Accredited Social Health Activists (ASHAs)

Recognizing the importance of health in social and economic development and improving the quality of life of the people, Government of India has launched the National Rural Health Mission, (NRHM), in the year 2005. The mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, hygiene, sanitation and safe drinking process.

The main purpose is to provide effective health care to the entire rural population in the country. The core strategy of the mission is to provide well trained female health activist (Accredited Social Health Activist- ASHA) in each village (1/1000 population) to fill the gap of unequal distribution of health services in rural area.

ASHAs are expected to create awareness on health and its determinants, mobilize the community towards local health planning, and increase utilization of the existing health services.

Read this article for comparision between ASHA and ANM

Role of ASHA:

Create awareness
They create awareness about the Health, Nutrition, basic sanitation, hygienic practices, healthy living and working conditions, information on existing health services and need for timely utilization of health, nutrition and family welfare services.

Counseling.

ASHAs counsel people for Birth preparedness, importance of safe and institutional delivery, breast-feeding, immunization, contraception, prevention of RTI/STI, Nutrition and other health issues.

Mobilization

Facilitate to access and avail the health services available in the public health system at Anganwadi Centers, Sub Center, Primary Health Centre and district hospitals.

Village health plan

Work with the village Health and sanitation Committee to develop the village health plan.

Escorts/ Accompany

They escort the needy patients to the institution for care and treatment.

• Accompany the woman in labor to the institution and promote institutional delivery
• Provision of Primary Medical Health Care
• Minor ailments such as fever, first aid for minor injuries, diarrhea.
• Provider for DOTS
• Depot Holder ORS, IFA, DDK, chloroquine, oral pills and condoms
• Care of new born and management of a range of common ailments
• Inform Births, deaths and unusual health problem or disease out break
• Promote Construction of household toilets

Recently the Mission Steering Group (the highest decision making body of the NRHM)has approved the proposal for involving ASHAs in activities such as spacing between births, promoting iodised salt and village sanitation.

Thus the accredited social health activists (ASHAs) — the first port of call for health cares under the National Rural Health Mission (NRHM) — will be entrusted with additional responsibilities, albeit with better monetary incentives.

The ASHAs will now have to work as a counseller for the newly-married couples and those with one child to have their first child after two years of marriage and space their children for at least three years. For this, the ASHAs would be paid an incentive of Rs. 500 per couple she manages to convince for spacing between births.

It has also been decided to involve ASHAs in organising the monthly village health sanitation and nutrition committee (VHSNC) meeting for which she will be paid an incentive of Rs. 150 a month. This meeting will be followed by the meeting of women and adolescent girls where the health and sanitation needs of adolescent girls would be discussed.

Importantly, it has also been decided to further incentivise ASHAs by providing an additional Rs. 100 for every child who receives complete first year immunisation and Rs. 50 for every child who further completes two years of immunisation as per the stipulated schedule. As of now, ASHA gets Rs. 150 for mobilising children to immunisation session sites.

The Centre has also identified 303 anaemia endemic districts in the country where each ASHA will be given an honorarium of Rs. 25 a month for testing 50 salt samples for checking iodine content.

Thus the additional responsibilities along with the monetary incentives have been proposed to encourage and motivate ASHAs for better work.