Lok Sabha Question No. 5049 (UNSTARRED), answered on 2022-04-01
Subject: Remuneration to ASHA Workers
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Rajeshbhai Naranbhai Chudasama, Sumalatha Ambareesh, Dean Kuriakose, Kinjarapu Ram Mohan Naidu, Feroze Varun Gandhi

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 5049

## TO BE ANSWERED ON THE 01 ST  APRIL, 2022

## REMUNERATION TO ASHA WORKERS

5049:  SHRI RAJESHBHAI CHUDASAMA:

SHRI RAM MOHAN NAIDU KINJARAPU:

SHRIMATI SUMALATHA AMBAREESH:

ADV. DEAN KURIAKOSE:

SHRI FEROZE VARUN GANDHI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) the State-wise breakup of total number of ASHA workers in the country;
- (b) the total amount given as remuneration/ honorarium to ASHA workers, State-wise, including Uttar Pradesh;
- (c) whether the Government is aware that the wages given to ASHAs is much lower than the minimum wage for Class IV workers as recommended by the 7th pay commission;
- (d) whether  the  Government  plans  to  revise  the  remuneration  to  reach  the  minimum  wage threshold, if so, the details thereof and if not, the reasons therefor;
- (e) whether any dues/honorarium of ASHA workers is pending to be paid by the Government and if so, the details thereof, State/UT-wise;
- (f) the increase in total compensation provided to ASHA workers over the last six years; and
- (g) whether this increase in compensation has been consistent with the inflation rate during the period and if so, the details thereof?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a)  to  (g)  ASHAs  are  envisaged  to  be  community  health  volunteers  and  are  entitled  to task/activity  based  incentives.  State-wise  details  of  total  numbers  of  ASHA  workers  as  per NHM-MIS report (as on 30.09.2021) is placed at Annexure-I.

During FY 2018-19, the Union Cabinet approved the revised amount of routine recurrent incentive  for  ASHAs  from  Rs.  1000/month  to  Rs.  2000/month.  Now,  ASHAs  receive  a  fixed monthly incentive of Rs. 2000 per month for routine and recurring activities and the details are placed  at Annexure-II .  Additionally,  they  are  provided  performance-based  incentives  for  a varied  set  of  activities  under  various  National  Health  Programmes  and  details  are  placed  at Annexure-III . States/UTs in their Programme Implementation Plans (PIPs) have also been given flexibility to provide a range of monetary incentives to the ASHAs and the details are placed at Annexure-IV.

After the launch of the Ayushman Bharat scheme with operationalisation of Ayushman Bharat-  Health  and  Wellness  Centres  (AB-HWCs),  ASHAs  are  now  additionally  eligible  for Team Based Incentives (TBIs) along with ANMs based on monitored performance indicators (up to Rs. 1000 per month).

States were requested to ensure that incentive for routine and recurrent activities was paid in full for all the ASHAs.

The Government has also approved a cash award of Rs. 20,000/- and a citation to ASHAs who leave the programme after working as ASHAs  for minimum of 10 years, as acknowledgement of their contribution.

The ASHA benefit package was introduced acknowledging significant contribution and commitment of ASHAs. The package providing coverage for:

- i) Pradhan Mantri Jeevan Jyoti Beema Yojana (PMJJBY) with a benefit Rs. 2.00 Lakh in case of death of the insured (annual premium of Rs. 330 contributed by GOI).
2. ii) Pradhan Mantri Suraksha Beema Yojana (PMSBY) with a benefit of Rs. 2.00 lakh for accidental death or permanent disability; Rs. 1.00 lakh for partial disability (annual premium of Rs. 12 contributed by GOI).
3. iii) Pradhan Mantri Shram Yogi Maan Dhan (PM-SYM) with pension benefit of Rs. 3000 pm  after  age  of  60  years  (50%  contribution  of  premium  by  GOI  and  50%  by beneficiaries).

