Socio-structural Factors in Functioning of Women Health Workers: A Study of Frontline Workers in Hardoi District of Uttar Pradesh

  • Sonia VermaEmail author
  • Sanghmitra S. Acharya


The frontline health workers, majorly women, play very important role in improving health statistics of rural India as they work in resource-poor condition and yet deliver the health services to needy. Working in a close community is not an easy job as many a time they have to choose the appropriate needy, without having rational choice. The health system is as much hierarchical as the Indian society; both do not allow the women health workers outside of the system. There are several structural and social factors that guide their working, and hence their functioning. The present paper is based on primary data conducted for PhD thesis. It tries to understand the challenges frontline women health workers go through, thereby identifying the structural and social barriers. For the study, ANMs and ASHAs across social groups were selected.


ASHA Women health worker Frontline workers 


Conflict of Interest

No potential conflict of interest was reported by the authors


  1. Acharya, S. S. (2010). Caste and patterns of discrimination in rural public health care services. In S. Thorat & K. N. Neuman (Eds.), Blocked by caste: Economic discrimination and social exclusion in modern India (pp. 208–229). New Delhi: Oxford University Press.Google Scholar
  2. Agarwal, A., Garg, S., & Pareek, U. (2011). Strengthening human resource practices in healthcare in India: The road ahead. Journal, Indian Academy of Clinical Medicine, 12(1), 39.Google Scholar
  3. Ashtekar, S. (2011). Revisiting the community health worker. In Qadeer, I., et al. (Eds.), Public health and the poverty of reforms (pp. 427–435). New Delhi: Sage Publications.Google Scholar
  4. Beteille, A. (1965). Caste, class, and power: Changing patterns of stratification in a Tanjore village. London: University of California Press.Google Scholar
  5. Gopalan, S. S., Mohanty, S., & Das, A. (2012). Assessing community health workers’ performance motivation: A mixed-methods approach on India’s Accredited Social Health Activists (ASHA) programme. British Medical Journal Open, 2(5), e001557.Google Scholar
  6. Haan, A. (1997). Poverty and social exclusion: A comparison of debates on deprivation. Working Paper No. 2, Poverty Research Unit, Sussex University, Brighton.Google Scholar
  7. Hogg, M. A., & Ridgeway, C. L. (2003). Social identity: Sociological and social psychological perspectives. Social Psychology Quarterly, 66, 97–100.Google Scholar
  8. Irudayam, A, Mangubhai, J. P., & Lee, J. G. (2006). Dalit women speak out: Violence against Dalit women in India (Vol. I and II). New Delhi: National Council for Dalit Human Rights.Google Scholar
  9. Jaspal, R. (2011). Caste, social stigma and identity processes. Psychology & Developing Societies, 23, 27–62.CrossRefGoogle Scholar
  10. Jenkins, K. (2008). Practically professionals? Rural women as local experts—A Peruvian case study. Political Geography, 27, 139–159.CrossRefGoogle Scholar
  11. Jesani, A. (1990). Limits of empowerment: Women in rural health care. Economic and Political Weekly, 1098–1103.Google Scholar
  12. Kumar, V., & Mishra, A. J. (2015). Quality of health care in primary health care system: A reflection from Indian state. International Journal of Health System and Disaster Management, 3(3), 136.CrossRefGoogle Scholar
  13. Maes, K., & Kalofonos, I. (2013). Becoming and remaining community health workers: Perspectives from Ethiopia and Mozambique. Social Science and Medicine, 87(2013), 52–59. Scholar
  14. Mehrotra, S. (2008). Public health system in UP: What can be done? Economic and Political Weekly, 43(49), 46–53.Google Scholar
  15. Mishra, R. (1997). Female health workers: Problems and implications. Economic and Political Weekly, 2791–2793.Google Scholar
  16. Mohan, P., Iyengar, S. D., Mohan, S. B., & Sen, K. (2003). Auxiliary Nurse Midwife: What determines her place of residence. Journal of Health and Population in Developing Countries. http://www.jhpdc.unc/edu.
  17. Nair, V. M., Thankappan, K. R., Sarma, P. S., & Vasan, R. S. (2001). Changing roles of grass-root level health workers in Kerala, India. Health Policy and Planning, 16(2), 171–179.CrossRefGoogle Scholar
  18. National Health Systems Resource Centre. (2011). ASHA which way forward…? Evaluation of Asha program NHSRC, NRHM.Google Scholar
  19. Poitevin, G. (1988). Primary health care as a gender issue. Economic and Political Weekly, 23(44), WS65-WS69+WS71-WS72.Google Scholar
  20. Verma, S., & Acharya, S. S. (2018). Social identity and perceptions about health care service provisioning by and for the Dalits in India. Social Identities, 24(3), 327–338.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Giri Institute of Development StudiesLucknowIndia
  2. 2.School of Social Sciences, Centre of Social Medicine and Community HealthJawaharlal Nehru UniversityNew DelhiIndia

Personalised recommendations