Kerala removes performance-linked conditions for ASHA workers' full honorarium

The Kerala government has issued a new order removing the performance-linked conditions that previously prevented Accredited Social Health Activists (ASHAs) from receiving their full honorarium. The order, dated August 4, marks a significant concession to the demands of ASHA workers, who have long argued that such conditions were unfair and often depended on demographic factors beyond their control.

ASHAs are community health workers who serve as the first point of contact for health services in rural areas. They play a crucial role in maternal and child health, family planning, immunisation, and the promotion of health awareness. Their honorarium, paid partly by the central and state governments, has been a subject of contention, with workers demanding that it not be tied to performance targets.

Under an earlier government order issued in March 2025, the state had relaxed conditions for the payment of honorarium from the State Budget and had amended the criteria linked to the payment of fixed incentive. In June 2026, the government further amended this order to allow medical officers to certify cases where ASHAs were unable to meet targets due to factors beyond their control, such as working in areas with very few pregnant women or children. This certification allowed them to receive the full honorarium.

However, the Kerala ASHA Health Workers Association (KAHWA), which had led strikes demanding higher honorarium, continued to press for the complete removal of these criteria. The association argued that even the certification process involved administrative hassles and that the performance-linked structure itself was unjust. It pointed out that demographic realities, such as low population density or, conversely, high workload in dense areas, could not be attributed to individual workers.

With the new order, the government has fully removed the requirement that ASHAs must earn ₹500 as a performance incentive to receive the full honorarium. It has also done away with the need for certification from medical officers for this purpose. The honorarium payment is now no longer tied to any performance criteria.

This decision is expected to benefit thousands of ASHA workers across Kerala, who will now receive their full honorarium without conditions. The state government has framed the move as a step towards recognising the essential role of ASHAs in public health, while the workers' association has welcomed it as a victory for their sustained campaign.

The development also brings Kerala in line with demands from health activist groups that have consistently called for decent and unconditional remuneration for community health workers. Observers note that while the honorarium itself remains modest, the removal of conditionalities ensures greater financial stability for these workers, many of whom are women from marginalised communities.

The government order is seen as part of a broader effort to address the grievances of frontline health workers, who were particularly stretched during the COVID-19 pandemic and subsequent public health campaigns. The KAHWA has stated that it will continue to press for an increase in the overall honorarium amount, but has expressed satisfaction with the removal of the performance-linked conditions.