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The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response
India's nearly 1-million strong band of quasi-volunteer accredited social health activists (ASHAs) have been key actors in government efforts to control COVID-19. Utilizing a nationalist rhetoric of war, ASHAs were swiftly mobilized by the government in March 2020 as ‘COVID warriors’ engaged in...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Authors. Published by Elsevier Ltd.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531667/ https://www.ncbi.nlm.nih.gov/pubmed/36213893 http://dx.doi.org/10.1016/j.polgeo.2022.102770 |
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author | Nichols, Carly Jalali, Falak Fischer, Harry |
author_facet | Nichols, Carly Jalali, Falak Fischer, Harry |
author_sort | Nichols, Carly |
collection | PubMed |
description | India's nearly 1-million strong band of quasi-volunteer accredited social health activists (ASHAs) have been key actors in government efforts to control COVID-19. Utilizing a nationalist rhetoric of war, ASHAs were swiftly mobilized by the government in March 2020 as ‘COVID warriors’ engaged in tracking illness, disseminating information, and caring for quarantined individuals. The speed at which ASHAs were mobilized into mentally and physically grueling labor was all the more stunning given these minimally paid community health workers have long been seen to have low morale given their precarious, informalized work arrangements. Building on work examining the spatialities of global health governance alongside literature on geographic contingency, this paper explores the ways that nationalist COVID-19 war rhetoric promulgated from Delhi worked as a technology of health governance to propel ASHAs into certain forms of action, yet also opened up spaces of potentiality for them to reimagine their relationship to both the state and the communities they serve. In particular, in our analysis of in-depth telephone interviews with ASHA workers in the state of Himachal Pradesh, we find that their hailing as COVID warriors inspired patriotic calls to duty and legitimized their (long over-looked) roles as critical governance actors, yet also was subject to resistance and reworking due to a combination of institutional histories, local politics, as well as happenstantial everyday encounters of ASHA work. The precarious employment of ASHAs – in terms of basic remuneration as well as the great on-the-job risks that they have faced – underscores both the fragile nature of India's health governance system as well as possible political movements for its renewal. We conclude by calling for geographers to give greater attention to community health care workers as a key window into understanding the uneven ways in which health systems are made manifest on the ground, and their ability to respond to citizens' healthcare needs – both in the COVID-19 pandemic and beyond. |
format | Online Article Text |
id | pubmed-9531667 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Authors. Published by Elsevier Ltd. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95316672022-10-05 The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response Nichols, Carly Jalali, Falak Fischer, Harry Polit Geogr Full Length Article India's nearly 1-million strong band of quasi-volunteer accredited social health activists (ASHAs) have been key actors in government efforts to control COVID-19. Utilizing a nationalist rhetoric of war, ASHAs were swiftly mobilized by the government in March 2020 as ‘COVID warriors’ engaged in tracking illness, disseminating information, and caring for quarantined individuals. The speed at which ASHAs were mobilized into mentally and physically grueling labor was all the more stunning given these minimally paid community health workers have long been seen to have low morale given their precarious, informalized work arrangements. Building on work examining the spatialities of global health governance alongside literature on geographic contingency, this paper explores the ways that nationalist COVID-19 war rhetoric promulgated from Delhi worked as a technology of health governance to propel ASHAs into certain forms of action, yet also opened up spaces of potentiality for them to reimagine their relationship to both the state and the communities they serve. In particular, in our analysis of in-depth telephone interviews with ASHA workers in the state of Himachal Pradesh, we find that their hailing as COVID warriors inspired patriotic calls to duty and legitimized their (long over-looked) roles as critical governance actors, yet also was subject to resistance and reworking due to a combination of institutional histories, local politics, as well as happenstantial everyday encounters of ASHA work. The precarious employment of ASHAs – in terms of basic remuneration as well as the great on-the-job risks that they have faced – underscores both the fragile nature of India's health governance system as well as possible political movements for its renewal. We conclude by calling for geographers to give greater attention to community health care workers as a key window into understanding the uneven ways in which health systems are made manifest on the ground, and their ability to respond to citizens' healthcare needs – both in the COVID-19 pandemic and beyond. The Authors. Published by Elsevier Ltd. 2022-11 2022-10-04 /pmc/articles/PMC9531667/ /pubmed/36213893 http://dx.doi.org/10.1016/j.polgeo.2022.102770 Text en © 2022 The Authors Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Full Length Article Nichols, Carly Jalali, Falak Fischer, Harry The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title | The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title_full | The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title_fullStr | The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title_full_unstemmed | The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title_short | The “Corona Warriors”? Community health workers in the governance of India's COVID-19 response |
title_sort | “corona warriors”? community health workers in the governance of india's covid-19 response |
topic | Full Length Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531667/ https://www.ncbi.nlm.nih.gov/pubmed/36213893 http://dx.doi.org/10.1016/j.polgeo.2022.102770 |
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