Accredited Social Health Activist

(ASHA)

State Institute of Health & Family Welfare, Jaipur

 ASHA
Accredited
 Recognized by the community


Social
 From the community, By the community and
 For the community


Health Activist
 Spreading awareness for health concerns

 Promoting change in health related practices

•
SIHFW: an ISO9001: 2008 certified institution 2
 ASHA

Ø Community based functionary

Ø

Ø First contact level for Community for

Health
Ø

Ø Change agent on health in a village

•

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ASHA-Sahyogini: Convergence brought
in
Ø Convergence of ICDS and health Dept.


Ø Sahyogini as 3rd worker at AWC already existed

before NRHM
Ø

Ø To avoid Duplication- Sahyogini taken as ASHA

Ø

Ø Nomenclature devised as ASHA-Sahyogini

•

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ASHA-Sahyogini: Selection

Ø Listing of interested and eligible women by

ANM and LS
Ø

Ø Panel of three names

Ø

Ø Approval through Gram Sabha- Community

empowerment)


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 ASHA-Sahyogini: Selection
Eligibility
Ø Intensive mobilization to get active ASHA-
Sahyogini
Ø

Ø Any woman can not be the ASHA-Sahyogini

Ø

Ø Combinations of eligible criteria

Ø

ØAge- 21years to 45 years

Ø

ØQualification- 8th Pass Minimum

(relaxation for tribal and desert areas)



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 Ø
ØStatus-
Ø

ØMarried/divorcee/separated
Ø

ØMust be ‘BAHU’ of the commun

Ø

ØResident of the village

Ø

ØActive/Vocal/leadership qualities
•

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 ASHA-Sahyogini: Trainings
 GOI norms- 23 days and 5 phases
Phase Days
1st 6 days
2nd 4 days
3rd 4 days
4th 5 days
5th 4 days

4 ro u n d s o f 2 3 d a ys ( 1 0 + 4 + 5 + 4 d a ys)
Pre se n tly 3 rd phase rolled out
DTT for 15 days integrated training for
fresh ASHAs started(Oct. 2009)
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 ASHA-Sahyogini: Trainings

State Training Team NIHFW

District Trainer Team SIHFW

(DTT)

Block Trainers Team

DTT
(BTT)

ASHA-Sahyoginis BTT & NGOS

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 Support Structure
Ø ASHA mentoring group State Level
Ø ASHA Resource centre Earlier at
SIHFW, now
at SPMU
Ø Joint Strengthening Committee

At State level- ACS/PHS/Secretaries

At District level- CMHO/DD-ICDS
At Block level- BCMO/ CDPO
At PHC level- MO/LHV/LS/ANM

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 Monitoring

Ø PHC level monthly meetings

ØReview of ASHAs work
ØCollection and compilation of
reports
ØIncentive payments to ASHAs
Ø

Ø MCHN monitoring by external

agency
Ø

Ø Monthly reports from districts

•
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Monitoring Indicators for ASHAs

Institutional 5 Deliveries per year ( 80%

deliveries of total deliveries should be
escorted by ASHAs)

Social 80% beneficiaries (ANC &

Mobilization children) of the due list should
be mobilized for MCHN day

Sterilization 1 case per month

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 Reporting System for ASHA
Ø Form no. 6-9:- Deliveries escorted by
ASHAs


Ø NRHM formats:- NO. of ASHAs, training,

monthly meetings,
performance, integrated package
etc.
Ø CHC monitoring:- Deliveries escorted by
ASHAs Sterilization
motivated by ASHAs


 SIHFW: an ISO9001: 2008 certified institution 13

 Integrated Compensation
One time honorarium Amount
(Rs.)
Monthly meeting 100
Social mobilization for MCHN day 150
Organizing monthly VHSC meeting 100
Bi-monthly conduction of meeting for 100
adolescent girls
Total to be paid by NRHM 450
Amount to be paid by WCD after 500
attending monthly meeting at PHC
Total 950
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Performance Based Compensation
Activity Amount
(Rs.)
JSY 400+100+100 600
Sterilization 200,150
DOTS 250
Cataract 175

