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In a significant labor dispute with profound public health implications, over 16,000 contractual employees under Chhattisgarh’s National Health Mission (NHM) initiated an indefinite strike starting August 18, 2025, protesting government policies including a stringent “no work, no pay” directive imposed by the state. This unprecedented strike has notably disrupted essential healthcare services across the state, particularly affecting child vaccination programs and frontline public health delivery. The standoff highlights ongoing challenges in workforce management, contractual job security, and service continuity in India’s state health systems.
Key Developments
On August 30, 2025, the Chhattisgarh state government issued a stern directive enforcing the “no work, no pay” policy for NHM employees absent from duty due to the strike. The Department of Health and Family Welfare instructed district Chief Medical and Health Officers (CMHOs) to withhold salaries for absent staff and to initiate disciplinary proceedings against persistent non-returnees, including show-cause notices and potential termination. The government labeled the strike “against public interest and completely unjustified,” emphasizing the critical nature of uninterrupted health services.
The striking NHM workforce, represented by the NHM Karmachari Sangh, cited unaddressed grievances despite submitting 160 memoranda to government authorities. Their ten-point demands include job security through regularization, establishment of a dedicated public health cadre, determination of grade pay scales, transparency in performance evaluations, a pending 27% salary hike, reservation for recruitment, compassionate appointments, provision for medical or other leave, a transfer policy, and minimum medical insurance coverage of Rs 10 lakh.
Impact on Public Health Services
The strike has caused widespread disruption of health services across Chhattisgarh. According to Kaushlesh Tiwari, General Secretary of NHM Karmachari Sangh, the child vaccination program has nearly come to a halt, raising concerns about potential outbreaks of vaccine-preventable diseases. Hospital officials have reported an increased burden on regular government healthcare staff, who are unable to compensate fully for the absence of contractual workers, resulting in reduced operational capacity such as fewer vaccination counters.
However, some district officials, including Bilaspur’s CMHO Dr. Shubha Garewal, assert that vaccination efforts continue on a reduced scale through remaining regular staff, with scheduled immunization days and crowd management strategies. Nonetheless, the overall strain on public health services remains significant.
Government and Expert Perspectives
Chhattisgarh Health Minister Shyam Bihari Jaiswal acknowledged the prolonged nature of the strike and reinforced the government’s stance on the “no work, no pay” principle for contractual employees. He clarified that while some demands—such as a 22% pay hike, transfer policy, and medical leave provisions—have been agreed upon, regularization of NHM staff depends on the approval of the central government.
Experts in public health workforce management note that contractual employment in state health missions often leads to job insecurity, impacting motivation and service delivery. Dr. Amit Miri, President of NHM Karmachari Sangh and participant in the strike, emphasized regularization as a critical issue for ensuring workforce stability and improving public health outcomes.
Context and Background
The National Health Mission is a major government initiative aimed at strengthening health infrastructure and services in rural and underserved areas. However, many NHM staff are employed on contractual terms with limited job security and benefits, which has historically led to periodic unrest and strikes in various states of India.
Job regularization, defining clear pay grades, and improving working conditions have been persistent demands among contractual health workers nationwide. Such instability in the frontline health workforce poses challenges for sustaining vital programs such as immunization, maternal-child health, and disease control efforts.
Public Health Implications
The disruption of child vaccination services amid the strike raises public health concerns by potentially increasing susceptibility to vaccine-preventable diseases such as measles, polio, and diphtheria. Interruptions in immunization schedules can undermine herd immunity and precipitate outbreaks, especially in resource-limited settings.
Moreover, the strike underscores the delicate balance between labor rights and maintaining continuous health services. The government’s “no work, no pay” policy reflects an effort to enforce accountability but may exacerbate financial and job insecurity, affecting staff morale and future recruitment.
Limitations and Counterarguments
The government states that ongoing vaccination drives are managed by regular staff to mitigate service disruption, although this may not fully compensate for the loss of the contracted workforce. The long-term solution, as suggested by experts, involves structured employment reforms and adequate resource allocation rather than short-term punitive measures.
The strike also highlights systemic issues in the contractual employment model within public health sectors that need addressing to prevent recurrent labor disputes and service interruptions.
Practical Considerations for Readers
For health-conscious readers and communities in Chhattisgarh and similar regions, awareness of potential service disruptions is important for planning health visits, especially for children’s immunizations. Engagement with local health authorities and timely follow-up on vaccination schedules can help mitigate risks during such periods of unrest.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
References
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Economic Times Health. “Over 16K NHM staff declares indefinite strike, govt orders ‘no work no pay’.” August 30, 2025.
- https://health.economictimes.indiatimes.com/news/policy/chhattisgarh-nhm-staff-launches-indefinite-strike-amidst-governments-no-work-no-pay-policy/123614847?utm_source=top_story&utm_medium=homepage
