ASHA and Community Health Workers

ASHA and Community Health Workers

ASHA and Community Health Workers

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ASHA: Introduction - Village Health Stars

  • ASHA: Accredited Social Health Activist.
  • Female community health volunteer; vital link between community & public health system.
  • Selection Criteria:
    • Woman resident of the village (married/widow/divorced).
    • Age: 25-45 years.
    • Education: Preferably literate, ideally up to 10th standard.
    • Good communication & leadership skills.
  • Coverage Norm:
    • 1 ASHA per 1000 population (general areas).
    • Relaxed for tribal, hilly, desert areas (e.g., 1 ASHA per habitation).
  • Accountable to the Village Panchayat/Gram Sabha.
  • Launched under National Rural Health Mission (NRHM, 2005), now part of National Health Mission (NHM).

⭐ ASHA is primarily an honorary volunteer who receives performance-based incentives, not a fixed government salary.

ASHA worker with mother and child in rural Indiaoka

ASHA: Functions - Tasks & Triumphs

  • Core Functions & Tasks:
    • Health education & counseling: Maternal & Child Health (MCH), nutrition, family planning, sanitation, hygiene.
    • Mobilize community for health services: Immunization, Antenatal Care (ANC), Postnatal Care (PNC).
    • Escort services: To facilities for institutional delivery, immunization, emergencies.
    • Home-Based Newborn Care (HBNC) visits.
    • DOTS provider for Tuberculosis; Malaria: RDTs, presumptive treatment.
    • Depot holder: ORS, Iron Folic Acid (IFA), contraceptives, basic medicines.
    • Report vital events (births, deaths); maintain essential records.
    • Facilitate Village Health, Sanitation & Nutrition Committee (VHSNC) meetings.
  • Key Triumphs:
    • ↑ Institutional deliveries, comprehensive ANC/PNC coverage.
    • ↑ Full immunization coverage in children.
    • Significant ↓ in Infant Mortality Rate (IMR) & Maternal Mortality Ratio (MMR).
    • Improved community health awareness & health-seeking behaviors.

Community Health Worker Program Model

⭐ ASHA acts as a depot holder for essential provisions and typically serves a population of 1000.

ASHA: Support Systems - Training & Teamwork

  • Training:
    • Initial: 23 days, structured in modules (e.g., 5 core modules).
    • Focus: MCH, immunization, family planning, nutrition, DOTS, first-aid, communication.
    • Periodic refresher training and skill enhancement.
  • Teamwork & Support:
    • Mentoring & guidance: ANM, AWW, Medical Officer (MO).
    • Regular review meetings at Sub-centre/PHC.
    • Support from VHSNC/PRI.
    • Performance-based monetary incentives.

⭐ ASHA's training is competency-based, typically involving 23 days spread over several months in distinct modules.

CHWs: Linkages - ASHA & Allies

  • ASHA (Accredited Social Health Activist): Primary community interface.
    • Coordinates with Anganwadi Worker (AWW): ICDS, nutrition, health education.
    • Supports ANM (Auxiliary Nurse Midwife): Immunisation, MCH, referrals, Sub-Centre activities.
    • Member of VHSNC (Village Health Sanitation and Nutrition Committee).
  • Key Allies:
    • AWW: Focus on child development, maternal nutrition.
    • ANM: Skilled care, facility-based services.

ASHA Scheme Structure and Activities

⭐ ASHA acts as a crucial link between the community and the public health system, facilitating access to services and promoting health-seeking behaviours among rural populations for schemes like JSY and JSSK.

ASHA Program: Evaluation - Gains & Gaps

  • Gains:
    • Improved access: ↑ Antenatal Care (ANC), institutional deliveries, immunization
    • Better maternal & child health (MCH) outcomes
    • Strengthened community-health system interface
  • Gaps:
    • High workload; inadequate/delayed performance-based incentives
    • Insufficient training, irregular supplies
    • Weak supportive supervision
    • Overemphasis on curative tasks vs. promotive/preventive

⭐ ASHA (Accredited Social Health Activist) must be a woman resident of the village, preferably aged 25-45 years, with formal education up to class 8th, and good communication skills.

High‑Yield Points - ⚡ Biggest Takeaways

  • ASHA (Accredited Social Health Activist): A trained female community health volunteer.
  • Acts as a key link between the community and the public health system.
  • Focuses on Maternal & Child Health (MCH), immunization, family planning, and basic care.
  • Receives performance-based incentives, not a fixed salary.
  • Norm: One ASHA per 1000 population (flexible for difficult areas).
  • Crucial for JSY & JSSK success, promoting institutional deliveries and newborn care.
  • AWW (Anganwadi Worker): Manages Anganwadi centers focusing on child nutrition and pre-school education (ICDS).

Practice Questions: ASHA and Community Health Workers

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In implementation of a health programme, best thing to do is -

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Flashcards: ASHA and Community Health Workers

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HWC-PHC is functional for a population of _____ in a tribal area and _____ in a plain area.

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HWC-PHC is functional for a population of _____ in a tribal area and _____ in a plain area.

20,000; 30,000

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