## Annexure-I

| State-wise details of total numbers of ASHA workers as per NHM-MIS report (as on 30.09.2021)   | State-wise details of total numbers of ASHA workers as per NHM-MIS report (as on 30.09.2021)   | State-wise details of total numbers of ASHA workers as per NHM-MIS report (as on 30.09.2021)   | State-wise details of total numbers of ASHA workers as per NHM-MIS report (as on 30.09.2021)   | State-wise details of total numbers of ASHA workers as per NHM-MIS report (as on 30.09.2021)   |
|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|
| Sr. No.                                                                                        | States/ UTs                                                                                    | ASHAs (Rural)                                                                                  | ASHAs (Urban)                                                                                  | Total ASHAs                                                                                    |
| 1                                                                                              | Bihar                                                                                          | 92198                                                                                          | 594                                                                                            | 92792                                                                                          |
| 2                                                                                              | Chhattisgarh                                                                                   | 68212                                                                                          | 3771                                                                                           | 71983                                                                                          |
| 3                                                                                              | Himachal Pradesh                                                                               | 32356                                                                                          | 34                                                                                             | 32390                                                                                          |
| 4                                                                                              | Jammu &Kashmir                                                                                 | 12550                                                                                          | 73                                                                                             | 12623                                                                                          |
| 5                                                                                              | Jharkhand                                                                                      | 41085                                                                                          | 1585                                                                                           | 42670                                                                                          |
| 6                                                                                              | Madhya Pradesh                                                                                 | 76890                                                                                          | 5131                                                                                           | 82021                                                                                          |
| 7                                                                                              | Orissa                                                                                         | 45868                                                                                          | 1865                                                                                           | 47733                                                                                          |
| 8                                                                                              | Rajasthan                                                                                      | 63423                                                                                          | 4307                                                                                           | 67730                                                                                          |
| 9                                                                                              | Uttar Pradesh                                                                                  | 157748                                                                                         | 6775                                                                                           | 164523                                                                                         |
| 10                                                                                             | Uttarakhand                                                                                    | 11906                                                                                          | 1205                                                                                           | 13111                                                                                          |
| 11                                                                                             | Arunachal Pradesh                                                                              | 4040                                                                                           | 42                                                                                             | 4082                                                                                           |
| 12                                                                                             | Assam                                                                                          | 31334                                                                                          | 1212                                                                                           | 32546                                                                                          |
| 13                                                                                             | Manipur                                                                                        | 3928                                                                                           | 81                                                                                             | 4009                                                                                           |
| 14                                                                                             | Meghalaya                                                                                      | 6620                                                                                           | 246                                                                                            | 6866                                                                                           |
| 15                                                                                             | Mizoram                                                                                        | 1091                                                                                           | 79                                                                                             | 1170                                                                                           |
| 16                                                                                             | Nagaland                                                                                       | 1917                                                                                           | 75                                                                                             | 1992                                                                                           |
| 17                                                                                             | Sikkim                                                                                         | 641                                                                                            | 17                                                                                             | 658                                                                                            |
| 18                                                                                             | Tripura                                                                                        | 7590                                                                                           | 454                                                                                            | 8044                                                                                           |
| 19                                                                                             | Andhra Pradesh                                                                                 | 39009                                                                                          | 3200                                                                                           | 42209                                                                                          |
| 20                                                                                             | Goa                                                                                            | 0                                                                                              | 0                                                                                              | 0                                                                                              |
| 21                                                                                             | Gujarat                                                                                        | 44241                                                                                          | 5676                                                                                           | 49917                                                                                          |
| 22                                                                                             | Haryana                                                                                        | 17542                                                                                          | 2583                                                                                           | 20125                                                                                          |
| 23                                                                                             | Karnataka                                                                                      | 38515                                                                                          | 8538                                                                                           | 47053                                                                                          |
| 24                                                                                             | Kerala                                                                                         | 28328                                                                                          | 2148                                                                                           | 30476                                                                                          |
| 25                                                                                             | Maharashtra                                                                                    | 60967                                                                                          | 8139                                                                                           | 69106                                                                                          |
| 26                                                                                             | Punjab                                                                                         | 19281                                                                                          | 2981                                                                                           | 22262                                                                                          |
| 27                                                                                             | Tamil Nadu                                                                                     | 4025                                                                                           | 1335                                                                                           | 5360                                                                                           |
| 28                                                                                             | Telangana                                                                                      | 29257                                                                                          | 3318                                                                                           | 32575                                                                                          |
| 29                                                                                             | West Bengal                                                                                    | 57790                                                                                          | 5819                                                                                           | 63609                                                                                          |
| 30                                                                                             | A&N Island                                                                                     | 412                                                                                            | 10                                                                                             | 422                                                                                            |
| 31                                                                                             | Chandigarh                                                                                     | 0                                                                                              | 18                                                                                             | 18                                                                                             |
| 32                                                                                             | D&N Haveli/ Daman &Diu                                                                         | 613                                                                                            | 6112                                                                                           | 6725                                                                                           |
| 33                                                                                             | Delhi                                                                                          | 0                                                                                              | 0                                                                                              | 0                                                                                              |
| 34                                                                                             | Ladakh                                                                                         | 593                                                                                            | 0                                                                                              | 593                                                                                            |
| 35                                                                                             | Lakshadweep                                                                                    | 110                                                                                            | 0                                                                                              | 110                                                                                            |
| 36                                                                                             | Puducherry                                                                                     | 0                                                                                              | 220                                                                                            | 220                                                                                            |

