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Focus: GS-II Social Justice

Why in news?

  • At the frontline of the country’s battle against COVID-19, Accredited Social Health Activists, or ASHAs, in Haryana have gone on strike after they were issued new Jio 4G SIM cards and their old SIMs disabled to ensure they migrate to android phones for better monitoring of service delivery.
  • But the workers, paid poorly with salaries often delayed, say they cannot afford smartphones to use the new SIM cards.
  • The ASHA workers say they were promised smartphones in 2018, but the procurement has been delayed.

Crucial tool

  • Mobile phones help ASHA workers remain in contact with beneficiaries in their area, receive calls seeking assistance such as during child birth, and send updates and GPS locations of new COVID-19 cases.
  • They have been delivering additional services, which include spreading awareness about preventive measures against coronavirus infection as well as detecting and referring suspected COVID-19 cases, despite the lack of any protective personal equipment or security from attacks while out on surveys.
  • This is in addition to their routine work which for an ASHA worker includes screening pregnant women, lactating mothers as well as children for communicable and non-communicable diseases, vaccination, care during pregnancy and child birth, among others.

Vital role

  • Since ASHA’s live in the community and belong to that community, they have a much deeper knowledge of and connection with the families.
  • Without such a connect, it will not be possible to ensure the last mile delivery of health services.
  • ASHA workers are also the ones helping with the TB and malaria control programmes.

What is ASHA?

  • Under the National Health Mission, Accredited Social Health Activists ASHA are envisaged to be community health volunteers. Under the National Health Mission, ASHA are entitled to task/activity-based incentives.
  • Under the National Health Mission, ASHAs act as a critical link between Healthcare delivery system and community.

The details task assigned to ASHA workers under National Health Mission

  1. To create awareness and 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 use of health services.
  2. To counsel women and families 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/STIs) and care of the young child.
  3. To mobilize the community and facilitate people’s access to health and health related services available at the village/sub-centre/primary health centres, such as Immunization, Ante Natal Check-up (ANC), Post Natal Check-up (PNC), ICDS, sanitation and other services being provided by the government.
  4. To work with the Village Health, Sanitation and Nutrition Committee to develop a comprehensive village health plan, and promote convergent action by the committee on social determinants of health. In support with VHSNC, ASHAs will assist and mobilize the community for action against gender based violence.
  5. To 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).
  6. To provide community level curative care for minor ailments such as diarrhoea, fevers, care for the normal and sick newborn, childhood illnesses and first aid. She will be a provider of Directly Observed Treatment Short-course (DOTS) under Revised National Tuberculosis Control Programme.
  7. She will also act as a depot holder for essential health products appropriate to local community needs. A Drug Kit will be provided to each ASHA. Contents of the kit will be based on the recommendations of the expert/technical advisory group set up by the Government of India. These will be updated from time to time, States can add to the list as appropriate.
  8. To act as a care provider can be enhanced based on state needs. States can explore the possibility of graded training to the ASHA to provide palliative care, screening for non-communicable diseases, childhood disability, mental health, geriatric care and others.
  9. To provide information on about the births and deaths in her village and any unusual health problems/disease outbreaks in the community to the Sub-Centres/Primary Health Centre. She will promote construction of household toilets under Total Sanitation Campaign.

Financial Aid provided

To improve the financial   security of ASHAs, the Government of India has already taken several steps in addition to routine and recurring incentives, which inter-alia includes:

  • Benefits of Life insurance, accident insurance and pension to eligible ASHAs and ASHA facilitators are extended by enrolling them under:
  • Pradhan Mantri Jeevan Jyoti BeemaYojana (premium of Rs. 330 contributed by GOI).
  • Pradhan Mantri Suraksha Beema Yojana (premium of Rs. 12 contributed by GOI).
  • Pradhan Mantri Shram Yogi Maan Dhan (PM-SYM) (50% contribution of premium by GOI and 50% by beneficiaries).
  • The government has also approved a cash award of Rs. 20,000/- and a citation to ASHAs who leave the programme after working as ASHAs for minimum of 10 years, as acknowledgement of their contribution.

-Source: The Hindu

December 2023