Kerala: NHM Employees Hold March, Allege Neglect from Union Govt

Employees of the National Health Mission (NHM) in Kerala held a Raj Bhavan march on August 1 against the continuing neglect of the Centrally-sponsored scheme by the Union government. From 90% in 2005, the year NHM was implemented, the Central share has come down to 60%, they said.

The wages paid to the employees continue to remain stagnant since the budgetary allocation for Human Resources (HR) has been reduced owing to the share cut from the Centre.

Around 12,500 employees, including allopathic and AYUSH doctors, graduate and general nurses, paramedical staff and administrative staff are employed for executing the goals set by the NHM. 

Despite the formation of sub-missions, including the National Urban Health Missions (NURM) and the proposed name change of the scheme to PM SamagraSwasthya Mission, the fortune of the employees has remained the same. Around 95% of the employees are appointed for a fixed period of time on contract, while the remaining are employed on daily wages. 

The denial of maternity leave for a large women workforce in the NHM is another major concern raised by the federation, besides demanding the implementation of social welfare measures. 

REDUCTION OF CENTRAL SHARE

The NHM was launched in 2005 with the aimof reducing the Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), providing universal access to public health services to women and children, prevention and control of communicable and non-communicable diseases, access to primary health care among others, particularly the poor in rural areas.

The NHM Employees Federation, affiliated to the Centre of Indian Trade Unions (CITU), has accused the Union government of diluting the scheme. The employees, including Accredited Social Health Activists (ASHAs), are underpaid in several states. 

“We have been fighting for ‘equal wages for equal work’. Since the Union government is cutting its share of the scheme, even a minimum wage is not paid to qualified employees. The salaries have been stagnant for quite a long time without any increment,” U P Joseph, president of the NHM Employees Federation, told NewsClick.

Around 1,000 employees attached to the NHM participated in the day-long protest. (Image Courtesy: CITU Kerala)

Joseph urged the Union government to restore its share in the scheme and avoid overloading state governments, which are already under a financial crunch owing to the lack of taxation powers and intense centralisation by the Bharatiya Janata Party (BJP)-led Union government. 

"Other service demands include improvement in the pay structure for all employees and regularisation of jobs from the present contract and daily wage system,” he added. 

SOCIAL WELFARE MEASURES

Most NHM employees are women, who are deprived of social welfare measures, including maternity leave, Employees State Insurance (ESI) and Employees Provident Fund (EPF). 

Speaking withNewsClick, Meera Nair, the federation's general secretary, claimed that women employees were denied maternity leave owing to break in service on March 31 every year. "This denial of a basic right must end, and the Union government must ensure that maternity leave is extended to all women workers, irrespective of the end and renewal of the contract period,” she added. 

The federation has called upon the Union government to allocate 6% of the gross domestic product (GDP) to ensure that health facilities are extended to all sections of the population. 

"The Kerala government is effectively intervening in the scheme for its successful implementation. The Union government must restore its share to 90% to ensure the scheme achieves its aims,” Nair added. 

The federation has flayed the NHM for directing the department not to pay the premium for employees from the current year, leading to denial of access to healthcare. "This has been done even though there is no change in the conditions by ESI Corporation. The facility must be reintroduced, and EPF enrolment must be ensured for all employees,” Joseph added. 

The federation also opposed the codification of labour laws, the violence in Manipur and Haryana by Right-wing elements, and the respective state and Union governments' “failure” to prevent atrocities against women and minorities.