The family context of ASHA and Anganwadi work in rural Rajasthan: Gender and labour in CHW programmes

ABSTRACT

Across the literature on CHWs globally, the role of CHWs’ families remains largely unexplored. This article focuses on ASHAs and Anganwadi Workers in a town in rural Rajasthan, India. We interviewed all twenty ASHAs and Anganwadi Workers in this town, and ten of their families; we also conducted participant observation in Anganwadi Centers, health centres, and family settings. ASHA and Anganwadi work was in high demand, despite being low paying, because of an overall lack of jobs for educated women. Every aspect of CHW work, from recruitment to selection to training to the number of hours spent on the job, was heavily determined by families. Women’s mobility, income, and workload was tied up in family structures. ASHA and Anganwadi Work increased the mobility and autonomy of the women who held those jobs in significant ways. But mostly, women stayed in these extremely low paying jobs because they and their families hoped that one day they would become permanent jobs with salaries and benefits. By providing honourable work, and keeping the idea of permanent employment in view but always just out of reach, the ASHA and Anganwadi programmes both exploited and strengthened gendered inequalities in the rural Rajasthani labour market.

KEYWORDS:

• Community health workers
• ASHAs
• Anganwadi workers
• Rajasthan

Acknowledgements

We are deeply grateful to the ASHAs and Anganwadi Workers, and their families, who opened their homes to us and spoke frankly with us. We are further grateful for the support and feedback provided by the Rajasthan Ministry of Women and Child Development, and by faculty at the Indian Institute of Health Management Research in Jaipur. We thank Rachel Neill for the helpful comments. This work was funded by the Fulbright-Nehru programme.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 All names of people and places are pseudonyms.

Additional information

Funding

This work was supported by the Fulbright-Nehru program [grant number 2018/APE(R-Flex)/136].