Women protesting on Kerala. Image credit – Kerala Asha Health Workers Association (KAHWA). Used with permission.
The indefinite strike led by the ASHA Health Workers Association (KAHWA) in the Indian state of Kerala, ongoing since February 10, 2025, has crossed the 100-day mark. The milestone coincides with a nationwide strike organised by a majority of trade unions demanding decent work conditions and fair wages for Accredited Social Health Activist (ASHA) workers, Anganwadi (rural child-care), and Mid-day Meal Scheme workers. It also marks the ninth year of the ruling Left Democratic Front (LDF) government in power. Over these 100 days, the striking women have endured extreme heat and heavy rains while camping day and night in a temporary shelter outside the Secretariat building in Thiruvananthapuram City. They have staged various forms of protest, including symbolic acts such as cutting their hair, organising public gatherings, and undertaking a 41-day hunger strike.
Paid less than unskilled daily labourers
ASHA workers provide voluntary healthcare to rural communities and act as a bridge between them and more formalised care through a government-sponsored program.
The Kerala ASHA Health Workers Association (KAHWA) is demanding that the state government increase their monthly honorarium to match the government-approved minimum daily wages for the state, INR 710 (USD 8.3). “Our demand is simple,” said KAHWA president V.K. Sadanandan:
An honorarium of Rs 21,000 (USD 245) per month — Rs 700 (USD 8.17) per day. This is not an impossible ask. If migrant labourers can be paid an average of Rs 700, why not ASHA workers?
KAHWA is also asking for several other measures: a one-time retirement benefit of INR 500,000 (USD 5,844), the removal of the compulsory retirement age of 62 (which has since been frozen by the state government), timely payment of wages (by the 5th of every month), and a fair workload — many ASHAs currently work 12 to 16 hours a day, every day.
Volunteers vs full-time workers
While the National Health Mission (NHM) designates ASHA workers as community health activists or “honorary volunteers” rather than formal workers, it explicitly stipulates that their workload should be voluntary and should not interfere with their ability to pursue other paid work or regular daily life. NHM guidelines suggest a commitment of just 1–2 hours per day. Since 2024, ASHA workers in Kerala have been receiving a fixed monthly honorarium of INR 7,000 (approximately USD 82), fully funded by the state budget.
According to a government order by Kerala's Health and Family Welfare Department, the responsibilities of ASHA workers in the state have expanded beyond those outlined in NHM directives. Importantly, this order prohibits ASHAs in Kerala from taking up part-time or full-time employment that could interfere with their assigned duties. The NHM assigns 100 tasks per month to ASHA workers, and the state has added 10 more responsibilities at the ward level, with intensive data work. In effect, these expanded duties occupy nearly all of their working hours, making them reliant on their ASHA income while still being officially classified as volunteers.
Failed negotiations
Three rounds of discussions between the Kerala state government and the Kerala ASHA Health Workers Association (KAHWA) have failed to yield a resolution. The government has since formed a committee comprising five bureaucrats from the departments of Health, Women and Child Development, Labour, Finance, and the National Health Mission (NHM), tasked with submitting a proposal within three months. Chief Minister of Kerala, Pinarayi Vijayan, has stated that the government will no longer engage in further negotiations with the striking workers.
KAHWA has rejected the formation of the committee, calling it a delaying tactic. They also vowed that they would not end the strike unless the government agreed to increase their wages by at least INR 100 (approximately USD 1.17) per day and clear all pending dues.
Since the beginning of the strike organised by the Kerala ASHA Health Workers Association (KAHWA) — with support from leftist political organisations such as the Socialist Unity Centre of India (SUCI), the All India Democratic Students Organisation (AIDSO), and various civil society groups — the dominant Left, including supporters and leaders of the ruling Left Democratic Front (LDF), have dismissed the movement as “politically motivated”. They allege that the strike is backed by opposition parties such as the Indian National Congress (INC) and the Bharatiya Janata Party (BJP) in an attempt to destabilise the state government. The state government has also tried to shift the blame to the central government.
The KAHWA strike is not an isolated case in its call for the right to decent work and fair wages. In recent years, Kerala has witnessed similar protests from fisherfolk, women civil police officers, farmers, and Indigenous communities, among others.
Silence of the civil society
Increasingly, academics and activists are challenging the prevailing narrative of the Kerala development model, once celebrated for its people and environment-centric approach, arguing that its foundational ideals are being compromised.
J Devika, a feminist Scholar from Kerala, notes the silence of the civil society on this issue:
There are no more public intellectuals, like V R Krishna Iyer or B R P Bhaskar, who could bridge political society and civil society. [..] Our writers, include those who have made a career out of selling women’s pain in middlebrow modernist and other kinds of aesthetic packaging — do not want to displease their consumer-bases, mostly Communist Party (CPM) supporters. Our film-makers are also of the same ilk — they produce really good cinema, crafted from the pain of ordinary people, but will be mostly silent when they cry out in pain. Thiruvananthapuram boasts of the first independent union of women workers, SEWA Kerala, who are, alas, among the silent.
Caught in the crossfire between the state and central governments — amid growing regional instability driven by climate breakdown, geopolitical tensions, and unchecked capitalism — ASHA workers in Kerala and across India face increasingly challenging conditions. Inflation and a deepening debt infrastructure have rendered them highly vulnerable, with little to no institutional safeguards for these essential community care workers.
Resilient protesters
KAHWA members argue that their demands are both reasonable and necessary, especially in light of the state’s substantial spending on public celebrations and wage increases for other sectors, such as workers within the Kudumbashree programme (poverty reduction and women's empowerment). While initially hurt and shocked by the government’s indifference and public slander, the ASHA workers have drawn strength from months of collective organising and the solidarity extended by global trade unions, civil society organisations, national people’s movements, women’s unions, medical professionals, and independent media. This support has renewed their resolve to continue their resistance.
At the failed minister-level negotiations, the strike organisers have remained steadfast in their demands, even as dominant, male-led, left-leaning trade unions such as the Centre of Indian Trade Unions (CITU) and the All India Trade Union Congress (AITUC) align with the government and exert pressure to break the strike. Despite the union's outreach efforts, public sentiment remains divided, with popular narratives continuing to question KAHWA’s motives and the legitimacy of their demands.
On June 17, the union will conclude its 45-day-long statewide protest march in Thiruvananthapuram. Since May 5, they have organised over a hundred public gatherings across Kerala, mobilised thousands of supporters, and maintained a visible presence in public spaces through sustained protest camps.
Despite repeated claims that the union is corrupt or politically motivated, no evidence has been presented over the past three months to substantiate these allegations. The ASHA strike has exposed deep fault lines within the state’s ideological framework and governance approach, serving as a warning sign for the Left. As internationally acclaimed author and activist Arundhati Roy mentioned in a solidarity statement:
Today, as governments all over the world swing to the far right… I hope that in my Kerala the people as well as the government will support the demand of the ASHA workers. I stand with them.
