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POSHAN Maah 2021

No Work From Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

While a lot of services were shut during the COVID-19 pandemic, grassroot health workers – Anganwadi workers, ASHAs and ANMs – continued their work and also supported the fight against the Novel Coronavirus

हिन्दी में पढ़े
No Work From Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19
Highlights
  • Anganwadi workers delivered ration to pregnant & lactating women and kids
  • ASHAs assisted in door-to-door COVID-19 survey
  • ASHAs and ANMs are also involved in COVID vaccination

New Delhi: “Namastey, Ma’am! Me Relu ka Mister bol raha hu. (Greetings, this is Relu’s husband speaking)”. “Is Relu around?”, I enquire as I make a request to speak to her. 28-year-old Relu Vasave, an Anganwadi worker lives in the remote tribal area of the Nandurbar district of Maharashtra. Her job involves monitoring the health of pregnant women, lactating mothers and children up to six years of age; providing medicines and nutritional supplements, as per the schedule and government protocol. To reach Anganwadi centre and perform her job every day, Relu rows 14kms to cross the river Narmada.

When NDTV reached out to Relu, she was out on work and her husband Ramesh informed,

My wife has gone away for a week for a camp at her Anganwadi Centre. You can take down her personal mobile number but there is hardly any network on the other side of the river.

Since 2016, Relu has been rowing a boat every day for 7km each way that takes her two hours, to reach out to the villagers. During the COVID-19 pandemic, her work doubled up as Anganwadi centers were shut and Relu had to go door-to-door to provide take home ration (THR), antenatal check-ups, and to educate villagers about COVID appropriate behaviour.

Also Read: An Anganwadi Worker From Maharashtra Rows 14 km Daily To Provide Support To Expecting Mothers And Newborns

An Anganwadi Worker From Maharashtra Rows 14 km Daily To Provide Support To Expecting Mothers And Newborns

The inspiring story of Relu Vasve from Maharashtra, who rows a boat for 14 km daily in bid to provide healthcare support to expecting mothers and newborns during the COVID-19 pandemic

Relu is one of the lakhs of women community health workers – the Anganwadi workers (AWW), Accredited Social Health Activists popularly known as ASHAs and Auxiliary Nurse Midwife (ANM) – who have been working on the frontlines providing basic healthcare including essential immunisation and nutrition to the country’s vast rural population. While a lot of services were shut during the COVID-19 pandemic, these frontline warriors continued with their work and also supported in the fight against the Novel Coronavirus.

NDTV spoke to some of these women community health workers from different parts of the country to understand their work, how they provided their service even during the lockdown, the challenges faced by them and their role in the nation’s battle against the COVID-19 pandemic.

ANMs, ASHA And Anganwadi Workers Continue To Work ON The Ground During COVID-19 Pandemic

48-year-old Sangeetha Kamble from Mankhurd, a suburb in eastern Mumbai, Maharashtra says, as an Anganwadi worker, their first job is to stop child and maternal mortality. Giving a gist of her work, Ms Kamble, who joined as an Anganwadi worker in 2006 said,

We look after pregnant women, lactating mothers and children till 6 years of age. Women work all the time and often ignore their health, so it’s our job to educate them on how to take care of their own health, what to eat, when to eat, how much to eat, among other things. We work in alignment with the government hospitals and primary health centers (PHCs) ensuring smooth delivery, immunisation and that mother and her child gets all the benefits they are entitled to like under Pradhan Mantri Matru Vandana Yojana (PMMVY), a maternity benefit programme, Rs. 5,000 is given to pregnant women and lactating mothers for the birth of the first living child.

