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Introduction

India’s expanding care economy increasingly depends on frontline workers such as Accredited Social Health Activist (ASHA) Programme workers and Anganwadi Services staff. Despite delivering essential health, nutrition and childcare services, many remain classified as “volunteers”, raising concerns about labour rights, gender equity and the sustainability of India’s welfare delivery system.

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Challenges Faced by Frontline Care Workers

• Low and Irregular Honorariums: Most workers receive modest honorariums rather than regular salaries, making income insecure.
  Eg: ASHA and Anganwadi workers are paid small honorariums instead of formal wages, as highlighted in the article.
• Lack of Formal Employment Benefits: They lack employment protections such as maternity benefits, paid leave or pension security.
  Eg: Many workers rely only on schemes like Ayushman Bharat and Pradhan Mantri Shram Yogi Maandhan for limited support.
• Absence of Job Security and Contracts: Despite performing permanent public functions, they are classified as “volunteers”.
  Eg: Over 5 million women in welfare programmes operate without formal employment contracts.
• Heavy Workload and Multiple Responsibilities: Workers perform several tasks such as maternal health tracking, nutrition monitoring and community mobilisation.
• Limited Voice in Policy and Decision-Making: Frontline workers have little representation in policy discussions affecting their work.

Reasons for the Challenges

• Gendered Perception of Care Work: Care work is often viewed as a natural extension of women’s domestic roles rather than skilled labour.
• Structural Informality in Welfare Delivery: Government welfare programmes rely on informal workers to minimise fiscal obligations.
  Eg: The state classifies these workers as “honorary workers” to avoid formal employment costs.
• Care Penalty and Gender Inequality: Women disproportionately bear unpaid and low-paid care responsibilities.
  Eg: The 2024 Time Use Survey shows women spend 140 minutes daily on caregiving, compared with 74 minutes for men.
• Fragmented Policy Responses Across States: State-level responses such as honorarium hikes vary widely.
• Lack of Institutional Integration in Skill Programmes: New caregiving initiatives often overlook the existing workforce.
  Eg: The National Skills Qualification Framework training proposal in the Union Budget 2026–27 does not clearly integrate current ASHA or Anganwadi workers.

Need to Formally Recognise and Strengthen the Care Economy

• Ensuring Labour Rights and Fair Wages: Formal recognition would ensure wages, contracts and social protection.
  Eg: In 2025, the Dharam Singh & Anr. vs State of U.P. & Anr. ruling stated that recurrent institutional work cannot be treated as temporary indefinitely.
• Improving Quality of Public Welfare Services: Better working conditions would enhance efficiency in healthcare, nutrition and childcare delivery.
• Addressing Gender Inequality in Labour Markets: Formalisation would reduce gender disparities in employment and pay.
• Strengthening the Care Workforce through Skill Development: Existing workers can be upskilled rather than replaced by new recruits.
  Eg: Extending NSQF-aligned training programmes to Anganwadi and ASHA workers can enhance their professional status.
• Building a Sustainable Care Economy: Formal recognition ensures continuity and resilience in welfare delivery systems.
  Eg: The International Labour Organization promotes the 5R Framework for Decent Care Work, emphasising reward and representation.

Conclusion

India’s ambitions for a robust care economy require recognising frontline workers as skilled professionals rather than volunteers. Formal employment status, fair wages, skill development and policy representation are essential to strengthen welfare delivery while advancing gender equity and building a sustainable, inclusive care infrastructure for the future.

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