## Annexure-II

## The details of incentives for routine and recurring activities given to ASHAs

| S. No.   | Incentives                                                                                                                           | Previous Incentives   | Revised Incentives (September, 2018)   |
|----------|--------------------------------------------------------------------------------------------------------------------------------------|-----------------------|----------------------------------------|
| 1        | Mobilizing and attending Village Health and Nutrition Days or Urban Health and Nutrition Days                                        | Rs.200/ session       | Rs.200/ session                        |
| 2        | Conveying and guiding monthly meeting of VHSNC/MAS                                                                                   | Rs. 150               | Rs. 150                                |
| 3        | Attending monthly meeting at Block PHC/UPHC                                                                                          | Rs. 150               | Rs. 150                                |
| 4        | a. Line listing of households done at beginning of the year and updated every six months                                             | Rs. 100               | Rs. 300                                |
| 4        | b. Maintaining village health register and supporting universal registration of births and deaths to be updated on the monthly basis | Rs. 100               | Rs. 300                                |
| 4        | c. Preparation of due list of children to be immunized on monthly basis                                                              | Rs. 100               | Rs. 300                                |
| 4        | d. Preparation of list of ANC beneficiaries to be updated on monthly basis                                                           | Rs. 100               | Rs. 300                                |
| 4        | e. Preparation of list of eligible couple on monthly basis                                                                           | Rs. 100               | Rs. 300                                |
|          | Total                                                                                                                                | Rs. 1000/-            | Rs. 2000/-                             |