Also Read: The Unsung Heroes Of India’s Primary Healthcare The Anganwadi Workers And ASHAs

Due to the COVID-19 pandemic, Anganwadi centers across the country were shut as a result of which teaching young children (aged 3 to 6) at the center and providing hot cooked meals came to a halt. But, apart from that, all services continued, said Ms Kamble who was on the frontlines regularly. Further talking about her work during the pandemic, Ms Kamble said,

Once in two months, the government sends dry ration which we deliver to pregnant women and children and provide a report of the same to the government. To continue with our awareness and education programmes, initially, we created multiple WhatsApp groups of pregnant women, children (0-3-years of age and 3-6-year-olds) and lactating mothers and on WhatsApp, we used to share informational videos. But the challenge here is, not every woman has a personal mobile phone. Most of them use their husband’s numbers who are out for work all day. Therefore, our effort of teaching through WhatsApp didn’t reap good results.

To overcome the challenge of technology, Ms Kamble went door-to-door to support pregnant women and new mothers and conduct COVID surveys – keeping a record of who entered the village recently, whether he/she is in quarantine or not and checking people for symptoms.

Working on the ground and closely with people came with a risk of contracting the highly infectious COVID-19 disease but Ms Kamble said, she had prepared herself mentally. Also, to protect her family, she asked them to move to their paternal village for a few months.

Ms Kamble believes that as a frontline worker she didn’t face as much hardship as women who had to run from pillar to post for their delivery during the COVID-19 outbreak. Recalling an incident, she said,

The majority of the government hospitals were catering to COVID-19 patients because of which people were scared of going to government hospitals. I remember, a woman didn’t even have Rs. 50 to hire an auto-rickshaw to ferry her to the hospital. To top that, all small and local hospitals were shut. Together, we all chipped in money and helped her. There was another woman who had a normal delivery, but the family didn’t have enough money to put food on the table as due to the lockdown, people from the community had lost their jobs.

Also Read: Women Empowering Women: Here’s How Jeevika Initiative Changed The Life Of Bihar’s Pawan Rekha Devi And Her Family

Similar to Ms Kamble, 45-year-old Anita Tiwari from Surguja district of Chhattisgarh, who has been working as an Anganwadi worker since 2006, took Anganwadi services to the doorstep of people. Sharing her experience of working during the pandemic, Ms Tiwari said,

When women come to the center, we provide hot cooked meals, educate them on how to feed a baby, for how long exclusive breastfeeding should be practised, dos and don’ts of breastfeeding, children are taught to read and write. However, due to the lockdown, all of these activities stopped. But, since we wanted to ensure the well-being of new mothers, we went door-to-door to provide monthly ration which includes rice, pulses, soybean, oil, and flour. This was to cover the hot cooked meals. Along with this, ready-to-eat or easy-to-cook food packets like peanuts, daliya (cracked wheat), among others were provided. The challenge here was to carry ration on our shoulders and also, there was a risk of getting the infection.

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

Anganwadi worker Anita Tiwari

Ms Tiwari informed that during home visits, she and fellow Anganwadi workers used to take stock of women’s and children’s health and educate them about hygiene practices and nutrition. To ensure routine immunisation of children, the Anganwadi centre was opened once after full sanitisation and children were vaccinated in batches.

I was not scared of working on the frontlines as this is my duty. We would take all precautions, wear gloves, double mask and maintain physical distance, said Ms Tiwari.

Also Read: Into The Life Of Corona Warriors, Fighting The COVID-19 Pandemic Since The Start

A similar story of courage and dedication was heard from Kerala where 43-year-old Shyni A K, an Anganwadi Worker for the last 20 years, went an extra mile to ensure the health and education of children are not hampered. Teaching pre-school children through songs, stories, and games is an essential service provided by Anganwadi centers in India. Though the Anganwadi centres are still shut, the Department of Women and Child Development in the state has been broadcasting these theme based activities performed by Anganwadi functionaries and explained by ICDS (Integrated Child Development Services) officials as a series called ‘Killikonjal’ (chirping of birds) on Doordarshan.

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

Shyni, Anganwadi Worker

To ensure children who don’t have access to television or smartphones are not left out, Shyni, on directions of the department, presented a gift pack consisting of a workbook used at Anganwadi, crayons, and chart papers. She would also visit children, give them one-to-one classes and guide parents on assisting children in using the workbook.

