts to save the lives of mothers and children, Screening and Referral of NCD Cases, Ensuring 100% Full Immunization Coverage of new-borns up to 1 year of age and Ensuring 100% ANC Coverage for Pregnant Mothers, among others.
It was also informed that a dedicated Committee will be put in place for streamlining the newly announced CHIS for ASHA. The committee will comprise one ASHA representative from each district, a representative from VHC from each district, NHM Officials, and State Officials. It will also look into all the grievances put forth by the ASHAs during the discussion in today’s meeting.
With regards to this demand, the minister said, “We are saying that if ASHAs are an important component in the system, we will talk to them but there is a limit to this talk. 20 months ago, there was a dialogue. Everything was okay. 20 months later, again you meet us and again there is a protest. We would like to see that this does not happen.”
Also referring to the pay commission in the case of hiking the salary of government servants, Lyngdoh said, “There should be some justification everytime you ask for your increments. Look at government servants. A pay commission in the government of Meghalaya doesn’t happen very often like other central government organizations yet people are working.”
“In the same manner we look at it in that perspective so that there is no undue demand which will not be justified to the Chief Minister who heads the state of Meghalaya takes care of the state’s coffer. The exchequer should not feel a strain and drain by these components of workers,” she added.
Asking the ASHA workers to give only 6 hours of their free time, not everyday, the minister said, “We have ANMs who are supporting us in the village, we have the mid level health workers, who are also supporting us in the system. Everybody do your work, don’t burden these ASHAs, who are volunteers. And we hope that our state, alongside this expenditure, sees the corresponding improvement in health indicators.”
“Chief Minister sends his greetings to all ASHAs, whether you are protesting, whether you are continuously working quietly and do your work, we appreciate what you are doing and we want to be seen as a government which is sensitive to the people’s requirements,” she said adding, “We will take this in the correct spirit. Incorrect words will be said in anger if anything has been said by any government machinery including me, who represents this department forgive but do not create these pressures for us which instigate us to react in a certain manner which again can be very unfortunate.”
Meanwhile, the minister urged all ASHA workers to resume their work from tomorrow on the grounds that the system needs them.
“Don’t allow the government to make decisions, which will be detrimental to your service,”she also warned.
Speaking during the discussion, Sampath Kumar, Principal Secretary, Health & Family Welfare Department reiterated that the State has taken up the concerns and issues raised by ASHA workers with utmost sincerity and dedication. He added that the State has been working strategically to address the systemic issues and to address the challenges of the community-level health workers. The State played a pivotal role in implementing the “ASHA First” application for seamless payment of ASHA incentives and to avoid delays in payments.
He also emphasized that ASHAs are community volunteers identified by their respective village communities, and therefore the spirit of volunteerism has to be kept alive with an aim to save peoples’ lives by assisting health teams of their respective health facilities. The primary objective of ‘saving lives’ should not be forgotten.
He also informed that in order to ensure that the ASHAs are not overburdened, the Health Department had also recently issued an executive order emphasizing the role of Medical officers, Mid Level Health Care Providers and the ANMs in each of the health facilities for visiting villages more frequently to take healthcare services closer to the people.
Meanwhile, MASHAWU president Mirajune Myrsing confirmed that the union had received the written assurance from the state government and will soon take a call on the matter.
“The ASHAs have requested the state government to enhance the fixed incentive. The health minister has offered Rs 1000 enhancement which means (it will now increase to) Rs 3,000 from the state government,” she told reporters while adding “We have told the minister that we cannot say whether we will accept or not because (we are yet to discuss with the) over 200 executive members of the union. So we request time from the state government to allow us to discuss the matter with the ASHA workers and convey our decision later.”
Myrsing said that the union will study the official communication from the state government and decide on its future course of action.
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