ASHAs in less populated areas get relief as Kerala delinks performance and honorarium
Follow TNM's WhatsApp channel for news updates and story links.The Kerala government has decided to remove the minimum performance incentive required for Accredited Social Health Activists (ASHAs) to receive their full monthly honorarium. Workers in sparsely populated regions say this has brought them relief, as they believed the performance targets unfairly penalised despite carrying out their routine duties.Under the earlier guidelines, ASHA workers had to earn at least Rs 500 a month through performance-based incentives to qualify for the full state honorarium of Rs 12,000. If the total incentive earned in a month fell even slightly short of Rs 500, the worker's honorarium was reduced by half to Rs 6,000.The incentives were linked to specific tasks, including accompanying pregnant women for antenatal care, ensuring institutional deliveries, and facilitating immunisation of children. For instance, an ASHA worker received Rs 50 for each pregnant woman and Rs 20 for every infant brought for vaccination. ASHA workers say the system disproportionately affected those posted in areas with low populations, where the number of pregnancies and children requiring immunisation was naturally lower.Rani, an ASHA worker from Kasaragod district, said the change addresses a long-standing concern for workers in hilly and sparsely populated regions."Even if an ASHA worker earned Rs 400 or Rs 450 as incentive, the honorarium would be reduced to half. That was not right. With this order, that condition has been removed, which will benefit workers in less populated areas. I work in a hilly region in Kasaragod where I am sometimes unable to meet the target because the population is very small and families live scattered. There are not many cases to attend in a ward. This is a relief," she said.Sajesh Eliyar, ASHA coordinator for Wayanad district, said the revised order would particularly benefit workers serving tribal settlements."Some ASHA workers from tribal regions faced the issue of lower incentives, and this will help them. In tribal settlements in Wayanad, where there are fewer houses, workers used to face this problem. It is not a question of ASHA workers not attending cases or not working, because they have to perform their routine duties to receive the honorarium. Most workers got lower incentives only because the population was less, which was not their fault," he said.However, the impact of the decision is expected to be limited in urban areas where ASHA workers generally have no difficulty meeting the minimum incentive threshold."Reaching the Rs 500 incentive has always been easy for me. I don't think it is difficult for ASHA workers in urban wards because there are enough pregnant women, infants, and other cases. In the last 10 years, I have never faced a problem in reaching the minimum incentive," said Anitha Kumari, an ASHA worker from Anchuthengu in Thiruvananthapuram.The revised government order, issued on August 4, removes both the requirement to earn a minimum of Rs 500 as performance incentive and the provision introduced earlier that required medical officers to certify cases where workers could not meet the target due to reasons beyond their control.The move follows repeated representations by the Kerala ASHA Health Workers Association (KAHWA), which argued that linking the honorarium to performance indicators unfairly affected workers in regions with fewer beneficiaries. The association had also opposed the certification mechanism introduced earlier, saying it created unnecessary administrative hurdles.With the latest order, the state has delinked the payment of the monthly honorarium from performance-linked criteria, ensuring that ASHA workers will receive the full honorarium irrespective of the number of cases in their assigned areas.
Follow TNM's WhatsApp channel for news updates and story links.
THE Kerala government has decided to remove the minimum performance incentive required for Accredited Social Health Activists (ASHAs) to receive their full monthly honorarium.
Workers in sparsely populated regions say this has brought them relief, as they believed the performance targets unfairly penalised them despite carrying out their routine duties.
Under the earlier guidelines, ASHA workers had to earn at least Rs 500 a month through performance-based incentives to qualify for the full state honorarium of Rs 12,000. If the total incentive earned in a month fell even slightly short of Rs 500, the worker's honorarium was reduced by half to Rs 6,000.
The incentives were linked to specific tasks, including accompanying pregnant women for antenatal care, ensuring institutional deliveries, and facilitating immunisation of children. For instance, an ASHA worker received Rs 50 for each pregnant woman and Rs 20 for every infant brought for vaccination.
ASHA workers say the system disproportionately affected those posted in areas with low populations, where the number of pregnancies and children requiring immunisation was naturally lower.
Rani, an ASHA worker from Kasaragod district, said the change addresses a long-standing concern for workers in hilly and sparsely populated regions.
"Even if an ASHA worker earned Rs 400 or Rs 450 as an incentive, the honorarium would be reduced to half. That was not right. With this order, that condition has been removed, which will benefit workers in less populated areas. I work in a hilly region in Kasaragod where I am sometimes unable to meet the target because the population is very small and families live scattered. There are not many cases to attend in a ward. This is a relief," she said.
Sajesh Eliyar, ASHA coordinator for Wayanad district, said the revised order would particularly benefit workers serving tribal settlements.
"Some ASHA workers from tribal regions faced the issue of lower incentives, and this will help them. In tribal settlements in Wayanad, where there are fewer houses, workers used to face this problem. It is not a question of ASHA workers not attending cases or not working, because they have to perform their routine duties to receive the honorarium. Most workers got lower incentives only because the population was smaller, which was not their fault," he said.
However, the impact of the decision is expected to be limited in urban areas where ASHA workers generally have no difficulty meeting the minimum incentive threshold.
"Reaching the Rs 500 incentive has always been easy for me. I don't think it is difficult for ASHA workers in urban wards because there are enough pregnant women, infants, and other cases. In the last 10 years, I have never faced a problem in reaching the minimum incentive," said Anitha Kumari, an ASHA worker from Anchuthengu in Thiruvananthapuram.
The revised government order, issued on August 4, removes both the requirement to earn a minimum of Rs 500 as a performance incentive and the provision introduced earlier that required medical officers to certify cases where workers could not meet the target due to reasons beyond their control.
The move follows repeated representations by the Kerala ASHA Health Workers Association (KAHWA), which argued that linking the honorarium to performance indicators unfairly affected workers in regions with fewer beneficiaries. The association had also opposed the certification mechanism introduced earlier, saying it created unnecessary administrative hurdles.
With the latest order, the state has delinked the payment of the monthly honorarium from performance-linked criteria, ensuring that ASHA workers will receive the full honorarium irrespective of the number of cases in their assigned areas.