Also Read: Kerala Health System On Heightened Alert With Advent Of Nipah Amid COVID Pandemic

 

With the help of a local charity group, I identified children who don’t have smartphones and through community participation and local sponsorship, I supplied smartphones to some pre-school and school going children, said Shyni.

As part of Sampushta Keralam (POSHAN Abhiyaan or nutrition campaign), the Department of Women and Child Development in Kerala organises various community based events (CBE) at the Anganwadi level to disseminate the information to reduce malnutrition, anaemia, encourage good eating habits, immunisation, and other things. During the pandemic, the Anganwadi functionaries conducted online CBEs.

Anganwadi workers also performed the liaison work for promoting ‘Nutrition Clinics’ started as part of the POSHAN Abhiyaan. Ms Shyani conducted two outreach programmes at her Anganwadi where nutrition counselling was provided to parents.

Also Read: Celebrate The Work Of Women Swasth Warriors Who Are Making India Healthy

Providing COVID Treatment And Fighting Vaccine Hesitancy Through Education And Information

Ms Shyni is also a part of the COVID rapid response team consisting of local ward members, elected representatives and ASHAs. As soon as someone tests positive for COVID, Shyni is contacted and she then takes care of the patient.

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

Anganwadi worker Shyni A K and her colleagues went door-to-door to distribute take home ration

One pre-school child got COVID-19 and three were in quarantine. I visited their home and gave them assistance. My job involves keeping a track of people who test positive and assist others in registering for vaccination, said Shyni.

30-year-old Radhika Kumavat, an Anganwadi worker from Tata Nagar in Madhya Pradesh who conducted multiple COVID surveys especially during the second wave of the pandemic said people were scared of reporting even regular cough and cold. Explaining her role during COVID, Ms Kumavat said,

No Work From Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

Anganwadi worker Radhika Kumavat

We were given thermal scanners and asked to check people for COVID like symptoms, but people would shut doors on our face, hurl abuses at us and not talk to us. But since we kept visiting them, we witnessed a change; neighbours became vigilant and they would tell us that in this particular house, the person has a cold or this person recently came from a trip. The community engagement helped us in a big way.

On the other hand, are ASHAs, the grassroot health workers assisting the Ministry of Health and Family Welfare (MoHFW) in delivering primary healthcare, particularly for women and children, in both rural and urban areas since 2005. The services provided by ASHAs include identifying and registering new pregnancies, births and deaths, checking on immunisation schedules of babies and pregnant women, escorting pregnant women for institutional delivery, among others.

Also Read: COVID-19 Pandemic Impact On Women And Their Struggle To Feed Their Families

During the pandemic as cases rose and the vaccination also began in January 2021, ASHAs were given additional duties of first keeping a record of people entering the village from other states, ensuring they quarantine for 14 days and then encouraging people to get vaccinated. 40-year-old Nirmala Devi, an ASHA worker from Hardua Khalsa, a village in Kanpur Dehat of Uttar Pradesh said,

One of the major challenges was to get people for vaccination. Earlier, only people above 60 were eligible for the COVID-19 vaccine. Later, the guidelines evolved and everyone above 18 years of age except pregnant and lactating women were included in the vaccination drive. People were scared of taking the vaccine because of the possible side-effects they had heard of through word of mouth. For instance, your neighbor gets a fever after the first dose of the vaccine. He/she will come and tell you the same and this might stop you or make you think twice before taking the vaccine. The same thing happened in our village. Under such a situation, we would give our example that we have taken the dose and we are doing completely fine, so, you can also take it. Soon after, pregnant and lactating women were also included in the list of vaccine beneficiaries and this raised a lot of questions among them – ‘Why are we being included now?’, ‘Is the vaccine safe for my child?’, ‘Can I breastfeed my child after vaccination?’. We explained to them that vaccine helps build immunity and fight the virus.

