Home Health Aides and Accredited Social Health Activists (ASHAs) by Joy M. @joycming
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A TALE OF TWO FRONTLINE HEALTH WORKERS: Home Health Aides & Accredited Social health Activists (ASHAs) by @joycming
AIDES
- New York, USA
- Long-term care or aging in place
- Activities of daily living & clinical monitoring
- Employed by agency/self, min. wage (Medicare/aid)
ASHAs
- Uttar Pradesh, India
- Mothers & newborns
- Community-based care & liaising
- “Honorary” employees of govt, paid per activity
Even as key connectors of patients <> healthcare system, both face challenges due to these factors:
- IDENTITY: threatened or belittled, asked to do extra housework
- LOCATION: devalued work in the home, increased surveillance b/c distribution
- CLINICAL STATUS: knowledge ab. patient overlooked, not included in key decisions, have to gather info own own
Invisible Work
Both have to do extra work to navigate boundaries:
- ASSIGNED/ASKED: patients make requests that are not part of their job scope; job requirements change a lot (e.g., COVID caused last min. changes)
- SELF/OTHERS: handle interpersonal conflicts that arise, often turning to others’ authority; filling in for others, even unpaid, because of solidarity/camaraderie
- WORK/LIFE: developing coping mechanisms to handle high stress job; having to bring work home (e.g., calls outside work hours)
- SEEN/UNSEEN: supervisors surveil to ensure compliance, but do not respond quickly to feedback/issues; feeling background, like servants/housekeepers
