As dedicated health workers serve tirelessly in remote villages, their unwavering commitment remains unseen and unprotected—it’s time to transform policy with compassion, stability and respect for those who keep India healthy
In every village, town, and mountain pass of India, someone is keeping a health centre open. Someone is trekking with vaccines on their back, conducting maternal checkups under candlelight, or filling registers with one hand while holding a stethoscope with the other. That “someone” is often an NHM employee under the National Health Mission and, more often than not, they are invisible to the policy rooms that plan India’s health budget. They are the ones who keep India’s public healthcare running, especially in remote and underserved areas. They are the heart of the National Health Mission, but often, their dedication is rewarded with insecurity.
Year after year, NHM workers find themselves listed under a heading called “contractual staff” in state and central budget documents. A line. A number. A cost to the system. But we are not just a line item. We are not a “project cost.” We are people.
When institutional deliveries go up in remote areas, it’s an NHM staff nurse working double shifts. When immunisation coverage rises, it’s the ANMs and ASHAs ensuring no vial goes to waste. When NQAS certification is awarded, it’s the NHM staff who prepare documents, manage logistics, and clean storerooms after hours.
But rarely is the human face acknowledged. Our names don’t appear in awards. Our contracts don’t improve with years of service. And the public, often unaware of this silent backbone, thinks we are “government employees” with all the perks. We are not. We are government-linked, not government-supported.
The Emotional Cost of Being “Temporary Forever”
Many NHM employees have served 10–15 years without permanent status. They’ve witnessed death and birth, chaos and calm, without ever having the peace of job security. Some work with their children’s school fees delayed or medical bills unpaid. They stay because the mission is greater than their own convenience. But how long can commitment survive without recognition? Imagine working through COVID-19, risking your life daily, being praised as a “Corona Warrior,” and then being asked to renew your contract again the next year with no promotion and the same uncertainty.
Numbers Don’t Heal — People Do
Healthcare systems talk about budgets, allocations, and targets. But health doesn’t run on Excel sheets. It runs on people. And the NHM workforce is not a disposable tool. We are mothers and fathers, sons and daughters, trying to serve our communities, but also hoping for stability and respect. Even a machine demands maintenance. Even a chair has a warranty. But many NHM workers have no health insurance, no retirement plan, and no guarantee of employment next year.
The Way Forward: Policy with Compassion
NHM has transformed rural healthcare — no doubt. But it’s time the people behind the mission are also transformed, from temporary, underpaid, overburdened workers to valued, secure members of the health workforce.
We need:
Time-bound regularisation policies
Equal pay for equal work
Defined benefits, leave, and insurance
Mental health and well-being programs for frontline staff
Public recognition of NHM’s role in every health achievement
In Conclusion
As a medical officer under NHM, I write not just with facts, but with firsthand pain and pride. I’ve seen how deeply committed my colleagues are — from the ASHA working in -20°C weather to the data manager who stays up to send reports at midnight. We don’t want to be remembered in footnotes. We don’t want to be thanked only during health days and disasters. We often say, “Healthcare is a human right.” But what about the rights of those who deliver it? It is time for the government, media, and the public to recognise the human beings behind the mission. NHM employees are not temporary when it comes to service. Their dedication is permanent, even if their contracts aren’t. They are contractual by designation, but committed by soul. We want to be seen as human beings, as professionals, and as partners in building India’s healthcare. We are not just a line in the budget. We are the heartbeat behind the numbers.
The writer is a Medical Officer at the PHC Shargole
Dr Fazal Wani
wa*******@***il.com