In the vast and intricate public service delivery landscape of India, an army of underpaid and unrecognized workers sustains the foundational pillars of health, nutrition, and education. Accredited Social Health Activists (ASHAs), Anganwadi workers, mid-day meal cook-cum-helpers etcetera form the backbone of essential government schemes that reach millions of Indians, particularly in rural and marginalized communities.

Yet, these workers ~ overwhelmingly women, many from Dalit, Adivasi, and other vulnerable backgrounds ~ continue to suffer systemic neglect, facing precarious working conditions, inadequate compensation, and a fundamental lack of recognition for their labour. Their plight is not merely a matter of economic injustice but one deeply intertwined with the caste-patriarchal structures that define India’s labour market. Recognizing them as formal workers with full labour rights is not just a policy imperative but a moral necessity, one that requires strong political will and a reimagining of the value of care work in our society. ASHAs, introduced under the National Rural Health Mission (NRHM) in 2005, are the first point of contact between the rural populace and the public health system. Their responsibilities include maternal and child health support, immunization drives, tuberculosis and malaria control, and even, as seen during the Covid-19 pandemic, frontline health surveillance and contact tracing.

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Despite being celebrated as the “foot soldiers of health,” ASHAs remain classified as voluntary workers, receiving a performance-based honorarium rather than a fixed salary. On average, their monthly earnings range between Rs 2,000 and Rs 5,000 ~ far below the legal minimum wage in most states. The Indian government increased their incentives in 2018 and again during the pandemic, but these marginal raises have done little to rectify their fundamental lack of employment security, social benefits, and fair compensation. Anganwadi workers, part of the Integrated Child Development Services (ICDS) launched in 1975, have an equally crucial role in early childhood nutrition, education, and maternal care.

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