By Our Reporter
SHILLONG, Nov 22: The Meghalaya Accredited Social Health Activist Workers’ Union (MASHAWU) is undecided about accepting or rejecting the offer of the government to increase their monthly incentives from Rs 2,000 to Rs 3,000 in the absence of any written assurance.
“We want the Health Department should provide us with written assurance on increasing the incentive by Rs 1,000. We gave the government two hours’ time to provide us with the copy of the notification on this decision but we did not receive it,” MASHAWU president, Marajune Myrsing told reporters.
She said the union’s executive committee comprising 276 members would need to discuss if the government’s offer should be accepted or rejected.
“I have conveyed to the Health Minister that we will inform her about our decision through WhatsApp,” Myrsing said.
She said the verbal assurance given in the meeting does not hold any water. “We have experience that nothing materializes by way of verbal assurance. We would like to see whether this assurance was recorded in the minutes of the meeting,” she said. She also said the ASHA workers are going ahead with their indefinite sit-in at the main secretariat on November 27 in addition to holding a protest march.
Earlier on Wednesday, the state government decided not to accept the demand of the ASHA workers to increase their monthly honorarium from Rs 2,000 to Rs 5,000. It instead decided to implement the community-based health incentive (CHI) to compensate the ASHA workers for transportation expenses for shifting the patients to any of the health centres.
Speaking to reporters after the meeting with the leaders of MASHAWU, Health Minister Ampareen Lyngdoh said the proposal for implementing the CHI was made during a meeting with Chief Minister Conrad K Sangma on Tuesday.
“We placed the proposal we plan to implement before ASHA workers,” she said, adding that the new scheme would be implemented through the Dorbar Shnongs.
She said the government would work closely with the ASHA workers in the interest of the people of the state. She also said the government decided to constitute a committee in the districts to look into the problems faced by the ASHA workers.
The health minister said the state is annually spending about Rs 17 crore on fixed incentives at the rate of Rs 2,000 per month on the honorarium given to the ASHAs in addition to around Rs 22-23 crore annually from NHM as performance-based incentives.
The fixed incentive for the ASHAs was initiated in April 2021 because about 70% of villages in Meghalaya have a small population. 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).
Lyngdoh stated the new initiative will be called the Community-Based Health Incentive Scheme (CBHIS) for ASHA.
Under this scheme, the fixed incentive of ASHAs will be increased from Rs 2,000 to Rs 3,000.
“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 said.
She also said the CM agreed in principle that an additional amount of Rs 1,000 could be considered and added to the existing Rs 2,000 fixed incentive from the state government.
Under the new scheme, the revised incentives for ASHAs will be based on the contribution of the ASHAs and their efforts along with the VHCs and health teams of PHCs/CHCs/sub-centres 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 newborns up to 1 year of age, and ensuring 100% ANC coverage for pregnant women.
It was also informed that a dedicated committee will be put in place to streamline the newly announced CBHIS for ASHA. The committee will comprise one ASHA representative from each district, a representative from the 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 Wednesday’s meeting.
Speaking during the discussion, Principal Secretary of Health and Family Welfare Department, Sampath Kumar said the state has taken up the concerns and issues raised by the ASHA workers with utmost sincerity and dedication.
He added that the state has been working strategically to address the systemic issues and 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.
Kumar 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.
Stating that the primary objective of saving lives should not be forgotten, he said it should be ensured that the ASHAs are not overburdened.
The Health Department had also recently issued an executive order emphasizing the role of medical officers, mid-level healthcare providers, and the ANMs in each of the health facilities for visiting villages more frequently to take healthcare services closer to the people.