Urgent Appeal to Chief Minister of Kerala: Uphold Kerala’s public‑health legacy and address the just demands of ASHA workers
napm india
From: All India Feminist Alliance - ALIFA NAPM <nariva...@gmail.com>
Date: Thu, 4 Sep, 2025, 3:51 pm
Subject: Urgent Appeal to Chief Minister of Kerala: Uphold Kerala’s public‑health legacy and address the just demands of ASHA workers
To: <chiefm...@kerala.gov.in>, <pinaray...@niyamasabha.nic.in>
Cc: <chie...@kerala.gov.in>
(Word & PDF Versions of Letter Attached)
Urgent Appeal to Chief Minister of Kerala:
Uphold Kerala’s public‑health legacy and address the just demands of ASHA workers
4th Sep, 2025
To
The Chief Minister,
Government of Kerala,
Thiruvananthapuram
Sub: Uphold Kerala’s public‑health legacy and address the just demands of ASHA workers, immediately.
Sir,
We the undersigned are writing to you on behalf of the All-India Feminist Alliance (ALIFA) of the National Alliance of People’s Movements (NAPM). We write in unwavering feminist solidarity with the Accredited Social Health Activists (ASHAs) and Kerala ASHA Health Workers Association (KAHWA) who have maintained an indefinite sit‑in outside the State Secretariat since 10th February, 2025 demanding dignity, security and fair pay. Their vigil has already cost them many weeks and months of wages, without any time-bound decision or measurable relief in sight. This letter calls on you to act decisively, not only to avert further hardship for these frontline women care workers, but to uphold the very credibility of Kerala’s celebrated public‑health model.
Since early April 2025, thousands of ASHA workers have undertaken hunger strikes and launched a 45‑day protest march from Kasaragod to Thiruvananthapuram to highlight their plight. Despite multiple negotiation rounds, the state’s only concrete step has been the appointment of a five‑member committee on 15 May, a move the workers rightly view as a delay tactic. In July 2025, the Union Government raised its fixed ASHA incentive from ₹2,000 to ₹3,500 and the retirement grant from ₹20,000 to ₹50,000. Deeming it grossly inadequate, ASHA leaders judged this insufficient and now demand that Kerala at least match higher‑paying states such as Maharashtra (₹10,000).
The state’s reliance on precarious, gendered care work reveals a profound contradiction in Kerala’s progressive self‑image. Many ASHA workers, hailing from marginalised caste and class backgrounds, anchor the public health infrastructure on their shoulders, yet are deemed 'volunteers' who are paid on the basis of tasks. They remain without any rights or security of employment.
Facts the Government cannot ignore:
1. Scale of labour: Kerala’s ASHAs, mostly women from marginalised caste‑class locations, cover every panchayat - tracking pregnancies, TB, hypertension and mental‑health referrals. International Health Policies calls them the “first point of contact” for millions.
2. Chronic under‑valuation: Despite 12–16‑hour workdays, they receive a flat ₹7,000—below the legal minimum for unskilled labour.
3. New central incentive, old state apathy: The 26th July hike to ₹3,500 has not altered Kerala’s stagnant share of ₹7,000.
4. Workers’ specific demands: ASHA unions seek a ₹21,000 wage, ₹5 lakh retirement benefit, arrears by the 5ᵗʰ of each month, and formal employee status with pension, EPF, ESI and risk insurance.
5. Escalating protest: On the 50‑day mark (31st March) hundreds of ASHAs cut their hair to highlight the humiliation of ‘global praise’ without local rights.
These facts expose a structural contradiction wherein Kerala’s health indicators are world‑class precisely because these women’s reproductive, emotional and physical labour is systematically undervalued. A model that reproduces patriarchal exploitation is extractive, not progressive. ASHA’s volunteerism subsidizes the State and a patriarchal society.
