Highlighting the role played by ASHA workers in public health system of India, discuss the challenges faced by them.
Answers
Accredited Social Health Activist (ASHA) is a trained female community health activist. ASHA workers are selected from the community itself and are trained to work as an interface between the community and the public health system. At present, there are over 9 lakh ASHAs working in the Indian public health system.
Role played by ASHA workers in the public health system of India :-
- First port of call :- ASHAs serve as the first port of call for any health related requirement of deprived sections of the population, especially women and children who find it difficult to access health services.
- Creating awareness :- They provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, existing health services etc.
- Role as a counsellor :- They counsel women on birth preparedness, safe delivery, breast-feeding, immunization, contraception and prevention of Sexually Transmitted Infections and care of their young children.
- Delivery of first contact health care :- Empowered with knowledge and a drug kit to deliver first-contact healthcare, ASHAs act as a depot holder for essential provisions like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA), Chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms etc.
While performing their role, ASHA workers face multiple challenges as follows :-
- Low payments :- ASHA workers are some of the lowest paid health care providers in India. They normally earn around Rs.300 through antenatal care and institutional delivery, Rs.150 for family planning and Rs.100 for immunization rounds etc.
- Delay in payments and release of funds :- As there is no dedicated budgetary allocation for ASHA workers, they are paid from the funds of the National Rural Health Mission, for which they have to wait for a long period.
- Issues with training and availability of drugs/equipment :- They lack skills related to counselling for family planning, recognition of danger signs of pregnancy, and first contact care for sick new-born babies and children (10th CRM Report). They also face problems relating to the availability and replenishment of drugs and equipment kits.
- Harassment by nurses, paramedics and senior medical staff :- ASHA workers are often subjected to harassment by senior staff members which demotivates them to work further.
ASHA workers play a very crucial role in the public health system in India. Solutions like Project Sanghosti (building a low cost technology-enabled solution for empowering ASHA workers), increasing the incentive packages for ASHAs, better governance of the ASHA programmes, taking serious action on cases of harassment etc. can be of great help in empowering the ASHA workers and facilitating them to realise their true potential as health activists.
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