A similar story of vaccine hesitancy and breaking the myths through correct information was narrated by ASHA Kanti Kumari from the Gaya district of Bihar. She said, we knocked on the same doors twice, thrice and until people agreed to get vaccinated.

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

ASHA Kanti Kumari from Bihar

We told people that by taking the vaccine dose, you will not only protect yourself from getting a severe disease but also your community. It is only after a few people from the village got vaccinated, others got the confidence to follow the suit, said Ms Kumari.

Also Read: Pregnant Women Can Be Vaccinated Against COVID-19, Says Union Health Ministry

In India, the ANM acts as a resource person for the training of ASHAs. The ANM motivates ASHAs to bring beneficiaries to the institution for check-ups and counseling. During the pandemic, ANMs are equally involved in disseminating information and the vaccination process. 30-year-old Soniya Batla who works as an ANM in Uttar Pradesh’s Agra said ASHA workers act as a bridge between villagers and ANM. Explaining the role of ASHAs and how they helped ANMs, Ms Batla said,

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

ANM Soniya Batla

When it comes to healthcare, rural India is dependent on ASHAs as they are from within the community, so people tend to trust them. And during COVID-19, they only provided us all the data on COVID patients, people in isolation or quarantine, vaccination and others. We, ANMs are majorly involved in deliveries and vaccination.

As part of her job, Ms Batla who gave birth to a baby girl during the first lockdown in March 2020, is also involved in COVID vaccination. From her experience, vaccine hesitancy in rural areas is coming down as more people get vaccinated.

Initially, even men wouldn’t turn up for vaccination because of various myths; one of the top, which you will find everywhere, is death due to vaccination. Since we are frontline workers, we got the vaccine in January so we would give our own example of being alive even after full vaccination. They would say, “Ye madam ese hi bol rahi hai. Inka to kaam hai, ye to lagvayege vaccine” (This lady is talking just like that. It’s her job, she will take the vaccine). But slowly, people started understanding and when you see someone from your community taking the vaccine, you get the confidence and that’s exactly what we are seeing. I remember, recently, I was at Sisiya in Agra for COVID vaccination and we were allotted 250 doses for the day. Around 4:45pm, we ran out of doses for the day and we were leaving when a woman held my stole from the back and said, ‘I won’t let you go until you vaccinate me’. It took me a while to convince her that we will come tomorrow and give you the vaccine. It is awareness only that now even women want to get vaccinated desperately, said Ms Batla.

Also Read: India’s Gender Inequity In COVID-19 Vaccination Narrows

Grassroot Healthcare Workers Demand Better Pay And Health Insurance

Almost all the Anganwadi and ASHA workers and ANMs NDTV spoke to demand better pay. Anita Tiwari from Chhatisgarh started the work at a salary of Rs. 1,000 per month but even after 15 years of service, her salary has increased only to mere Rs. 6,000.

No Work From Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

ASHA Nirmala Dhannotiya

No Work From Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

ASHA Nirmala Devi from Uttar Pradesh

 

53-year-old, Nirmala Dhannotiya from Madhya Pradesh started working as ASHA in 2010 after her husband’s death, to fend for the family. For assisting in deliveries along with the additional COVID work, she gets only Rs. 2,000 a month, she said. Another ASHA worker, Nirmala Devi from Uttar Pradesh resonated with her namesake’s opinion and informed that she was given Rs. 4,000 despite the additional work during the pandemic.

We feel we are underpaid; we get work calls at any time of the day as a result of which we are neither able to focus on household chores nor assist the family in farming, said Ms Devi.

Shyni A K from Kerala called for a better pension and a health insurance policy. Giving an example of her former colleagues she said,

I know of people who have given 40-45 years of their life to the nation but still, their pension is minimal. Even during the pandemic, we are working with full dedication and risking our lives, but we don’t have health insurance cover. What if we get infected?

