Table 1 Frontline health workers in the public health system in India

Ministry of Health and Family Welfare

 Within the health department, PHCs are the peripheral most centres which provide the first contact between the community and a doctor in rural areas. PHCs provide basic preventive, promotive and curative, and outreach services through SCs. An SC covers a population of 3000–5000. Each SC is proposed to have one or two auxiliary nurse midwives (ANMs) and one male multipurpose health worker (male-MPHW). Previously, only one regular ANM (1st ANM) was stationed at SC, but in 2005, the Indian government introduced a contract position for 2nd ANM. At the same time, government introduced accredited social health activists (ASHAs), who are incentive-based community volunteers that serve as an interface between the community and public health system at a village level.

Ministry of Women Development and Child Welfare

 The Integrated Child Development Services (ICDS) scheme aims to improve health and nutrition status of women and children. Under this scheme, nutrition centres/Anganwadi centres (AWCs) were established and services are provided by an Anganwadi worker (AWW) with support from a helper. The government envisages convergence between ANMs, ASHAs and AWWs.

For this study, the regular staff, ANMs, male-MPHW and AWWs, are referred as FLHWs while ASHAs are mentioned separately.