ASHA

Concept

Asha Sahayogini

Roles & Responsibilities

Training

Incentives

ASHA Mentoring Group

ASHA Resource Center

 

 

 

 

click to go top Accredited social Health activist (ASHA)

The Government of India and Government of Rajasthan have launched a National Rural Health Mission to address the health needs of rural population, especially the vulnerable sections of the society. The sub center is the most peripheral level of contact with the community under the public health infrastructure. This caters to the population norm of 3000 - 5000. The worker in sub center is an ANM who is directly involved in all the health issues of this population, which is spreaded over the wide area of many kilometers and covering 5 to 8 villages. Many a times the villages are not connected by public or private transport system making her more difficult to achieve the objectives and goals of providing quality health care for the poor and oppressed sections of the society. So the new band of community based functionaries, named as Accredited Social Health Activist (ASHA) is proposed in the NRHM who will serve the population of 1000 and 500 in hilly and desert terrene.

ASHA is the first port of call for any health related demands of deprived sections of the population, especially women, children, old aged, sick and disabled people. She is the link between the community and the health care provider.

Department of Medical and Health at State and at Center is looking at ASHA as a change agent who will bring the reforms in improving the health status of oppressed community of India. The investment on ASHA will definitely result in to better health indicators of state and at large the country.

click to go topASHA Sahayogini

Convergence of DWCD and NRHM
In each Anganwadi Center apart from Anganwadi Worker and Sahayoka one additional worker named 'Sahyogini' is envisaged to provide door to door information and services of Nutrition, Health, preschool education. Her role is quite similar to the role of ASHA under NRHM. So to avoid duplication of workers providing same types of services in the same area, the decision was taken at State level, that there will be only one worker coterminous with Anganwadi, who will work with DWCD and DMHS. This worker is called as 'ASHA Sahyogini', selected by the community through Gram Panchayat and responsible to the community.

Criteria for selection
One ASHA Sahyogini for each Anganwadi Center.
• Woman resident of that area, Married/ Widow/ Divorcee
• Age between 21 to 45 years
• ASHA Sahyogini should have effective communication skills, leadership qualities and be able to reach out to the community.
• ASHA Sahyogini should be literate woman with formal education up to eighth class, In tribal and desert areas the educational qualification may be relaxed if the 8th pass candidate is not available. This is permitted only after the approval of State level Committee.
• Adequate representation from disadvantaged population groups.

- Create awareness
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
 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, PHC , CHC and district hospitals.

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

- Escorts/ Accompany
Escorts the needy patients to the institution for care and treatment. She will 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. A drug kit will be provided to ASHA
- 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
 

Capacity building of ASHA is critical in enhancing her effectiveness. It has been envisaged that training will help to equip her with necessary knowledge and skills. Training of ASHA Sahyogini is a continuous process. Considering her range of functions and task to be performed, her induction training is planned for 23 days in 4 rounds (10+4+4+5 days). The trainings are planned in cascade model. The non governmental organizations are involved in the training of ASHA Sahyoginis at grass root level.


Under NRHM ASHA Sahyogini is a voluntary worker who will get performance linked incentives. The honorarium is linked with the performance indicators of ASHA Sahyogini. The generic Compensation package made for ASHA Sahyogini by linking her with different health programmes.


The detailed compensation package is worked out at state level. If she works as per the expected standards she would earn approximate Rs. 1067 per month. ASHA will get the package on
Apart from the above package she may get prizes for extraordinary performance in cash or kind from the untied funds. Some of the selected ASHA Sahyoginis will visit different places in the State and outside State during exposure visits.


Drug Kit for ASHA Sahyogini - The drug Kit is provided to ASHA Sahyogini to provide primary Health Care to the community like minor elements like fever, pain, First Aid etc. The replenishment of medicines is made from PHC /Subcenter stocks.

Monthly Meetings - The joint monthly meetings are conducted at PHCs by DWCD and DMHS. ASHA Sahyoginis are interacting with service providers in this monthly meeting. The replenishment of Medicines and payment of incentives are ensured during these meetings.

 

For strengthening ASHA- Sayogini Programme in the State a State Level Mentoring Group is constituted under the Chairpersonship of Mission Director, NRHM. This group will oversee the implementation of the scheme and facilitate in developing the policy guidelines. Mentoring Group will act as a think - tank for the programme. The mentoring group will provide technical inputs and support mechanism. The members of ASHA Mentoring Group are Director DWCD, PHED, RD,PRI, IEC, RCH, PH, AIDs, representatives from development partners and NGOs.

The Mentoring Group will meet once in three months to review and to provide inputs for the ASHA- Sahyogini Intervention. ASHA Resource Center is the Nodal Agency to organize the meetings and do the follow ups with the support of SPMU- NRHM.