Across India and globally, community‑based caregivers such as ASHA, anganwadi workers, home‑based nurses and elder‑care aides occupy the lowest rung of the health economy even though its survival depends on them. Their labour is feminized, informal and invisibilized: classified as “voluntary” or “honorary,” they receive token honoraria that rarely breach subsistence thresholds, yet shoulder responsibilities that now span epidemic surveillance, digital data entry, mental‑health triage and palliative care. Because they work in private homes and scattered hamlets, occupational risks like gender‑based violence, heatstroke, dog bites, infectious disease etc, are borne individually, without insurance or legal recourse.
The 2019 pandemic magnified the injustice; caregivers were celebrated as “front‑line warriors” while many died without compensation, their families denied even widow pensions. The state’s cost‑saving sleight of hand is simple: shift public‑health workload onto women’s unpaid time, then cite “budget constraints” to resist wage justice. This model entrenches caste‑class hierarchies as most caregivers come from socio-economically marginalized communities; and perpetuates inter‑generational poverty as daughters substitute in domestic work to cover household gaps. Recognizing, professionalizing and remunerating caregivers is, therefore, not a peripheral welfare gesture but rather a structural imperative to secure health equity, gender justice and the resilience of the very systems governments claim to champion.
Sir, what your government does next on the ASHA strike will decide both public trust and health outcomes:
· First, Kerala’s vaunted model of “people‑centred” health collapses under the hypocrisy of relying on impoverished women to deliver essential services for a pittance. Every day the sit‑in continues, the state’s credibility as a ‘global public‑health exemplar’ erodes.
· Second, the longer that the government takes to recognize and meet the demands of the workers; the longer the women have to continue their protests, which will have far-reaching consequences. Missed antenatal visits, un‑screened hypertension, and postponed mental‑health referrals are already accumulating in panchayat logbooks; the epidemiological lag means today’s administrative inertia will manifest as tomorrow’s spikes in maternal deaths, stroke admissions, and suicide attempts. The costs will far exceed the price of fair wages.
· Finally, feminist political‑economy makes plain that public health is a form of social reproduction: when the state refuses to pay for care, the burden does not disappear, instead it is displaced onto women’s bodies and minds, unpaid hours, and inter-generational poverty traps. Meeting ASHA demands is, therefore, not a “hand‑out”; it is a fiscally prudent investment in Kerala’s human‑development engine and an ethical obligation to dismantle gender‑caste hierarchies.
In the light of the above, our collective feminist demands are as follows:
Immediate wage justice:
- Enhance the state component so every ASHA receives ₹21,000 per month, indexed to the Consumer Price Index (CPI).
- Release three months’ pending honoraria with interest, as already budgeted.
Status and security:
- Convert ASHAs from “honorary volunteers” to regular employees of the Health & Family Welfare Department.
- Introduce EPF, ESI, paid maternity leave and accident insurance commensurate with high‑risk fieldwork.
Comprehensive retirement and welfare:
- Legislate a ₹5 lakh retirement benefit and a pension at least 50 % of final wage.
- Abolish the age‑62 exit ceiling, recognizing that poverty, not age, forces many women out of service.
Safe and enabling work environment:
- Provide PPE, smartphones, data plans, travel allowances and rest‑rooms in every PHC through NHM flexi‑pools.
- Mandate an eight‑hour workday with one weekly off; compensate for extra‑departmental duties separately.
Participatory monitoring & budget transparency:
- Create a joint monitoring committee with equal representation from ASHA unions, autonomous feminist civil society and officials, reporting quarterly.
- Publish district‑wise wage and incentive data on the state portal.
We stand ready to lend support to any genuine process securing ASHA workers’ rights. We look forward to a prompt response to this earnest appeal and substantive fair action from your Government.