No Work For Home For India’s Grassroot Health Workers – Anganwadi Workers, ASHAs And ANMs – Even During COVID-19

Anganwadi worker Shyni A K teaching children at one of the Anganwadi Centers in Kerala

Also Read: A Victim Of Poverty Herself, Ishrat Bano, An Anganwadi Worker In Jaipur Is Committed Towards Welfare Of Children In Her Area

NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (WaterSanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollutionwaste managementplastic banmanual scavenging and sanitation workers and menstrual hygiene

World

22,95,44,435Cases
19,20,52,504Active
3,27,83,741Recovered
47,08,190Deaths
Coronavirus has spread to 195 countries. The total confirmed cases worldwide are 22,95,44,435 and 47,08,190 have died; 19,20,52,504 are active cases and 3,27,83,741 have recovered as on September 22, 2021 at 3:49 am.

India

3,35,31,498 26,964Cases
3,01,9897,586Active
3,27,83,741 34,167Recovered
4,45,768 383Deaths
In India, there are 3,35,31,498 confirmed cases including 4,45,768 deaths. The number of active cases is 3,01,989 and 3,27,83,741 have recovered as on September 22, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

65,27,629 3,131

44,269 960

63,44,744 4,021

1,38,616 70

Kerala

45,39,926 15,768

1,61,765 5,813

43,54,264 21,367

23,897 214

Karnataka

29,69,361 818

13,769 617

29,17,944 1,414

37,648 21

Tamil Nadu

26,48,688 1,647

16,993 9

25,96,316 1,619

35,379 19

Andhra Pradesh

20,40,708 1,179

13,905 483

20,12,714 1,651

14,089 11

Uttar Pradesh

17,09,693 13

194 0

16,86,612 13

22,887

West Bengal

15,62,710 537

7,741 69

15,36,291 592

18,678 14

Delhi

14,38,556 39

400 21

14,13,071 18

25,085

Odisha

10,21,216 462

4,844 103

10,08,226 560

8,146 5

Chhattisgarh

10,05,120 26

297 0

9,91,260 26

13,563

Rajasthan

9,54,275 12

99 8

9,45,222 4

8,954

Gujarat

8,25,751 14

133 0

8,15,536 14

10,082

Madhya Pradesh

7,92,410 8

90 6

7,81,803 14

10,517

Haryana

7,70,754 8

328 12

7,60,618 20

9,808

Bihar

7,25,907 6

60 9

7,16,188 15

9,659

Telangana

6,63,906 244

4,938 53

6,55,061 296

3,907 1

Punjab

6,01,359 36

304 3

5,84,554 37

16,501 2

Assam

5,98,864 441

5,081 97

5,87,970 338

5,813 6

Jharkhand

3,48,139 14

65 10

3,42,941 4

5,133

Uttarakhand

3,43,405 12

249 18

3,35,765 29

7,391 1

Jammu And Kashmir

3,28,214 145

1,450 11

3,22,345 154

4,419 2

Himachal Pradesh

2,17,403 263

1,715 99

2,12,033 162

3,655 2

Goa

1,75,690 107

886 76

1,71,507 29

3,297 2

Puducherry

1,25,618 101

922 55

1,22,864 46

1,832

Manipur

1,18,870 197

2,174 9

1,14,861 203

1,835 3

Tripura

83,956 51

353 7

82,794 44

809

Mizoram

82,815 1,355

15,363 223

67,184 1,127

268 5

Meghalaya

79,817 150

1,878 18

76,558 167

1,381 1

Chandigarh

65,195 7

44 3

64,333 4

818

Arunachal Pradesh

54,190 64

413 3

53,504 60

273 1

Sikkim

31,014 43

627 27

30,007 70

380

Nagaland

30,959 52

470 3

29,832 46

657 3

Ladakh

20,743 6

144 6

20,392

207

Dadra And Nagar Haveli

10,670

0 0

10,666

4

Lakshadweep

10,360 1

9 1

10,300

51

Andaman And Nicobar Islands

7,607 7

17 4

7,461 3

129

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