For nearly two decades, the National Health Mission (NHM) has been the invisible backbone of Jammu and Kashmir’s fragile healthcare system. In snow-bound villages of Kupwara, conflict-scarred pockets of Kishtwar, and far-flung primary health centres across the Valley and Jammu division, more than 12,000 NHM doctors, paramedics and support staff have carried the state’s medical burden. They stitched wounds during curfews, ran operating theatres at night, and stood firm through pandemics and disasters. Yet in 2026, applause has replaced action—and gratitude has not translated into justice.
These workers perform the same duties as regular government employees: surgeries, emergency response, maternity care, immunisation drives and epidemic control. The difference lies not in responsibility, but in remuneration. While permanent staff enjoy the protections and benefits of the 7th Pay Commission, NHM employees continue to survive on modest contractual packages. A marginal hike in incentives—from 15 to 17 percent, looks insulting in an era of relentless inflation. Equal work, unequal pay is not merely an administrative oversight; it is a moral failure.
Worse is the permanence of their impermanence. Many NHM workers have served for 15 to 20 years, yet remain trapped in contractual limbo—no pension, no promotions, no career progression. They are now in their forties and fifties, still drawing entry-level salaries, watching younger recruits in other cadres overtake them. In 2018, a PDP-BJP government promised phased regularisation and forwarded the proposal to the Finance Department. Eight years later, the file appears buried beneath layers of bureaucratic dust, while 12,000 families live with perpetual uncertainty.
The human cost is mounting. With no formal transfer policy, staff—particularly women—are posted hundreds of kilometres from home for years on end. Burnout is rampant; morale is crumbling. Technical objections and procedural excuses have become convenient shields for inaction, even as the administration publicly celebrates health indicators that these very workers made possible.
The way forward is neither radical nor unaffordable. Implement the long-pending 2018 regularisation plan in phases. Align NHM salaries with at least the minimum scale of regular employees, in line with the Supreme Court’s Jagjit Singh judgment on equal pay for equal work. Introduce a “Senior” category after ten years of service, with enhanced roles and remuneration. Frame humane transfer policies for veterans and those with family or medical compulsions.
A government cannot claim to strengthen healthcare while allowing its frontline workforce to languish in anxiety and neglect. Two decades of service demand more than certificates and speeches. They demand dignity, security—and justice long overdue.
