Community Health Work is Work!

ABOUT THE CAMPAIGN

CHWs hold a pivotal role in enhancing public health throughout South Asia, a region grappling with myriad health challenges, from infectious diseases to limited healthcare access. They bridge these gaps by delivering vital healthcare services to communities, imparting education, raising awareness, and advocating preventive measures. Their significance is amplified in remote areas with scant formal healthcare infrastructure. They are known as Accredited Social Health Activists (ASHAs) in India, Lady Health Workers in Pakistan, and Female Community Health Volunteers in Nepal. They serve as the initial point of contact during health emergencies. 

Regrettably, this workforce, primarily composed of women from rural, socio-economically disadvantaged backgrounds, suffers due to gendered assumptions about their work. Their contributions are often undervalued, and they are poorly compensated. They perform their indispensable tasks without proper recognition as public health workers. Except in Pakistan, CHWs are denied the basic right to a minimum wage and lack essential social security benefits like pensions, medical coverage, and maternity leave. 

The Unions of CHWs and Public Services International (PSI) launched the campaign “Community Health Work is Work” in 2020 during the peak of COVID-19 pandemic. Even though CHW were at the highest risk of contracting COVID-19 owing to their work, they were denied health and life insurance and pensions. Governments recognised CHW as “warriors against COVID-19” and yet failed to provide adequate personal protective equipment (PPE), training, wages or any other support. The Unions documented a litany of threats and violations endured during the pandemic, including heightened infection risks, long working hours, psychological distress, fatigue, burnout, discrimination, and physical and psychological harassment. Articulating these experiences, the Unions and PSI launched the campaign and a set of demands ahead of the International Day for Universal Health Coverage. 

Despite their invaluable role during the pandemic, the struggles of CHWs continue to be overlooked. Neoliberal policies and international financial institutions are pushing for privatisation of public services, making their working conditions even more precarious. Thus, the campaign has continued too!  

In August 2023, CHWs from Nepal, Pakistan, and India convened in Kathmandu to unveil a comprehensive Charter of Demands. In the Charter, the CHWs staunchly demand formal recognition as workers, rather than volunteers, alongside infrastructural development and social security. Notably, a Member of Parliament from Nepal and representatives from the World Health Organization and International Labour Organization attended the launch. The event fostered cross-border exchange of experiences and mutual learning. The Charter is poised to serve as a unifying force for CHWs in South Asia and is set to garner international support for their rights.