Volunteerism to Incentivisation: Changing Priorities of Mitanins Work in Chhattisgarh

There is increasing informalisation in the public sector workforce, especially at the lower levels. Women form a huge part of the informal labour force. The health sector is also witnessing similar trends where another concept of ‘volunteerism’ is also emerging, as seen in the Mitanins of Chhattisgarh. The Mitanin programme, considered to be a precursor to the accredited social health activist (ASHA), had started on a different note. It had hoped that the community will pay for the loss of wages in future, instead of the government, so that the Mitanin remains a community representative. In the initial couple of years, the Mitanins were not compensated and later, activity-oriented payment was started, thus leading to incentivisation of their activities. Post-National Rural Health Mission (NRHM), this mode of compensation got cemented. This article will explore how one of the most important agendas during the conceptualisation of the programme, of the Mitanin being able to raise the community’s concerns and demands, being a community representative and organiser, was not met and she became a very lowly paid, honorary worker of the government health service system. This article is based on extensive fieldwork conducted intermittently between 2004 and 2008.