| Annexure-III                                                                                                                                     | Annexure-III                                                                                                                                     | Annexure-III                                                                                                                                     |
|--------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------|
| Details of performance-based incentives for a varied set of activities under various National Health Programmes                                  | Activities                                                                                                                                       | Amount in Rs/case                                                                                                                                |
| I                                                                                                                                                | Maternal Health                                                                                                                                  | Maternal Health                                                                                                                                  |
| 1                                                                                                                                                | JSY financial package                                                                                                                            |                                                                                                                                                  |
| a.                                                                                                                                               | For ensuring antenatal care for the woman                                                                                                        | Rs.300/Rs.200 (Rural/Urban areas)                                                                                                                |
| b.                                                                                                                                               | For facilitating institutional delivery                                                                                                          | Rs. 300/Rs.200 (Rural/Urban areas)                                                                                                               |
| 2                                                                                                                                                | Reporting Death of women                                                                                                                         | Rs. 200 (reporting within 24 hours)                                                                                                              |
| II                                                                                                                                               | Child Health                                                                                                                                     |                                                                                                                                                  |
| 1                                                                                                                                                | Home Visit-care of the New Born and Post-Partum mother etc. / Young Child / follow up                                                            | Rs. 250 /Rs. 50 per visit / Rs.150 only after MUAC is equal to nor- more than 125mm                                                              |
| 2                                                                                                                                                | Intensified Diarrhoea Control Fortnight                                                                                                          | Intensified Diarrhoea Control Fortnight                                                                                                          |
| a.                                                                                                                                               | Week-1-ASHA incentive for prophylactic distribution of ORS to families with under-five children                                                  | Rs. 1 per ORS packet for 100 under five children                                                                                                 |
| b.                                                                                                                                               | Week-2- ASHA incentive for facilitating growth monitoring of all children in village                                                             | Rs. 100 per ASHA for completing at least 80% of household                                                                                        |
| c.                                                                                                                                               | MAA(Mother's Absolute Affection) Programme                                                                                                       | Rs. 100/ASHA/ Quarterly meeting                                                                                                                  |
| III                                                                                                                                              | Immunization                                                                                                                                     |                                                                                                                                                  |
| 1                                                                                                                                                | Full immunization for a child under one year/ up-to two years age                                                                                | Rs. 100 /Rs. 75                                                                                                                                  |
| 2                                                                                                                                                | Mobilizing children for OPV immunization / DPT Booster                                                                                           | Rs. 100 per day / Rs. 50                                                                                                                         |
| IV                                                                                                                                               | Family Planning                                                                                                                                  |                                                                                                                                                  |
| 1                                                                                                                                                | Ensuring spacing of 2 years/ 3 years after birth of 1st child / permanent limiting method after 2 children after marriage                        | Rs. 500 / Rs. 500 / Rs. 1000                                                                                                                     |
| 2                                                                                                                                                | Counselling, motivating and follow up of the cases for Tubectomy                                                                                 | Rs. 200 in 11 with high fertility rates states,Rs.300 in 146 MPV districts, Rs. 150/Rs200 in remaining states                                    |
| 3                                                                                                                                                | Counselling, motivating and follow up of the cases for Vasectomy and NSV and Female Postpartum sterilization                                     | Rs. 300 in 11 states with high fertility rates and Rs. 400 in 146 MPV districts and Rs. 200 in remaining states                                  |
| Mission ParivarVikas- In selected 146 districts in six states-(57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh and 2 in Assam) | Mission ParivarVikas- In selected 146 districts in six states-(57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh and 2 in Assam) | Mission ParivarVikas- In selected 146 districts in six states-(57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh and 2 in Assam) |
| 4                                                                                                                                                | Injectable Contraceptive MPA (Antara Program) and a non-hormonal weekly centchroman pill (Chhaya) - Incentive to ASHA                            | Rs. 100 per dose                                                                                                                                 |
| 5                                                                                                                                                | Mission ParivarVikas Campaigns Block level activities                                                                                            | Rs. 150/ ASHA/round                                                                                                                              |
| 6                                                                                                                                                | NayiPahel - an FP kit for newly weds                                                                                                             | Rs. 100/ASHA/NayiPahel kit distribution                                                                                                          |
| 7                                                                                                                                                | SaasBahuSammelan- mobilize SaasBahu for the                                                                                                      | Rs. 100/ per meeting                                                                                                                             |

