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ASHA Workers

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May 24, 2022

Why in news?

The WHO has recognised India's 10.4 lakh Accredited Social Health Activists (ASHAs) as 'Global Health Leaders'.

Who are ASHA workers?

The ASHA programme was based on Chhattisgarh’s successful Mitanin programme, in which a Community Worker looks after 50 households.

  • ASHA workers are volunteers from within the community who are trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.
  • They act as a bridge connecting marginalised communities with facilities such as primary health centres, sub-centres and district hospitals.
  • Role - The role of these community health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.
  • Eligibility- ASHAs are
    • primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community
    • must have good communication and leadership skills
    • should be literate with formal education up to Class 8, as per the programme guidelines
  • Aim- The aim is to have one ASHA for every 1,000 persons or per habitation in hilly, tribal or other sparsely populated areas.
  • Presence- There are around 10.4 lakh ASHA workers across the country, with the largest workforces in Uttar Pradesh, Bihar and Madhya Pradesh.
  • Goa is the only state with no such workers, as per the latest National Health Mission data available from September 2019.
  • Salary- Since ASHA workers are considered volunteers, governments are not obligated to pay them a salary and most states don’t.
  • Their income depends on incentives under various schemes and all this adds up between Rs 6,000 to Rs 8,000 a month.

What is the role of ASHA workers?

  • Go door-to-door in their designated areas creating awareness about basic nutrition, hygiene practices, and the health services available
  • Focus primarily on ensuring that women undergo ante-natal check-up, maintain nutrition during pregnancy, deliver at a healthcare facility, and provide post-birth training on breast-feeding and complementary nutrition of children
  • Counsel women about contraceptives and sexually transmitted infections
  • Motivate children to get immunized
  • Provide medicines daily to TB patients under directly observed treatment of the national programme
  • Screen for infections like malaria during the season
  • Provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anaemia, and contraceptive pills
  • Get people tested and get their reports for non-communicable diseases
  • Tasked with informing their respective primary health centre about any births or deaths in their designated areas

How did the ASHA network help in pandemic response?

  • During the pandemic, when everyone was scared of the infection, ASHA workers had to perform a myriad of functions.
    • Check people for Covid-19 symptoms
    • Inform the authorities and help the people reach the quarantine centres
    • Explain the quarantine procedure to the people
    • Provide the patients with medicines and pulse-oximeters
    • Motivate people to get their vaccination shots
    • Collect data on how many people are yet to get vaccinated

What are the issues of concern?

  • They get performance-based payments, not a fixed salary like government servants.
  • In many states, the payout is low, and often delayed.
  • They do not get any benefits like pension or health insurance.
  • There have been agitations demanding employee status for ASHA workers.
  • There is a strong argument to grant permanence to some of these positions with a reasonable compensation as sustaining motivation.

 

References

  1. https://indianexpress.com/article/explained/asha-public-health-experiment-village-community-7932457/
  2. https://indianexpress.com/article/explained/explained-who-asha-workers-women-healthcare-volunteers-who-7932479/

 

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