Conference Agenda

Community Health Workers (CHWs) form a critical institutional bridge between healthcare systems and communities in developing countries, yet their positioning as 'volunteers' often undermines their integration and effectiveness. India's Accredited Social Health Activist (ASHA) program, employing over one million women nationwide, operate at the intersection of volunteerism and formal employment exemplifies this challenge. Through an analysis of Kerala, an Indian state recognized for its progressive labor practices, this study examines how innovative institutional arrangements can transform volunteer health workers from marginalized service providers to empowered agents of change.

Research Questions:

1. How do institutional innovations in human resource management influence the empowerment and integration of community health workers operating in quasi-voluntary positions?

2. What mechanisms enable the development of inclusive labor institutions that effectively support and protect volunteer workforces?

Methodology:

Drawing on 31 semi-structured interviews conducted in 2024 across five districts of Kerala, including 21 ASHAs, 6 frontline supervisors, and 4 state health officials, this study employs a rigorous qualitative approach. Primary data collection was supplemented by extensive document analysis of government reports, program guidelines, and policy documents. Using Braun & Clarke's six-step thematic analysis framework, we systematically coded and analyzed the data through multiple iterations to ensure reliability. Interview transcripts were analyzed in both Malayalam (local language) and English to preserve narrative authenticity, with member checking employed to validate interpretations. The analysis maps institutional practices onto the Ability-Motivation-Opportunity (AMO) framework while maintaining sensitivity to power dynamics and structural constraints inherent in volunteer workforce management.

Contribution:

This research advances our understanding of institutional innovation in the informal/volunteer sector by: (1) demonstrating how hybrid institutional arrangements can reconcile volunteer ethos with professional integration, (2) revealing how participatory governance enables both worker voice and institutional effectiveness, and (3) providing evidence-based insights for developing inclusive labor institutions that protect and empower volunteer workforces.

Findings:

Our analysis identifies three key institutional mechanisms that enable effective volunteer workforce management: (1) formalized yet locally-embedded recruitment processes that legitimize workers' roles while maintaining community connections, (2) hybrid compensation systems that combine performance incentives with basic security, and (3) decentralized governance structures that facilitate worker voice and participatory decision-making. These findings suggest that building effective labor institutions for volunteer workforces requires moving beyond traditional employment paradigms to develop context-sensitive frameworks that balance formalization with flexibility.

Introduction and literature

International research has shown that the Early Childhood Education and Care (ECEC) sector is crucial to the functioning of inclusive labour markets as it both enables parents (predominantly mothers) to enter and re-enter work, while also directly providing job opportunities, often women from more deprived communities (Black, 2020; Fudge and Mundlak, 2021). But despite a brief recognition of the value of ECEC during the pandemic, many countries are now facing the twin challenge of expanding, affordable and flexible provision meeting the needs of parents, while addressing chronic staff shortages and high turnover (Smyth 2024). In many cases the policy response has been to expand parental entitlements to subsidised care (often met by the private market) without considering the entrenched problems of low pay, insecure work, and weak career development (Hardy et al 2023). Recognising the scale and the unequal impacts of the ‘crisis of social reproduction’ is essential to raise the status and value of the ECEC workforce that is highly feminised and ethnically diverse (Black, 2020; Cullen and Murphy 2020).

Methods

This paper draws on a comparative study of campaigns and initiatives that aim to address the ECEC crisis. International differences are explored using original empirical material (including interviews with activists, workers, employers, unions and government officials) gathered across four regions in four countries: Montreal Canada, Bremen Germany, the Greater Manchester UK, and New York US, these are contextualised as they are triangulated together with gray literature and statistical sources. Using a gender lens to understand the arguments that were being put forward to overcome the crisis and the impact this had in particular on working conditions and staffing.

Findings and contributions

What we find is that while all four regions are faced with similar challenges, social actors have adopted different campaigning and bargaining strategies to improve the quality of work and care within ECEC. In Bremen and Montreal, ECEC is more explicitly articulated as a feminist cause, whereby trade unionists work closely in coalition with other actors (such as parents and the local state) to put forward gender equality arguments in support of the sector. In contrast, in the New York and the Greater Manchester, campaigning is largely ‘gender blind’, in that ECEC is often framed as a means to promote economic growth and labour market participation. Across all countries however, staff shortages remain linked with the low social valuation of ECEC work.

The International Labour Organization’s (ILO) Decent Work Agenda emphasizes four objectives: promoting rights at work, fostering employment, enhancing social protection, and encouraging social dialogue. In 2011, the ILO ratified the Domestic Workers Convention, 2011 (No. 189), the first international legal instrument focused on domestic workers. Women comprise 76.2% of domestic workers globally, with one in twelve female employees engaged in this sector. Additionally, 80% of domestic workers lack social security (ILO, 2023). Despite global progress, domestic workers in India still face systemic barriers, including informal employment, lack of legal recognition, and minimal state intervention. Their exclusion from institutional dialogues further exacerbates their vulnerability.

This paper explores the challenges and opportunities related to decent work for domestic workers in India through three dimensions. First, it identifies the obstacles they face in asserting their rights and examines how social security programs can be improved. Second, it assesses ways to restructure labour institutions to ensure domestic workers' participation in shaping their working conditions and rights protection. Third, it explores innovative policies that balance existing labour laws with domestic workers’ lived realities. The study addresses two key questions: What institutional arrangements can improve domestic workers' conditions? How can social mobilization and representative democracy contribute to safer, better work conditions?

Using a mixed-method approach, this study combines quantitative data from national labour surveys with qualitative insights from interviews with 50 domestic workers across five Indian states, employing a stratified sampling method. It also examines implicit collusion among domestic workers and employer awareness of decent work. To assess the accessibility of existing legislation and informal structures, the study adopts an interpretive paradigm and thematic analysis, centering on workers’ narratives. A measurement scale is developed to standardize the evaluation of decent work conditions for domestic workers in India.

Preliminary findings reveal that India's fragmented social security system, lack of uniform employment contracts, and weak legal recognition perpetuate informality and exploitation. Female domestic workers face heightened vulnerabilities. Innovative alternatives, such as cooperatives and online platforms, show promise but require institutional support to scale effectively.