Community Psychiatry in India

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Volunteer model vs Payment model: Court Intervenes.


The Kerala High Court intervenes in the issue of Anganwadi worker’s pay dispute.  The details are summarised below based data in the Newindianexpress report.

Blog Comment: It is unfortunate that valuable time of our courts have to be drawn into these issues which should have been sorted out at policy level. It is the  government’s non committal to raise the percentage public spending on health from a meager less than 1% to at least 2 to 3%, the underlying reason for this situation. There has been a constant demand from health workers at the cutting edge of delivery of various governmental schemes for fair remuneration. The issue is complex as one can immediately see by going thorough the various arguments that came before the court and as also discussed elsewhere in various other forums.

The petitioners: (Anganwadi Workers)ang the wages being paid…is below the minimum wages in spite of the hectic work assigned…

… the work done is not less noble or tiresome than the work of primary school teachers who get a minimum of Rs 15,000. It was also pointed out that part-time sweepers in the state are given Rs 6000 and above.

The government: (Center and State)gov .… the workers and helpers cannot be declared as government employees. Hence they are not entitled to benefits like pension and gratuity.

.. the petitioners are not civil servants and they cannot claim any enhancement of emoluments.

The Kerala High Court:cou

… one cannot be oblivious of the fact that the presence of anganwadi workers and helpers in their respective villages is extremely important.

… if the anganwadi workers and helpers are under the dictate of the governments, they are entitled to a decent remuneration to lead a decent living.

… the Centre to appoint a commission without delay to study the issue and report suggesting ways and means to improve the service conditions of anganwadi workers.

the state government to increase the wages of the anganwadi workers to Rs 5,000 and that of the helpers to Rs 3500.

All photographs are only representative and downloaded from the web (no explicit permission has been sought).

added on oct 5, 2015

We must move beyond the ‘pay vs. no pay’ debate for community health workers

Increasingly, the human resource crises in LMIC are being recognized as not simply a crisis of numbers but also a crisis of human resource management.  Although strengthening local training capacity and increasing the output of health professionals is desirable, the experiences of various countries have demonstrated that it is not possible to ‘train’ our way out of this problem.  Even assuming they stay in the system, having more doctors, nurses or even stipendiary or volunteer community health workers available is simply no guarantee of universal access to good quality and essential health care services – as issues of distribution, motivation and retention all come into play.


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