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Frontline Health Workers: The backbone of rural healthcare system

April 7, 2020

There is nothing typical about Anandwati’s day, a resident of Kursi village, Hardoi. She is a frontline health worker who is ready to step out of her house at odd hours or when she is not feeling well, only to help others in her village. Being an accredited social health activist (or ASHA), this comes naturally to her and to many such frontline health workers who are dedicated to relentlessly uplift the rural healthcare system.


On 7th April 2020, the world celebrates achievements and work of nurses and midwives who play a critical role in keeping the world healthy. They remain at the forefront of battling any disease or medical issue while addressing community questions, providing respectful treatment and care to the people in need. Their relationship with patients is based on trust and providing the necessary, skilful reassurances.


In rural India, frontline health workers act as an essential link to designated health facilities by bringing various services to people’s doorsteps. Accredited Social Health Activist (ASHA), Anganwadi (AWW) and Auxiliary Nurse Midwife (ANM) are an important force of frontline health workers who come from the communities that they are serving. Rural communities as setup are more close-knit than urban communities. The lack of advanced facilities and literacy makes it difficult to permeate the need for speciality healthcare and other essential information. These social realities make the task of frontline health workers even more challenging. They need to be actively involved in people’s lives not just from the purpose of providing institutional healthcare but also to gain additional insights which provide them with an agency in the community to lead the beneficiaries in a more developed and healthy direction. They have the responsibility of the entire community’s well being once they gain their trust and understanding.


The multi-dimensional nature of rural healthcare system makes involvements outside the conventional design essential for ensuring smooth delivery of services. Anandwati reminisces about the days when she first started working as an ASHA worker in 2006. She clearly remembers that her motivation received strong resistance from the community.


“It wasn’t an easy journey but I managed. People have closed doors on my face several times but the only motivation that I always had was I want to change the condition of my village because that’s the only way we can grow. Health is an important subject and it cannot be dealt
with leniency”, says Anandwati.


Shiv Devi, from Suthena village of Hardoi, is an Anganwadi worker who is popular as a messenger of health and sanitation in her village. The villagers proudly call her Jhansi ki Rani because she makes it a point to ensure everyone in her village is getting better healthcare
services and nobody is left behind.


“I’m always on my toes and I don’t delay work for any reason. Even if people are hesitant or reluctant to listen to me, I make it a point that I will change the condition of my village and get everybody on a healthier path.”


ASHAs, ANMs and AWWs have varying responsibilities. From conducting regular health surveys of families to assisting with deliveries, they cover major aspects of the healthcare system. Door to door visits to the poorest and most vulnerable, counselling families and pregnant women, spreading awareness on health, nutrition, family planning, child growth and development and immunisations are some of the roles and responsibilities that fall under the purview of these frontline health workers.


Their role is indispensable in the health system and hence they cannot or should not be taken lightly. Keeping the rural dynamics in mind, there is all the more need that they are trained and capacitated enough to efficiently manage the intricacies of rural healthcare. HCL Samuday is supporting the frontline health workers with a host of interventions aimed at enabling them to discharge their duties effectively and thereby uplift the health status in the villages of our country.


Anandwati proudly says that there is no longer any home delivery in her village. By regularly visiting and counselling pregnant women, making them understand the importance of healthy food, taking them for regular health checkups, frontline workers like Anandwati have helped successfully manage 84% High-Risk Pregnancy cases where mother and child were both at riskn due to several health issues, across three blocks of Hardoi, Uttar Pradesh.


Frontline health workers play a crucial role in health promotion and health literacy. On this World Health Day, when we celebrate the hard work of nurses and other frontline health workers, it is imperative that more respect, appreciation, and recognition come their way. With the right knowledge, skills, opportunities and financial support, they can act as more efficient health practitioners for beneficiaries and their families.


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