Toilet construction 60
RT to Malaria cases 50

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 Work Load for ASHA for 1000 Pop
Beneficiary category Expected number in an Year

Pregnant women 30-31

Out of which 4-5 may have

complications
50% shall have anemia

New Borne 27-28

Children in 0-1 Year 30 ( 3 % of the population)
Children 1-5 years 130, (13 % of Population
Eligible couples 16-17% (15-45 years)
Eligible for Vasectomy/ 5-7% of Eligible couples
Tubectomy
Eligible for spacing Methods 11-12% of Eligible couples
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Palpable Impact: Increase in
Ø ANC registration in first trimester
Ø Institutional Deliveries
Ø Immunization – full immunization
Ø No. of Sterilization
Ø Practices
ØBreast feeding practices
ØHealth seeking behavior
Ø Referral
Ø Community involvement –VHC/MCHN
1.
•
SIHFW: an ISO9001: 2008 certified institution 17
Factors Critical to Success of ASHA

Ø Selection of ASHA by prescribed process as per

Ø
the ASHA guidelines
Ø Linkage with nearest functional health facility for
Ø
referral services
Ø Identified transport for referral of cases from
Ø
village to facility
Ø Priority and recognition of cases referred by
ASHA to MO / ANM

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Ø Successful organization of monthly Health and
Nutrition Day (in every village with the
Ø
ANM/AWW)
Ø Monthly meeting of ASHA at PHC
Ø

Ø Timely payment of incentives to ASHA

Ø

Ø Timely replenishment of ASHA kit

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 Role of DACs
Ø Create database of ASHA
Ø Liaise with district level stakeholders for
mobilizing support
Ø Supervision and monitoring of the ASHAs, NGOs
and Block ASHA facilitators and PHC ASHA
Supervisors
Ø Attend ASHA meetings at block and PHC
Ø Prepare annual training plan of ASHA for different
rounds

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Ø Compilation of monthly report with the help of Data
Assistant of DPMU.
Ø Dissemination of guidelines related to ASHA to all
functionaries at different levels.
Ø Follow up with Block ASHA facilitators/ BPMs on
the progress of assigned job
Ø Monitor timely payments of ASHAs
Ø Monitor physical and financial progress of the
component.
Ø Field visits

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 Role of DPM
Ø Develop annual plan for selection and training
for ASHA
Ø Drafting of annual targets for CHC-PHC wise
ASHA to achieve the health targets of District
like; sterilization, institutional deliveries and
immunization etc.
Ø Ensure adoption and implementation of plan and
fund flow at local level
Ø Support District ASHA Coordinator in developing
localised implementation plans
Ø Monitor physical and financial progress of the
component
•
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Collective Role of DACs/ DPMs

Ø Reporting – timely and properly

Ø

Ø Hand holding support to ASHAs

Ø

Ø Timely payments to ASHA-Sahyogini

Ø

Ø Regular monthly meetings at PHC/CHC

Ø

Ø Identification of non-performing ASHAs

Ø

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 Programmatic Check List

Ø Whether ASHA monthly meetings at PHC/CHC

are being organized or not
Ø

Ø Does every institution is organizing it or not

Ø

Ø How many ASHAs are regularly attending the

meeting?
Ø

Ø Are ASHAs getting their incentives as per

activities
•

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Measures of Effectiveness

Ø % of newborns who were visited thrice in

first week including once in first day
Ø

Ø % of ASHAs who received more than 20

visits for common illnesses per month
Ø

Ø % of ASHAs who have referred all ( or at

least half ) their pregnant women for
institutional delivery

SIHFW: an ISO9001: 2008 certified institution 25

ASHA at her house
ASHA with a mother
How to use ORS
In the
discussion….
ASHA at Work
Convening VHC Meeting