{"id":186133,"date":"2022-05-24T20:30:11","date_gmt":"2022-05-24T15:00:11","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=186133"},"modified":"2022-05-24T20:30:11","modified_gmt":"2022-05-24T15:00:11","slug":"asha-a-successful-public-health-experiment-rooted-in-the-village-community","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/asha-a-successful-public-health-experiment-rooted-in-the-village-community\/","title":{"rendered":"ASHA: A successful public health experiment rooted in the village community"},"content":{"rendered":"\n

News<\/strong>: The World Health Organisation (WHO) has recognized the contribution of India\u2019s 1 million Accredited Social Health Activists (ASHAs) during the Covid-19 pandemic<\/p>\n

ASHA workers have received the Global Health Leaders Award-2022<\/strong> in the backdrop of the on-going 75th World Health Assembly.<\/p>\n

Genesis of the ASHA worker programme<\/h5>\n

The ASHA programme was based on Chhattisgarh\u2019s successful Mitanin programme<\/strong>, in which a Community Worker<\/strong> looks after 50 households. The ASHA was to be a local resident, looking after 200 households.<\/p>\n

The programme had a very robust thrust on the stage-wise development of capacity<\/strong> in selected areas of public health.<\/p>\n

Many states tried to incrementally develop the ASHA from a Community Worker to a Community Health Worker, and even to an Auxiliary Nurse Midwife (ANM)\/ General Nurse and Midwife (GNM), or a Public Health Nurse.<\/p>\n

In many states, ASHAs are involved in national health programmes, and in the response to a range of communicable and non-communicable diseases. They get performance-based payments<\/strong>, not a fixed salary like government servants.<\/p>\n

– The idea behind this was to make her a part of the village community rather than a government employee, <\/strong>i.e. to prevent governmentalisation and promote communitisation.<\/p>\n

Over 98% ASHAs belong to the village where they reside<\/strong>, and know every household. Their selection involved the community and key resource persons. Educational qualification was a consideration.<\/p>\n

With newly acquired skills in health care and the ability to connect households to health facilities, she was able to secure benefits for households. She was like a demand-side functionary<\/strong>, reaching patients to facilities, providing health services nearer home.<\/p>\n

In a way, it became a programme that allowed a local woman to develop into a skilled health worker<\/strong>.<\/p>\n

The ASHAs brought basic health services to the doorstep of households.<\/p>\n

What were the challenges faced by ASHA workers, and how were they addressed?<\/h5>\n

The ASHAs faced a range of challenges: Where to stay in a hospital? How to manage mobility? How to tackle safety issues?<\/p>\n

The solutions were found in a partnership among frontline workers, panchayat functionaries, and community workers.<\/strong><\/p>\n

– The Community Worker added value to this process<\/strong>. Incentives for institutional deliveries and the setting up of emergency ambulance services like 108, 102, etc. across most states built pressure on public institutions and improved the mobility of ASHAs.<\/p>\n

There have been challenges with regard to the performance-based compensation<\/strong>. In many states, the payout is low, and often delayed.<\/p>\n

What have been the public policy lessons from the ASHA worker programme?<\/h5>\n

The important public policy lessons are –<\/p>\n

–<\/strong> the need to incrementally develop a local worker<\/strong> keeping accountability with the community,<\/p>\n

–<\/strong> make performance-based payments,<\/strong> and<\/p>\n

–<\/strong> provide a demand-side push with simultaneous augmentation of services<\/strong> in public systems. The system can sustain and grow only if the compensation is adequate, and the ASHA continues to enjoy the confidence of the community.<\/p>\n

What is the way forward?<\/h5>\n

There is a strong argument to grant permanence to some of these positions<\/strong> with a reasonable compensation as sustaining motivation.<\/p>\n

The incremental development of a local resident woman<\/strong> is an important factor in human resource engagement in community-linked sectors. This should apply to other field functionaries such as ANMs, GNMs, Public Health Nurses as well.<\/p>\n

It is equally important to ensure that compensation for performance is timely and adequate. <\/strong><\/p>\n

–<\/strong> Ideally, an ASHA should be able to make more than the salary of a government employee,<\/strong> with opportunities for moving up the skill ladder in the formal primary health care system as an ANM\/ GNM or a Public Health Nurse.<\/p>\n

Upgrading skill sets and providing easy access to credit and finance<\/strong> will ensure a sustainable opportunity to earn a respectable living while serving the community.<\/p>\n

Strengthening access to health insurance, credit for consumption and livelihood needs at reasonable rates, and coverage under pro-poor public welfare programmes will contribute to ASHAs emerging as even stronger agents of change.<\/p>\n

Source<\/strong>: This post is based on the article \u201cASHA: A successful public health experiment rooted in the village community<\/strong>\u201d published in The Indian Express<\/strong> on 24th May 22<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"

News: The World Health Organisation (WHO) has recognized the contribution of India\u2019s 1 million Accredited Social Health Activists (ASHAs) during the Covid-19 pandemic ASHA workers have received the Global Health Leaders Award-2022 in the backdrop of the on-going 75th World Health Assembly. Genesis of the ASHA worker programme The ASHA programme was based on Chhattisgarh\u2019s… Continue reading ASHA: A successful public health experiment rooted in the village community<\/span><\/a><\/p>\n","protected":false},"author":10328,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"footnotes":""},"categories":[1230,9],"tags":[212,10500],"class_list":["post-186133","post","type-post","status-publish","format-standard","hentry","category-9-pm-daily-articles","category-public","tag-gs-paper-2","tag-indian-express","entry"],"jetpack_featured_media_url":"","views":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/186133","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/users\/10328"}],"replies":[{"embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/comments?post=186133"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/186133\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=186133"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=186133"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=186133"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}