Thanking you,
Signatories to the Appeal:
1. Adv Albertina Almeida, Goa
2. Adv Amala, Advocate, Delhi
3. Adv. Priyanka, Lucknow
4. Ambika, Social activist, Hyderabad
5. Anita Cheria, OpenSpace, Bangalore
6. Anuradha Banerjee, Saheli, Delhi
7. Arundhati Dhuru, NAPM Lucknow
8. Bhanu Kalluri, Activist, Telangana
9. Bittu KR, Delhi
10. Chayanika Shah, Mumbai
11. Deepa, Bhopal
12. Deepthi, Hyderabad
13. Dr. A. Suneetha, ALIFA, Hyderabad
14. Dr. Shalu Nigam, Delhi NCR
15. Dr. Soma KP, New Delhi
16. Dr. Preeti Edakunny, Bangalore
17. Faiza Ahmad Khan, Filmmaker
18. Gouthami, Goa
19. Harpuneet Kaur, PFUS, Panjab University
20. Indira Rani, Independent Researcher
21. Iswarya, Chennai
22. J Devika, Feminist scholar, Kerala
23. Jayasree Subramanian, Hyderabad
24. K. Sajaya, Social Activist & Independent Journalist, Hyderabad
25. Kalpana Karunakaran, Teacher and Researcher, Chennai
26. Laxmi Murthy, Journalist and Researcher, Bangalore
27. Madhu Bhushan, Feminist Activist, Gamana Mahila Samuha, Bangalore
28. Mamata Dash, Activist, New Delhi
29. Mani, Academic & Feminist, Pune
30. Meena Saraswathi Seshu, Vidhrohi Mahila Manch, Maharashtra
31. Meera Sanghamitra (ALIFA - NAPM), Telangana
32. Moumita Alam, (North Bengal - Jalpaiguri)
33. Nandini Rao Akkaraju, New Delhi
34. Nidhi Agarwal, Delhi
35. Nikita, Climate and Social Justice activist, Social Worker, Hyderabad
36. Pranjali Tripathi, New Delhi
37. Puja, ALIFA - Delhi
38. Radhika Desai, Independent Gender, Social Development Researcher, Goa
39. Rahee, ALIYSA, ALIFA, NAPM
40. Richa Singh, Sangtin Kisan Mazdoor Sangathan, Uttar Pradesh
41. Sagari Ramdas, Food Sovereignty Alliance
42. Shahira Naim, Independent Journalist
43. Shilpa Nair, Menstrual Health and Gender Practitioner, Mumbai
44. Shilpa Parthan, Researcher, Kerala
45. Shraddha Halapnavar, Law Graduate, Karnataka
46. Gabriele Dietrich, Penn Urimay Iyakkam and NAPM, Tamil Nadu
47. Sumi, Gender Rights Activist, North Bengal
48. Svati Shah, Academic
49. Swathi SB, Public Health Practitioner, Action for Equity
50. Vanaja, Coastal Action Network, TN
51. Vihaan Vee, Bangalore
References
1. “ASHA Struggle in Kerala: An Overview of Unmet Demands and Systemic Impediments,” Countercurrents (19 Apr 2025); Economic Times report on indefinite sit‑in (26 Jul 2025).
2. Babbar K., Nagesh S., & Mangal V. “Frontline, Forgotten: The ASHA Workers’ Fight for Fairness,” International Health Policies (11 Apr 2025).
3. Shradha. “Women health workers in Kerala demand fair wages and recognition of work,” Global Voices (23 May 2025).
4. “Centre increases monthly incentive of ASHAs to ₹3,500,” Times of India (26 Jul 2025); “Agitating ASHA workers welcome Centre’s hike,” Economic Times (26 Jul 2025).
5. Namita Bhandare, “Mind the Gap: Why ASHA workers in Kerala are angry,” Hindustan Times (7 Apr 2025); Economic Times report on protest demands (26 Jul 2025).
6. “ASHA workers cut hair to mark 50th day of protest,” New Indian Express (31 Mar 2025).
All India Feminist Alliance (ALIFA – NAPM)
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