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Accepted Paper:

ASHA workers and the blurred margins of the State: reflections on health practices among Kondh tribal women in Odisha  
Bibekananda Nayak (Babasaheb Bhimrao Ambedkar University, Lucknow)

Paper short abstract:

This paper shows as to how ASHA workers among Kondh community in Odisha 'blur' the oft-presumed boundaries of the State-sponsored modern healthcare system and indigenous health practices.

Paper long abstract:

India's National Rural Health Mission (NRHM) mandates to improve the access and affordability of quality health care and reduce maternal mortality rate (MMR) and infant mortality rate (IMR). Accredited Social Health Activists or ASHA workers, under this scheme, are female members of the community that act as the link between the larger developmental machinery of the State (viz., PRIs, AWWs and ANMs). Studies on ASHA workers have mostly stressed on issues like location of primary health care centres and funding bottlenecks (Husain 2011 and Bajpai 2010). But following Sharma and Gupta (2006), I argue, in this paper that the ASHA worker does not merely act as an appendage, that merely facilitates institutional deliveries, child care and family planningthrough the provisioning of cash incentives. Instead, as seen among the tribal women of the Kondh community in Odisha, they 'blur' the oft-presumed boundaries of the State-sponsored modern healthcare system and indigenous health practices. In other words, the ASHA worker in such areas has helped to prioritize three key themes within the prevailing discourse on contemporary health practices: (a) a subtle appreciation of alternative therapies like AYUSH (b) invoking an epidemiological logic in investment pattern and finally (c) laying a stress on the appropriateness of technology and diffused decentralization of healthcare. Further, there are many untapped potentialities of the ASHA worker vis-à-vis its ability to emerge as a legitimate voice of the community, which the paper promises to reflect on as well.

Panel Med05
Understanding health workers at the interface of community and development
  Session 1