Fill over 3,800 posts, end to contractual norms: TN village health nurses protest

CHENNAI: Village Health Nurses (VHNs) of Tamil Nadu’s rural public health system protested in Chennai demanding urgent appointments to long-vacant posts and opposing what they call the quiet erosion of their role.

Organised by the TN Government Village and Community Nurses Federation, the protest brought together VHNs from across districts who fear that their decades-old role in immunisation, maternal care, and outreach is being side-lined.

“These posts have been vacant for four years. We’re managing work for 3 villages instead of 1,” lamented a VHN who had joined service in the late 1990s. According to the association, over 3,800 sanctioned VHN posts remain unfilled across the state’s Sub-Health Centres (SHCs), the first contact point in the rural public health system.

“From monitoring pregnancies and ensuring immunisation to conducting regular check-ups and helping women access government benefits, we’ve been the field-level staff supporting the state’s maternal and child health system. Today, we’re not only burdened with increased workload but also concerned about the continued existence of our role,” said Manimegalai, president of the association.

VHNs are trained auxiliary nurse midwives (ANMs) deployed to each health sub centres (HSCs) to serve a population of roughly 5,000 in plains and 3,000 in tribal areas. Their core responsibilities include maternal and child health, antenatal care, immunisation, family planning, and health education. Most come from disadvantaged backgrounds and have completed a government-recognised two-year diploma course.

At the centre of the protest is the health department’s move to involve mid-level health providers (MLHPs) contractual staff appointed under the National Health Mission in immunisation drives and field-based work traditionally handled by VHNs. Protesters are also opposing attempts to outsource vaccination delivery to private agencies.

“The government is still training students in colleges to be MLHPs, who will be recruited on a contract basis. When there’s a huge demand for nurses, why are they recruiting them for our job? Where will we go?” fumed a VHN from western belt.

“When actor Vivek died, people in tribal and rural areas were afraid to take the COVID vaccine. But they listened to us, because we’ve always been there,” recalled a VHN from a tribal block with over 30 years of service. “Despite our involvement in pandemic vaccination drives, we have received neither recognition nor did we have our demands met.”

The association submitted a 10-point charter demanding the immediate filling of vacancies through the Medical Services Recruitment Board (MRB), halting private outsourcing of immunisation, ensuring fair housing for VHNs, and restoring promotion and pension schemes. One demand includes upgradation to Mother and Child Welfare Officer posts for experienced VHNs.

“We’ve met Health Minister Subramaniam who assured us that vacancies will be looked into, and that the use of contract workers for our jobs will be reconsidered. We hope it will be resolved soon,” said Manimegalai, president of the association.