The World Health Organisation (WHO) has recognised India’s 4 lakh ASHA (Accredited Social Health Activist) workers as ‘Global Health Leaders’ for their efforts in connecting the community to the government’s health programmes and their work during Covid-19 pandemic.
ASHA received the Global Health Leaders Award-2022 in the backdrop of the on-going 75th World Health Assembly.
WHO acknowledged that ASHAs facilitate linking households to health facilities, and play pivotal roles in house-to-house surveys, vaccination, public health and Reproductive and Child Health measures.
About ASHA –
- ASHA is a trained female community health activist recognised as a key component of the National Rural Health Mission (NRHM).
- Selection criteria for ASHAs – In rural areas, ASHA must primarily be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years and literate preferably qualified up to 10th standard (formal education up to Class 8).
- In urban areas, ASHA must be a woman resident of the “slum/vulnerable clusters” and belong to that particular vulnerable group which have been identified by City/District Health Society for selection of ASHA and must have good communication and leadership skills
- Enrolment of ASHA – ASHA is chosen through a rigorous process of selection involving various community groups, self-help groups, Anganwadi Institutions, Block Nodal officer, District Nodal officer, the village Health Committee and the Gram Sabha.
- Number across country – There are around 10.4 lakh ASHA workers across the country, with the largest workforces in states with high populations – Uttar Pradesh (1.63 lakh), Bihar and Madhya Pradesh. Goa is the only state with no such workers, as per the latest National Health Mission data available from September 2019.
- Availability of ASHA – The aim is to have one ASHA for every 1,000 persons or per habitation in hilly, tribal or other sparsely populated areas.
Genesis and evolution of ASHA –
- The ASHA programme was based on Chhattisgarh’s successful Mitanin programme, in which a Community Worker looks after 50 households.
- The ASHA was to be a local resident, looking after 200 households. The programme had a very robust thrust on the stage-wise development of capacity in selected areas of public health.
- 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.
- Incentives for institutional deliveries across most states built pressure on public institutions and improved the mobility of ASHAs.
- Overall, it created a new cadre of incrementally skilled local workers who were paid based on performance.
- ASHA workers were constituted as an all-female cadre of community health workers by the Ministry of Health and Family Welfare under the National Rural Health Mission in 2006.
- NRHM seeks to provide every village in the country with a trained female community health activist ASHA, selected from the village itself and accountable to it.