Grassroot Level Health Workers: Have They Taken Root in India?

4 Pages Posted: 25 Oct 2019

See all articles by K Rajasekharan Nayar

K Rajasekharan Nayar

Global Institute of Public Health and Santhigiri Research Foundation

Date Written: October 17, 2019


The WHO constitution, 1948 recognized right to health as a fundamental principle which was later reaffirmed in the Alma Ata declaration in 1978. However, this concept could not gain momentum at the grassroot level settings. In the recent past, stress on the Sustainable Development Goals (SDGs) and the Universal Health Coverage (UHC) has given a boost to the right to health principle in a renewed and purposeful sense. Human health workforce is the most important component of delivery of health care especially for achieving Sustainable Development Goals and for ensuring Universal Health Coverage. The Bhore committee given its progressive vision of providing health care at the doorstep of the people paved the way for primary health care workers and this vision got strengthened in the light of Alma Ata Declaration. The need for need for grassroot level workers who would be the point of contact for the public health care delivery system was highlighted by all these documents. Many initiatives have been implemented, of which, the Community Health Workers/ Volunteers (CHVs), and the latest Accredited Social Health Activists (ASHA) need prime mention because they have a voluntary status. Such initiatives helped in placing people’s health people’s hands. T he broad group of Community-level Health Workers such as Auxiliary Nurses and Midwives (ANMs), Male Health Workers also are also important links with the community. The work of these primary care workers has been challenging mainly due to overload, comparatively low compensation and inadequate infrastructure facilities. But in a country like India where doctor population ratio is not up to the required level, use of such voluntary workers such as ASHAs and other health workers for health care delivery has helped to sustain primary health care. We conclude that by improving the quality of grassroot level health workers and volunteers would certainly help in rich dividends as far as ensuring Universal Health Coverage and achieving SDGs. The considerable experience of India with innovations in the grassroot level workers indicate that if the culture of primary care has to take root and need to be sustained, then such workers are the key players.

Suggested Citation

Nayar, K Rajasekharan, Grassroot Level Health Workers: Have They Taken Root in India? (October 17, 2019). Available at SSRN: or

K Rajasekharan Nayar (Contact Author)

Global Institute of Public Health and Santhigiri Research Foundation ( email )

Global Institute of Public Health, Ananthapuri Hos
Thiruvananthapuram, 695024

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