Experiences of Rajasthan and HP frontline workers during pandemic

The study has been authored by Anavi Kapur and others.

Anganwadi Workers (AWWs), Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) form the locus of healthcare and nutrition delivery in rural India. Approximately 13.3 lakh AWWs, 9.3 lakh ASHAs and 2.3 lakh ANMs across the country (RTI response, 2021; Ministry of Health and Family Welfare, 2019) serve as the first port of call for primary health and nutrition services, particularly in the domain of Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A).

Healthcare workers administer Covid-19 vaccine to beneficiaries during a special drive, in Beawar, Rajasthan, on July 8.(PTI Photo)

With the advent of Covid-19, Front Line Workers (FLWs) found themselves at the forefront of combating the pandemic. Their revised responsibilities included screening for Covid-19, contact tracing, communication of preventative measures, adapting

nutrition-related programmes, and doorstep delivery of maternal and child health services. Through its Inside Districts initiative, the Accountability Initiative (AI) at the Centre for Policy Research (CPR) has been documenting the oft-overlooked stories of government functionaries at the frontline of COVID-19 response since the initial lockdown.

Existing research illustrates that FLWs faced a high burden of responsibilities even prior to the pandemic, and encountered numerous challenges in areas such as remuneration, training, and supervisory support. AI received a research grant from the Azim Premji University to undertake a study examining the evolving role and experiences of FLWs during and after the nation-wide lockdown. The overall objectives for the study were two-fold:

To understand the evolving role of FLWs post Covid-19, including perspective on the impact on non-Covid work. Within this, we aimed to understand overall barriers and facilitators of performance.

To gain insights about processes and best practices related to training, implementation, and supportive supervision, which can inform policy makers and functionaries in the short to medium term.

The findings provide insights into how FLWs shouldered additional responsibilities, how they have adapted to the disruption of routine health and nutrition-related services, and how they are initiating creative responses to help the system adapt to the ‘new normal’. We hope that these insights enable the government, functionaries in other states, and funders to learn from key adaptations during this period that could be applied to future crises, or to augment ongoing work.

The study can be accessed by clicking here

(The study has been authored by Avani Kapur and others.)