Understand the Accredited Social Health Activist (ASHA) scheme, its objectives, duties, responsibilities, benefits, incentives, and how ASHA workers support immunization, maternal healthcare, child nutrition, and disease prevention in India.
The Accredited Social Health Activist (ASHA) plays a crucial role in connecting rural communities with public healthcare services in India, particularly in providing pregnancy-related care. A cross-sectional study was conducted to evaluate the proportion of women utilizing ASHA services during pregnancy and to assess ASHA workers' knowledge, attitudes, practices, challenges, and motivational factors related to maternal healthcare. The study also examined the key factors influencing the utilization of ASHA services for pregnancy-related needs. At present, 11,086 ASHA workers are serving across Uttarakhand, contributing significantly to maternal and child healthcare in the state.
What is ASHA?
The ASHA stands for Accredited Social Health Activist. The ASHA programme was launched on 12 April 2005 under the National Rural Health Mission (NRHM) by the Ministry of Health and Family Welfare, India. The ASHA programme strengthened healthcare services in rural India and was later expanded to urban areas through the National Urban Health Mission (NUHM) in 2013. ASHA workers are trained female community health volunteers selected from their local communities to serve as a vital link between the public healthcare system and the people. They play an important role in promoting health awareness, improving access to healthcare services, encouraging immunisation, supporting maternal and child health, assisting in tuberculosis (TB) control, and helping implement various national health programmes at the community level.
Accredited Social Health Activist (ASHA) Scheme
The Accredited Social Health Activist (ASHA) scheme was launched in 2005-06 under the National Rural Health Mission (NRHM) to improve access to primary healthcare in rural India by connecting communities with public health services. With the launch of the National Urban Health Mission (NUHM) in 2013, the programme was extended to urban areas. Introduced by the Ministry of Health and Family Welfare under the National Health Mission (NHM), ASHA workers are trained female community health volunteers who serve as a vital link between marginalized communities and healthcare. They promote health awareness, support maternal, child healthcare, encourage immunization, facilitate access to government health schemes and assist in disease prevention and family welfare programmes. Over the years, the ASHA programme has become the world's largest community health worker initiative, strengthening community participation in healthcare delivery. As of June 2022, more than 10.52 lakh ASHA workers were serving across all States and Union Territories of India, except Goa.
What are the Roles and Responsibilities of ASHA?
An Accredited Social Health Activist (ASHA) serves as the first point of contact between the community and the public healthcare system. She plays a vital role in improving healthcare access, creating awareness, and implementing national health programmes at the grassroots level. The ASHA workers also help people register for government health insurance programs. Let’s take a look at the roles and responsibilities of Accredited Social Health Activist (ASHA): -
1. Maternal and Child Healthcare
The Asha volunteer identifies and registers pregnancies within the first 12 weeks. They ensure pregnant women receive at least four health check-ups and tetanus injections. They also conduct mandatory home visits to check newborn health and maternal recovery.
2. Community Health and Awareness
Asha workers educate families on nutrition, sanitation, hygiene and safe drinking water. That’s how they spread community health awareness. They also inform local dispensaries about outbreaks of diseases like malaria, dengue and diarrhea within a community.
3. First Contact Medical Care
Asha volunteers provide first contact medical care by distributing basic medical kits containing ORS, iron-folic acid tablets, chloroquine and disposable delivery kits. They offer basic care for minor ailments before referring patients to a doctor.
4. Universal Health Coverage
Asha workers help spread awareness about health coverage by helping families register for government health insurance programs such as Ayushman Bharat PM-JAY. They help with the technicalities of the registration and educating people about the benefits.
5. Providing Direct Support
Asha volunteers provide direct support and escort community members to Primary Health Centres & Community Health Centres. They act as a Direct Observation Treatment Short course provider for tuberculosis patients.
Contributions of Accredited Social Health Activist (ASHA)
The Accredited Social Health Activists have made enormous contributions to the rural health system such as elimination of diseases, pandemic management and universal immunization. Their work has resulted in dropping of maternal and infant mortality rates: -
1. Drop in Maternal and Infant Mortality
ASHA workers shifted childbirth from unsafe homes to medical facilities which has resulted in dropping of India's Maternal Mortality Ratio. They detect early signs of neonatal illness which has drastically lowered the Infant Mortality Rate.
2. Elimination of Diseases
Asha workers play a huge role in making India Polio free by managing local booths and conducting door to door tracking. They ensure patients complete long term tuberculosis treatments which prevents drug resistance in people.
3. Pandemic Management
During the COVID-19 pandemic, ASHA volunteers played a crucial role in supporting the Government of India by leading contact tracing, monitoring home isolations, and successfully combating vaccine hesitancy in marginalized communities. Their dedicated efforts helped manage the pandemic effectively and saved countless lives.
4. Universal Immunization
Asha volunteers track drop-out children and pregnant women to ensure 100% completion of lifesaving vaccines. They ensure vaccines reach the most remote and marginalised infants, children and pregnant women.
5. Gender and Financial Inclusion
By stepping into leadership roles, the ASHA women workers have gained financial autonomy and enhanced social standing within conservative rural communities. They have set examples of gender inclusion through their work.
Key Pillars of the Accredited Social Health Activist (ASHA)
The ASHA program is built upon important pillars such as community-based leadership, grassroots collaboration, doorstep first aid and performance linked incentive structure. Asha workers get to enhance social entrepreneurship through the incentive-based programme. Let’s take a look at the key pillars of the accredited social health activist program: -
1. Community Based Leadership
Every ASHA worker is a female resident of the specific village or urban slum she serves. This ensures community-based leadership, deep trust and cultural familiarity. She is accountable to the local community through democratic bodies such as the Gram Sabha.
2. Grassroots Collaboration
The ASHA program relies on a structured, three-tiered community health network known as the AAA team which includes ASHA workers, Anganwadi workers and Auxiliary Nurse Midwives. This grassroots collection promotes healthcare activities on multiple levels.
3. Performance Linked Incentive Structure
ASHA workers are given direct financial incentives for completing specific health outcomes. Payments are dependent upon public health goals such as escorting a mother for a hospital birth or ensuring a child completes their immunization schedule.
4. Doorstep First Aid
ASHA workers are equipped with doorstep first aid, making them the immediate source for essential health supplies. They are trained to identify clinical red flags such as severe newborn jaundice or pregnancy complications and, in line with the guidelines of the World Health Organization (WHO), immediately refer patients to higher medical centres for timely treatment.
5. Social Entrepreneurship
Asha workers work on an incentive-based programme which encourages social entrepreneurship. This volunteer-based framework encourages social entrepreneurship as it allows women to opt for commission-based work.
Conclusion
Accredited Social Health Activists (Asha) are trained female community health volunteers who work under the National Health Mission. They are responsible for spreading awareness about nutrition, sanitation, hygiene and safe drinking water. The women are provided performance-based incentives after achieving specific health targets. Their work lies on various significant pillars such as community-based leadership, providing doorstep first aid and grassroot leadership. The ASHA workers have made contributions to reduce maternal mortality rates, eliminate diseases, educate people on health coverage and ensure complete vaccination of people.