15-05-2025
CHOs demand fair deal, strike continues in State
Disappointment and dissatisfaction with work for a long time have led to many community health officers (CHOs), who play a key role in delivering a wide range of health services to people at the grasroot level, striking their work indefinitely in the State.
Since April 24, CHOs have been organising protests in all district headquarters demanding completion of construction of Ayushman Arogya Mandirs, also called Health and Wellness Centres or Village Health Clinics (VHCs), and payment of the performance-based incentive of ₹15,000, pending for eight months, regularisation of their services of those who completed six years, resumption of PF, and an increase in their current pay of ₹25,000.
Launched in 2018 under the National Health Mission programme of the Centre, the concept of having an Ayushman Arogya Mandir or VHC for every 3,000-5,000 population was envisaged to deliver expanded range of services and to ensure that they reach everyone. It is the nearest clinic to the people in villages. All CHOs report to medical officers in primary health centres (PHCs). Usually, a VHC is staffed by a CHO, an ANM and two or three ASHAs.
While there are 1,77,243 functional Ayushman Arogya Mandirs in the country, there are around 10,000 in the State, the construction of which is reportedly incomplete in 80% of the cases. Some centres do not have a building at all, say the CHOs.
'When we were posted to villages, many of us had to rent a building to run the services. We are bearing the expenditure on rents, ranging between ₹1,000 and ₹5,000. On top of that, we have to spend from our pockets on eletrictity charges, around ₹500-₹700 and upkeep of the premises,' says a CHO from NTR district, who came to take part in the protest at Dharna Chowk in Vijayawada.
She adds that most of her income of ₹25,000 is spent on running the clinic. 'Should we worry about running our houses or running the clinics,' she asks. Moreover, the CHOs have not received their pay for April.
In the State, the first batch of CHOs, all of whom BSc Nursing or MSc Nursing holders, were recruited in 2019 on a contractual basis. There is no certainty regarding regularisation of their services, they say, adding that they do not have monetary benefits such as Dearness Allowance or transport charges for their field work.
President of the A.P. Midlevel Health Provider/Community Health Officers' Association Sandeep said there has been a false narrative against CHOs that many of them are found absent during duty hours. 'While our duty hours are 9 a.m. to 4 p.m., our days start at 7 a.m. to screen villagers, who go to work early, for various non-communicable diseases as part of surveys,' Mr. Sandeep said.
The CHOs also pointed out that after they begun their protest, the government has asked them to be on duty until 8 p.m., so as to remain available to people in the event of an emergency. The CHOs, most of whom are women, are opposing this move too, citing security reasons.
When asked about their concerns, Health and Family Welfare Commissioner G. Veerapandian said the government has addressed a few demands and requested them to resume duties. He said A.P. is paying the highest remuneration to CHOs in the country. Regarding rents, he said the CHOs are not submitting owners' bank account details for releasing the rent amount.
'There will be no problem in releasing rent,' he said, noting that there has been no disruption in delivery of services to people as, in their absence, District Medical and Health Officers have been instructed to keep VHCs open through ANMs and ASHAs.
The CHOs said they are open for talks with the government and Health Minister.
