In his interaction with doctors and officials of Varanasi on Friday, Prime Minister, Narendra Modi made a pointed reference to Accredited Social Health Activist (ASHA) and Auxiliary Nurse Midwife (ANM) frontline workers. PM Modi spotlighted their vital role in countering the ongoing Covid-19 second surge. He said: “They have played a stellar role and we need to take maximum advantage of their potential and experience.”

Pivotal role in Covid-19 containment

Their pivotal role in containing and curbing Coronavirus in India, especially rural areas has been exemplary. ASHA workers played a critical role in sensitising the communities about the preventive measures to be adopted to check Covid, such as regular hand washing with soap and water, importance of wearing masks when out in public spaces, and maintaining adequate physical distancing.

PM Modi lauds ASHA workers, praises them for their efforts in fight against #Covid19.@PreetiChoudhry #ITVideo#TTP full show: https://t.co/aCJ24AlNhC pic.twitter.com/ByC75fs3s2

— IndiaToday (@IndiaToday) May 21, 2021

These women workers also assisted the State Governments in contact tracing and community surveillance. This was very useful in the case of migrant workers returning to their villages in the first as well as the ongoing lockdown. They facilitated sample collection for Coronavirus testing as well as distribution of medicines to those affected.

Apart from tracing them, during the quarantine of these returnees, ASHA workers assisted by providing them healthcare and counselling during the isolation while also helping the local authorities in setting up of quarantine centres. For the home quarantine cases, workers explained in details to the families the steps to be taken while regularly visiting them.

Also they helped in keeping count of mortality in their region, thus keeping the local authorities updated on the status of the pandemic.

Genesis of ASHA

ASHA workers are one of the important components of the National Rural Health Mission launched in 2005. NRHM aims to provide every village in the country with these trained female community health activists.

What makes them special is the fact that they are selected from the village itself and accountable to it, and being trained as a health worker, are an interface between the community and the public health system.

ASHA workers in Uttar Pradesh helping in Covid-19 curbing campaign (Pic: Courtesy Twitter/@ANINews)

Salient features of ASHA

ASHA workers must primarily be a woman resident of the village. She could be married or widowed or divorced and should be preferably in the age group of 25 to 45 years.

She needs to be literate with preference given in selection to those who are qualified up to Class X. This criteria is relaxed if no suitable person is available.

They are chosen through a rigorous selection process involving various community groups, self-help groups, Anganwadi Institutions, the Block Nodal officer, District Nodal officer, the village Health Committee and the Gram Sabha.

To keep abreast with change in the health sector, capacity building of ASHA is seen as a continuous process. Therefore, they undergo a series of training episodes to acquire the necessary knowledge, skills and confidence for performing their roles.

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

Thus empowered with knowledge and a drug-kit to deliver first-contact healthcare, each of these workers is truly a fountainhead of community participation in public health programmes in their village.

Role and Responsibility

• Create awareness and provide information to the community on health such as nutrition, basic sanitation and hygienic practices, healthy living and working conditions.
• Provide information on existing health and family welfare services, and the need for timely utilization of these.
• Counsel women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections.
• Mobilize the community and facilitate them in accessing health and health related services available at the village/sub-centre/primary health centres, such as immunization, etc.
• Work closely with the Village Health and Sanitation Committee of the Gram Panchayat to develop a comprehensive village health plan.
• She arranges an escort or accompanies pregnant women and children requiring treatment and admission to the nearest health facility.
• Playing an important role in gathering statistics, ASHA workers inform about the births and deaths in their village as well as any unusual health related problems or diseases in the community.
• The ASHA workers act as a depot holder for essential provisions being made available to all villages and habitations like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet(IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills and & Condoms, etc.

Given the fact that the services rendered by ASHA workers both during the Covid-19 and other times, this institution needs to be further strengthened, further trained and also better remunerated as they are the first port of call for India’s health issues.