{"id":187960,"date":"2022-06-02T20:17:53","date_gmt":"2022-06-02T14:47:53","guid":{"rendered":"https:\/\/blog.forumias.com\/?p=187960"},"modified":"2022-06-03T11:21:22","modified_gmt":"2022-06-03T05:51:22","slug":"a-case-for-community-oriented-health-services","status":"publish","type":"post","link":"https:\/\/forumias.com\/blog\/a-case-for-community-oriented-health-services\/","title":{"rendered":"A case for community-oriented health services"},"content":{"rendered":"\n

News: <\/strong>Recently, India\u2019s Accredited Social Health Activists (ASHA)<\/strong> received the WHO\u2019s Global Health Leaders Awards 2022<\/strong> in recognition of their work during the COVID-19 pandemic as well as for serving as a link between communities and health systems.<\/p>\n

Contributions of the ASHA\u00a0 workers<\/strong><\/h5>\n

They have led to increased access to primary health-care services<\/strong>; i.e., maternal and child health including immunisation and treatment for hypertension, diabetes and tuberculosis, etc.<\/p>\n

Served<\/strong> both rural, urban populations and difficult-to-reach habitations.<\/p>\n

Worked to make India polio free<\/strong>, increasing routine immunisation coverage; reducing maternal mortality; improving new-born survival<\/strong> and in greater access to treatment<\/strong> for common illnesses.<\/p>\n

They have become pivotal<\/strong> to nearly every health initiative<\/strong> at the community level, <\/strong>and are integral to demand side interventions<\/strong> for health services in India.<\/p>\n

Genesis of the programme<\/strong><\/h5>\n

Inspiration:<\/strong> (1) 1975 WHO monograph titled \u2018Health by the people\u2019, (2) 1978 International conference on primary health care in Alma Ata, and (3) 2002 Mitanin<\/strong> initiative<\/strong> of Chhattisgarh in which all-female volunteers were available for every 50 households and 250 people.<\/p>\n

Initially, India launched the Community health volunteer\u2019s<\/strong> scheme<\/strong>. But it failed because of lack of development of a community connection and lack of political will.<\/p>\n

Launch of the programme<\/strong><\/h5>\n

It was launched in 2005-06 as part of the National Rural Health Mission.<\/strong> Later it was extended to <\/strong>urban settings after the launch of the National Urban Health Mission <\/strong>in 2013.<\/p>\n

Features of the ASHA Programme<\/strong><\/h5>\n

One, the key village stakeholders <\/strong>are involved in the process of ASHA<\/strong> selection<\/strong>. This ensures community ownership for the initiatives and forging a partnership.<\/p>\n

Two, ASHAs came from the same village where they worked. This ensured familiarity, better community connect and acceptance.<\/p>\n

Three, the phrase activist<\/strong> was joined in their name to reflect that they were\/are the community\u2019s representative<\/strong> in the health system, and not<\/strong> the lowest-rung government functionary<\/strong> in the community.<\/p>\n

Four, they were called volunteers to avoid a slow process for government recruitment and to include elements of the performance-based incentives<\/strong> and some accountability.<\/p>\n

Functioning of the Programme<\/strong><\/p>\n

Each of the women-only volunteers work with a population of nearly 1,000 people<\/strong> in rural<\/strong> and 2,000 people<\/strong> in urban areas<\/strong>.<\/p>\n

ASHAs coordinate things within villages and with the health system, with the help of Anganwadi workers (AWW)<\/strong>, Auxiliary Nurse Midwife (ANM),<\/strong> panchayat representatives and influential community members at the village level. The A-A-A: ASHA, AWW and ANM, act as three frontline functionaries <\/strong>at the village level and form the all-women partnership<\/strong> to provide the primary health-care services to the community.<\/p>\n

Platforms such as village<\/strong> health<\/strong>, sanitation<\/strong> and nutrition committees<\/strong> were created, for coordination and service delivery.<\/p>\n

What are the challenges?<\/strong><\/h5>\n

The ASHA volunteers have dissatisfaction. There are regular agitations and protests by ASHAs in many States of India.<\/p>\n

Among the A-A-A, ASHAs do not have a fixed salary. The total payment including performance-based incentives remain low and often delayed. They don\u2019t have opportunities for career progression<\/strong>.<\/p>\n

Way Forward<\/strong><\/h5>\n

The global recognition should be used as an opportunity to review and further strengthen the ASHA programme. This will make a stronger and community-oriented primary health-care system.<\/p>\n

Indian States need to develop mechanisms for higher remuneration<\/strong> for ASHA workers.<\/p>\n

An in-built institutional mechanism <\/strong>should be created for their capacity-building and providing avenues for career progression. For example, they can move to cadres such as ANM, public health nurse and community health officers.<\/p>\n

The ASHAs and their family should be given the benefits of the social sector services<\/strong> like health insurance.<\/p>\n

An independent and external review of the programme needs to be given urgent and priority consideration.<\/p>\n

Many of the temporary posts in the National Health Mission can be put to regularization. In fact, ASHAs can be made permanent government employees<\/strong>.<\/p>\n

Source<\/strong>: The post is based on an article \u201cA case for community-oriented health services<\/strong>\u201d published in the \u201cThe Hindu<\/strong>\u201d on 02nd<\/sup> June 2022<\/strong>.<\/p>\n","protected":false},"excerpt":{"rendered":"

News: Recently, India\u2019s Accredited Social Health Activists (ASHA) received the WHO\u2019s Global Health Leaders Awards 2022 in recognition of their work during the COVID-19 pandemic as well as for serving as a link between communities and health systems. Contributions of the ASHA\u00a0 workers They have led to increased access to primary health-care services; i.e., maternal… Continue reading A case for community-oriented health services<\/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":[212,10498],"class_list":["post-187960","post","type-post","status-publish","format-standard","hentry","category-9-pm-daily-articles","category-public","tag-gs-paper-2","tag-the-hindu","entry"],"jetpack_featured_media_url":"","views":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/187960","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=187960"}],"version-history":[{"count":0,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/posts\/187960\/revisions"}],"wp:attachment":[{"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/media?parent=187960"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/categories?post=187960"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/forumias.com\/blog\/wp-json\/wp\/v2\/tags?post=187960"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}