ASHA

Monitoring and evaluation of ASHA’s work

Governmemt of India has set up following indicators for monitoring ASHA.

1. Process Indicators:

• Number of ASHAs selected by due process
• Number of ASHAs trained
• % of ASHAs attending review meeting after one year

2. Outcome Indicactors:

• % of newborn who were weighed and families counselled
• % of children with diarrhoea who received ORS.
• % of deliveries with skilled assistance
• % of institutional deliveries
• % of JSY (Janani Suraksha Yojna) claims made to ASHA.
• % of of completely immunized in 12-23 months of age group
• % of unmet need for spacing contraception among BPL
• % of fever cases who received chloroquine within first week in a malaria detected area.

3. Impact Indicators:

• IMR
• Child malnutrition rates
• Number of cases of TB /Leprosy detected as compared to previous year.
• ASHA is an important topic. Read more details from Park or see the following questions:- Q no. 54 of Nov 2006; 58 of May 2007

NRHM was launched in the year 2005. ASHA workers were trained under the NRHM to help in bridging the gaps in rural health care delivery. 

Ref: Park 21st edition page: 405.

Ans. is ‘d’ i.e., Skilled birth attendant 

Accredited Social Health ActivistiASHA)

• ASHA is the central component of the National Rural Health Mission (NRHM)
• National Rural Health Mission (NRIIM) was launched to address the health needs of rural population, especially the vulnerable sections of society
• One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist – `ASHA’ or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system.

Following are the key components of ASHA:

• ASHA must primarily be a woman resident of the village – married/ widowed/ divorced, preferably in the age group of 25 to 45 years.
• She should be a literate woman with formal education up to class eight. This may be relaxed only if no suitable person with this qualification is available.
• ASHA will be the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services
• ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. She would be a promoter of good health practices.
• She will counsel women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/ Sexually Transmitted Infection ( RTIs/STI s) and care of the young child
• She will arrange escort/accompany pregnant women & children requiring treatment/ admission to the nearest pre-identified health facility i.e. Primary Health Centre/ Community Health Centre/ First Referral Unit (PHC/CHC /FRU).
• ASHA will provide primary medical care for minor ailments such as diarrhoea, fevers, and first aid for minor injuries. She will be a provider of Directly Observed Treatment Short-course (DOTS) under Revised National Tuberculosis Control Programme
• She will also act as a depot holder for essential provisions being made available to every habitation like Oral Rehyd ration Therapy (ORS), Iron Folic Acid Tablet (IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc. A Drug Kit will be provided to each ASHA.
• The general norm will be ‘One ASHA per 1000 population’. In tribal, hilly, desert areas the norm could be relaxed to one ASHA per habitation, dependant on workload etc.
• ASHA would be an honorary volunteer and would not receive any salary or honorarium. Her work would be so tailored that it does not interfere with her normal livelihood.

Ans. is ‘b i.e., AWW and ANM 

o Angan-Wadi Workers (AWW) and Auxiliary Nurse Midwife (ANM) act as resource persons far training of ASHA (Accredited Social Health Activist).

Ans. is `b’ i.e., Infant mortality rate 

Monitoring and Evaluation of ASII.Vs work

Government of India has set up following indicators for monitoring ASHA (41). 1.Process Indicators

a)   Number of ASHAs selected by due process

b)   Number of ASH As trained; and

c)   % of ASHAs attending review meeting after one year

2. Outcome Indicators

a)   % of newborn who were weighed and families counseled.

b)   % of children with diarrhoea who received ORS.

c)   % of deliveries with skilled assistance.

d)   % of institutional deliveries.

e)   % of JSY claims made to ASHA

f) % of completely immunized in 12 to 23 months age group.

g)   % of unmet need for spacing contraception among BPL.

h)   % of fever cases who received chloroquine with in first week in a malaria endemic area.

3.1mpact Indicators

a)     IMR

b)     Child malnutrition rates

c)     Number of cases of TB/leprosy detected as compared to previous year.

Ans. is ‘b’ i.e., Zero dose of OPV and BCG 

Ans. is ‘b’ i.e., Accredited social health activist 

Ans. B i.e. Education atleast till 4th class or higher

ASHA/Accredited Social Health Activists (ASHAs)

• ASHAs must primarily be female residents of the village that they have been selected to serve, who are likely to remain in that village for the foreseeable future.
• Married, widowed or divorced women are preferred over women who have yet to marry since Indian cultural norms dictate that upon marriage a woman leaves her village and migrates to that of her husband.
• ASHAs must have class eight education or higher, preferably be between the ages of 25 and 45, and are selected by and accountable to the gram panchayat (local government).

Ans. C: She must be educated till 4th class

Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system.

General norm of selection would be one ASHA per 1000 population.

Selection of ASHA:

Should be resident of the same village

Preferably in the age group of 25-45 years

Formal education up to eighth class

Having communications skills and leadership.

Following are the key components of ASHA:

• The ASHAs will receive performance-based incentives for promoting universal immunization, referral and escort services for Reproductive and Child Health (RCH) and other healthcare programmes, and construction of household toilets.

• ASHA will be the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services.

• ASHA will provide information to the community on determinants of health such as nutrition, basic sanitation and hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilisation of health and family welfare services.

Ans. is ‘d’ i.e., % of institutional deliveries