|      | Sammelan- maximum four rounds                                                                                              |                                                            |
|------|----------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------|
| 8    | Updating of EC survey before each MPV campaign                                                                             | Rs.150/ASHA/Quarterly round                                |
| V    | Adolescent Health                                                                                                          |                                                            |
| 1    | Sanitary napkins to adolescent girls                                                                                       | Rs. 1/ pack of 6 sanitary napkins                          |
| 2    | Organizing monthly meeting with adolescent girls pertaining to Menstrual Hygiene                                           | Rs. 50/meeting                                             |
| 3    | Conducting PLA meetings- 2 meetings per month                                                                              | Rs. 100/ASHA/per meeting                                   |
| VI   | Revised National Tuberculosis Control Programme                                                                            |                                                            |
| 1    | For Category I/ Category II of TB patients (New cases/ previously treated of Tuberculosis)                                 | Rs. 1000 for 42 contacts / Rs. 1500 for 57 contacts        |
| 2    | For treatment and support to drug resistant TB patients                                                                    | Rs. 5000 for completed course of treatment                 |
| 3    | For notification if suspect referred is diagnosed to be TB patient by MO/Lab                                               | Rs.100                                                     |
| VII  | National Leprosy Eradication Programme                                                                                     |                                                            |
| 1    | Treatment in pauci-bacillary cases /multi-bacillary cases of Leprosy - for 33 states (except Goa, Chandigarh &Puducherry). | Rs. 250 (for diagnosis) + Rs. 400/Rs.600 (for follow up)   |
| VIII | National Vector Borne Disease Control Programme                                                                            |                                                            |
| 1    | Malaria-Preparing Blood Slides/complete treatment for RDT or radical treatment of positive Pf cases                        | Rs. 15 per slide/ Rs. 75 per positive cases                |
| 2    | Lymphatic Filariasis-Listing of cases                                                                                      | Rs. 200                                                    |
| 3    | Acute Encephalitis Syndrome/Japanese Encephalitis Referral of AES/JE cases to the nearest CHC/DH/Medical College           | Rs. 300 per case                                           |
| 4    | Kala Azar elimination                                                                                                      |                                                            |
|      | Involvement of ASHAs during the spray rounds (IRS) / for referring a suspected case                                        | Rs. 100/- per round / Rs. 500/per                          |
|      |                                                                                                                            | notified case                                              |
|      | Incentive for source reduction &IEC activities for prevention and control of Dengue and Chikungunya                        | Rs. 200/- (1 Rupee /House for maximum 200 houses PM for 05 |
| 5    | Dengue and Chikungunya                                                                                                     |                                                            |
|      | in 12 High endemic States.                                                                                                 | months- during peak season).                               |
| 6    | National Iodine Deficiency Disorders Control Programme                                                                     |                                                            |
|      | ASHA incentive for salt testing                                                                                            | Rs.25/ month (for 50 salt samples)                         |
| IX   | Incentives under (CPHC) and Universal NCDs Screening                                                                       |                                                            |
| 1    | Maintaining data validation and collection of additional information                                                       | Rs. 5/form/family                                          |
| 2    | Filling up of CBAC forms of every individual                                                                               |                                                            |
|      |                                                                                                                            | Rs. 10/per form/per individual                             |
| 3    | Follow up of patients                                                                                                      | Rs. 50/per case/Bi-Annual                                  |
| 4    | Delivery of new service packages under CPHC                                                                                | Rs.1000/ASHA/PM                                            |
| X    | Drinking water and sanitation                                                                                              |                                                            |
| 1    | Motivating Households to construct toilet and promote the use of toilets and for individual tap connections                | Rs. 75 per household                                       |

## Annexure-IV

## State-wise details of monetary incentives provided to the ASHAs

1. Andhra Pradesh provides balance amount to match the total incentive of Rs.10,000/month;
2. Arunachal Pradesh-provides 100% top up;
3. Bihar- Rs.1000/- per ASHA per month linked with functionality of five specified 06 activities (started in FY 2019-20);
4. Chhattisgarh-75% of matching amount of the incentives over and above the incentives earned by an ASHA as a top up on an annual basis;
5. Delhi- Rs. 3000/- PM for functional ASHA (against the 12 core activities perform by ASHA);
6. Gujarat provides 50% top up;
7. Haryana- Rs. 4000/month from June-2018 and 50% top-up;
8. Himachal Pradesh- Rs. 2000/month;
9. Karnataka-Rs. 4000/month - recently introduced replacing the top up incentive;
10. Kerala-Rs.5000/month in FY 2020-21;
11. Odisha-Rs. 1000 /month from state fund launched on April 1st, 2018;
12. Rajasthan- Rs. 2700/month through ICDS;
13. Sikkim -Rs. 6000/month;
14. Telangana provides balance amount to match the total incentive of Rs. 6000/- pm;
15. Tripura provides 100% top up against 08 specified activities and 33% top-up based on other activities;
16. Uttarakhand- Rs.5000/year and Rs. 1000/month;
17. Uttar Pradesh- Rs.750/- per ASHA per month linked with functionality of five specified activities (started from March 2019); and
18. West Bengal-Rs. 3000/month.