 
 

click to go topASHA Resource Center for providing support to ASHA Programme at State level

Need for ASHA Resource Center - ASHA is at the base of NRHM pyramid and National Rural Health Mission is looking at ASHA as a change agent in Health Sector Reform. She will play a vital role in improving the health indicators of the State especially IMR and MMR. She will also facilitate the improvement in service off take of the healthcare institutions.
The State of Rajasthan is spread over a large geographic area with religious, social, cultural, economic variations, so implementation of ASHA component in the state is a challenging task. In this context it is very important to provide technical inputs and strong supportive mechanism to the programme so that expected results can be achieved. State Project Management Unit is established at state level under Director NRHM. SPMU is working as a technical and administrative body to implement the activities of NRHM in the State. ASHA Resource Center (ARC) is conceptualized to improve the quality of the programme. This Center will be established at state level and will work under direction of Mission Director of NRHM

Functions of the ASHA Resource Center-
1. Technical backstopping in Training - The training of ASHAs is planned for 23 days in a year with refresher trainings every year. ARC will develop user friendly training methodology and the training modules, print the modules in prescribed time, and disseminate the modules in the District. The modules are being developed by MOHFW; GOI .These will be modified in the state context on the basis of functions of ASHA. ARC will also work on the training modalities and will provide the supportive supervision to maintain quality checks and control at District and Block level.
2. Development of IEC material - ARC will be responsible for developing or collecting the IEC material from different agencies for dissemination during the training. The facilitation kit including flip books, chart, posters etc on different related issues will be developed and disseminated. Need based IEC material will be developed from time to time.

3. Planning of Monthly Meetings
- It is planned to conduct monthly meeting of ASHAs at block level to resolve day -to -day functional problems faced by ASHA and to ensure the progress of the activities conducted by ASHA. It is very important to revise the concepts and contents to improve the learning process .The topics covered during the training will be revised in the monthly meeting. ARC will develop tentative monthly agenda for the monthly meetings; provide required resource material and IEC material. It will develop the monitoring mechanism for the meetings.
4. Development of Reporting formats and registers - ASHA is envisaged as a voluntary worker and to facilitate her work some very easy and basic reporting formats and registers will be developed. The registers and the formats will be used by ASHA only to streamline her priorities. ARC will develop the formats and will orient ASHA for its utility and use.
5. Processing of Statistical Data and records- On the basis of reports and registers of ASHA and other sources of data’s. ARC will compile the statistical data, analyze the data and provide the feedback of the programme to the Mission.

6. Intersectoral Coordination pertaining to ASHA
- ASHA is conceptualized as a volunteer responsible for the Health needs of the particular village, Dhani or Mohalla. The credibility of ASHA in the community could be used by other Development Departments to promote their objectives. ARC will coordinate with different departments and facilitate empanelment of ASHAs in various other programmes like Sarva Shiksha Abhiyan, Total Sanitation Programme etc.

7. Involving NGOs to strengthen the programme
- Involvement of NGOs is an important task in the implementation of ASHA programme. NGOs could support the ASHA to work at community level or to develop capacities of ASHA etc. There could be many roles of NGOs and these roles would be identified by the ARC. In consultation of NRHM the NGOs should be involved in the programme.

8. Provision of Drug Kits
- ASHA will provide the basic medical care to the community. The drug kit with basic medicines and supplies will be provided to all the ASHAs under NRHM. The drug Kit will consist of allopathic as well as Ayush medicines. ASHA will charge the user fees from the community. Initially the drug Kits are being provided by GOI. They may need state level modification / supplementation. In such case ARC will facilitate the procurement process and supply it to ASHA. This is not one time activity and regular stocks should be available with ASHA. ARC will develop the mechanism to maintain at least two months stock of medicines with ASHA.


9. ASHA Sahyoginis role in Village Health Plan - NRHM is promoting the down - up approach for implementation of different health programmes. It is proposed to form Village Health Societies and Village Health Teams to address the health needs of the Village. ASHA Sahyogini will be one of the important members of VHC and VHT. ARC will be responsible for capacity building of ASHA Sahyogini so that she could help in planning and implementation of Health Programmes in the Village.

10. Organize Quarterly meeting of Mentoring Group - A Mentoring Group is constituted to provide overall guidance to the programme and act as a think - tank for the programme. The mentoring group will provide technical inputs and support mechanism. ASHA Resource Center will conduct the quarterly meetings of the mentoring group and incorporate the valuable inputs provided by the group in the programme.

11. Provision of services of Helpline - ASHA Sahyogini in near future will work in entire state. There will be more than 45,000 ASHA Sahyoginis in the State. Time to time trainings or monthly meetings may not suffice the need of the ASHA Sahyogini. So the ARC will form the helpline for the ASHA Sahyogini and associated functionaries. ARC will respond to the queries or clarifications needed in the field. ARC will ensure that the prompt help is provided to ASHA.


12. Organizing ASHA Sammelan, Exposure visits-
There will be Sammelans at State level, Zonal level and District level to share the experiences of ASHA Sahyogini and for cross learning’s. ARC will organize such events with the help of State Health Society and District Health Society. ARC will also organize the exposure visits with in the state and outside the state.

13. Other issues related to the functioning of ASHA - Some of the functions of ARC is mentioned above. The role of ARC is multifaceted and visualized in broader sense. The functions of ARC could be revised as per the need and requirement of the programme. Some new roles could also be incorporated.

14. Linkages of ASHA Resource Center- ASHA Resource Center is a Hub for ASHA Component under NRHM, which will work in close association with Mission Director. The administrative control on the ARC will be of the outsourced agency, but the Mission Director will be involved in major decisions like recruitment of professionals, budget etc. However day to day functioning will be the responsibility of outsourced agency. ARC will provide support to the districts through NRHM and all the administrative guidelines will be issued through NRHM.

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