An Accredited Social Health Activist (ASHA) is a community health worker employed by the Ministry of Health and Family Welfare (MoHFW) as a part of India's National Rural Health Mission (NRHM).[1] The mission began in 2005; full implementation was targeted for 2012. The idea behind the Accredited Social Health Activist (ASHA) was to connect marginalized communities to the health care system. The target was to have an "ASHA in every village" in India.[2] In July 2013, the number of ASHAs was reported to be 870,089.[3] In 2018, this number became 939,978. The ideal number of ASHAs envisaged was 1,022,265.[4]
Roles and responsibilities
ASHAs are women trained to act as health educators and health promoters in their communities. The Indian MoHFW describes them as:[5]
...health activist(s) in the community who create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services.
Their tasks include:
Motivating women to give birth in hospitals,
Bringing children to immunization clinics,
Encouraging family planning (e.g., surgical sterilization),
The tableau of Ministry of Health and Family Welfare highlighting - 'Aasha' during the Republic Day Parade, 2006
Their responsibilities can be classified into:
Counseling:
Breast Feeding
Skilled birth attendance
Prevention of diseases
Community sensitization:
Health
Nutrition
Related government programs
Provision of drugs:
Malaria
Tuberculosis
Diarrhoea
Escort:
Ante- and Post-natal care
Institutional delivery
Immunization
Diabetes test
Family planning
Diagnosis
Malaria
Pregnancy
Survey of health and related events
Others
Community mobilization
Health planning
Participation in community health and allied activities
Selection
ASHAs must primarily be female residents of the village that they have been selected to serve, who are likely to remain in that village for the foreseeable future.
Married, widowed or divorced women are preferred over women who are yet to marry, since Indian cultural norms dictate that, upon marriage, a woman leaves her home and/ or village and migrates to that of her husband.
ASHAs must have qualified up to the tenth grade; if there is no suitable literate candidate, this criterion may be relaxed.
They must preferably be between the ages of 25 and 45.
They are selected by and accountable to the gram panchayat (local government).[9]
Remuneration
Although ASHAs are considered volunteers, they receive outcome-based remuneration and financial compensation for training days. For example, if an ASHA facilitates an institutional delivery she receives ₹600 (US$7.20) and the mother receives ₹1,400 (US$17). ASHAs also receive ₹150 (US$1.80) for each child completing an immunization session and ₹150 (US$1.80) for each individual who undergoes family planning.[10] ASHAs are expected to attend a Wednesday meeting at the local primary health centre (PHC); beyond this requirement, the time ASHAs spend on their CHW tasks is relatively flexible.[citation needed]
An ASHA's monthly salary has two components:[citation needed]
A fixed component of Rs. 4,000/- (USD 53/- approximately), and
Incentives that vary from Rs. 5,000/- (USD 67/- approximately) to Rs. 8,000/- (USD 107 approximately), including a "COVID Bonus".
The average monthly salary comes to around Rs. 10,000/- (USD 133/- approximately).
Monitoring and Evaluation under National Rural Health Mission
A baseline survey was taken at the district level, for fixing decentralized monitoring goals and indicators. Community monitoring is at the village level. The Planning Commission is the ultimate agency for monitoring outcomes. External evaluation is taken up at regular intervals.[citation needed]
^Ministry of Health and Family Welfare (MoHFW). (2005c). ASHA.. Government of India. Accessed July 20, 2008, from "About ASHA". Archived from the original on 22 April 2009. Retrieved 22 May 2009.
^Ministry of Health and Family Welfare (MoHFW). (2005a). National Rural Health Mission: Mission Document. Government of India. Accessed July 1, 2008, from "Archived copy"(PDF). Archived from the original(PDF) on 12 June 2009. Retrieved 2009-05-22.{{cite web}}: CS1 maint: archived copy as title (link)
