Heroes of social change: rural India’s ASHA and Anganwadi workers

In my recent field visit to Madhya Pradesh’s Barwani district, my colleagues introduced me to three most resilient women. One of them works as an Accredited Social Health Activist, known as a village ASHA and two are Anganwadi Workers (AWW) who are primarily in charge of nutrition and well-being of children under five. All three had two things in common – a childhood brush with polio, and the unstoppable courage to defy the odds.

Life had dealt each of them a difficult hand before their second birthdays. Prior to when the Polio vaccine became widely available in India, all three women became victims of this debilitating disease. Each of them remembers getting a high fever, followed by paralysis, severe for one of them, milder, yet crippling for the other two. When I heard what daunting adversities these three women had surmounted and saw the courage and drive with which they were helping other women and children in their communities despite their own struggles, I felt that I must share their inspiring stories.

At The Antara Foundations (TAF), we regularly empower the ASHAs and AWWs, regarded as Frontline Health Workers (FLWs). A key part of the government workforce, the FLWs reduce maternal and infant health morbidity and mortality by providing critical services to pregnant mothers and infants, such as regular check-ups, access to medications and vaccines, and advice on family planning, nutrition, and healthcare. Although these workers each have a defined role, together they share a common goal to look after the well-being of the community they serve.

Rukmani Yadav has been an ASHA since 2006 in the village of Borlay in the Barwani district. Born in a poor family where her father was a daily wage labourer, she was the oldest of five daughters. As is common in most rural India, parents of girls keep conceiving to satisfy their yearning for a male heir who will look after them in their old age. Rukmani’s parents had a son following the birth of 5 daughters, but unfortunately, the son died by suicide in the prime of his youth. She held an ambition to study and become a judge or at least a lawyer.

Despite the stigma of polio attached to her, Rukmani had started to provide for her family from an early age. She was married off to a man who ran a flour mill for a living. However, Rukmani did not give up. She completed her 12th grade privately after her son was born, and even now, is relentlessly pursuing a B.A. in social sciences. Rukmani has an excellent work track record and has gained the trust of her entire village. Rukmani became the primary breadwinner of her family. Even though she cannot go walking door to door, her husband takes her for community visits on his motorbike.

Her village boasts of no home deliveries, and she makes sure every pregnant woman is registered as early as possible and receives the essential ante-natal check-ups and care. Rukmani is a fast learner, and although she has no formal training in nursing, she can do an abdominal exam and has a keen eye to spot danger signs of high risk. She is confident that if the need arises, she can help conduct a safe delivery in case the pregnant woman cannot make it to a hospital.

We later proceeded to meet the two other Anganwadi workers in Bagud village. Santoshi Solanki has been an AWW since 2001. Polio hit her hard when she was just a toddler. She needs to use a crutch as well as a stick to get around. In the monsoon, the village roads can be challenging even for an Olympic athlete. And yet, Santoshi navigates them with a smile, seeking help as needed from her three brothers, who give her a ride on their motorcycles to get to the Anganwadi centre and to her home visits. The Anganwadi helper too provides Santoshi support in conducting the activities for the children of the Centre. Santoshi remained single and devoted herself entirely to her work. She thinks of the Anganwadi children as her own. Her work record is exemplary.

Radha Khede is the third woman that we met. Donned in a bright red saree, Radha sported a contagious smile. She has been an Anganwadi worker since 1990. Both her parents were labourers, farming on the side, growing corn, a staple in this region. She has studied up to 8th grade but would have loved to pursue further education. She is married and has two children. Her 26-year-old daughter is completing her B.Ed.

Radha conscientiously makes sure every child in her village is weighed to check for malnourishment. She persuades the family to go to the Neonatal Rehabilitation Centre (NRC) if their child’s height-weight ratio places them in the severely malnourished category. She counsels each pregnant woman and patiently helps them with their problems. She is proud to have become a friend and confidante to every woman in her village.

Against all odds, these 3 unsung heroes and agents of social change, have faced their own misfortunes with courage and strive every day to bring good health and smiles to mothers and children in their villages. As Rukmani Yadav rightly says: Kisi ka charitra chapp jata he, kiskia chipp jata he (Some people’s biographies appear in print, some people’s biographies just disappear)

Madhura Nirkhe Ph.D.


In the image, L to R: Radha Khede, Santoshi Solanki and Rukmani Yadav.