Female frontline community healthcare workforce in India during Covid-19

Since the advent of the COVID-19 pandemic, 1 million Accredited Social Health Activists (ASHAs), 2.6 million Anganwadi workers (AWWs) and an entire cadre of Auxiliary Nurse Midwives (ANMs) have been at the forefront of the emergency health response system in India. During the pandemic, these three cadres of healthcare workers managed tasks like monitoring and conducting syndromic surveys, disease surveillance, data reporting, public health messaging, delivering essential food and ration services, at the community level. They routinely clocked over 12 hours work days and were on call the rest of the time. Despite being the backbone of India’s public health response, female frontline workers from across the country have reported being underpaid, undervalued, and alienated without any state support or protection. This report explores the role played by ASHAs, AWWs and ANMs during the pandemic, by analysing the information gathered from interviewing 201 frontline health workers across the 3 cadres from ten states. It offers crucial insight into their increased burden of work, economic vulnerabilities brought by reduced income and delayed payments, absence of medical insurance and adequate state support, as well as their consequently deteriorating physical and mental health