Knowledge Booster: ASHA & National Health Mission (NHM)

Why in the News?

• Congress MPs from Kerala protested outside Parliament demanding increased honorariums and retirement benefits for ASHA workers.

• A section of ASHA workers in Kerala has been protesting, seeking an increase in their honorarium to ₹21,000 per month and a one-time payment of ₹5 lakh as retirement benefits.

• Health Minister J P Nadda informed the Rajya Sabha that the Steering Group of the National Health Mission (NHM) has approved increased incentives for ASHAs, which will come into effect soon.

ASHA (Accredited Social Health Activist)

1. Role:

   • Volunteers from within the community trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.

   • Act as a bridge connecting marginalized communities with facilities such as primary health centers, sub-centers, and district hospitals.

   • ASHAs operates in rural areas alongside the anganwadi workers (AWWs) of the Integrated Child Development Scheme (ICDS).

2. Origin of ASHA Program:

   • The ASHA program was based on Chhattisgarh’s successful Mitanin program, in which a Community Worker looks after 50 households.

   • Government of Chhattisgarh started Mitanin Programme in 2002.

3. Eligibility:

   • Typically a woman who resides in the village she serves.

   • Aged between 25 and 45 years.

   • Preference is given to married, widowed, or divorced women, and those who have completed education up to Class 10.

4. Honorarium and Incentives:

   • The NHM sees ASHAs as volunteers and not employees, making them ineligible for earnings beyond task- or activity-based incentives.

   • Receive a nominal honorarium along with various incentives.

   • The honorarium varies from state to state.

   • The irregular payment of honorarium and incentives has been a persistent issue.

   • Both the state and central government contribute to the payment of ASHA workers, with the centre’s share being critical to run it.

5. Responsibilities:

   • Create awareness about basic nutrition, hygiene practices, and the health services available.

   • Focus primarily on ensuring that women undergo ante-natal check-up.

   • Maintain nutrition during pregnancy.

   • Deliver at a healthcare facility.

   • Provide post-birth training on breast-feeding and complementary nutrition of children.

   • Counsel women about contraceptives and sexually transmitted infections.

   • Ensuring and motivating children to get immunized.

   • Provide medicines daily to TB patients under directly observed treatment of the national programme.

   • Screening for infections like malaria during the season.

   • Provide basic medicines and therapies to people under their jurisdiction.

   • Informing their respective primary health centre about any births or deaths in their designated areas.

6. Recognition:

   • In 2022, the one million ASHA workers, who were at the forefront of healthcare delivery in India, received the Global Health Leaders Award-2022 in the backdrop of the 75th World Health Assembly.

National Health Mission (NHM)

1. Launch:

   • Launched as National Rural Health Mission (NRHM) by central government in 2005.

   • In 2013, the Centre included the urban component i.e. National Urban Health Mission (NUHM) in the mission and NRHM was rebranded as the National Health Mission.

2. Sub-Missions:

   • NRHM (National Rural Health Mission)

   • NUHM (National Urban Health Mission)

3. Components:

   • Health System Strengthening

   • Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCH+A)

   • Communicable and Non-Communicable Diseases

4. Aim:

   • Achieve universal access to equitable, affordable, and high-quality healthcare services that are accountable and responsive to the needs of the population.

5. Progress:

   • India is on track to meet its health targets well ahead of the 2030 deadline.

   • The Cabinet gave its nod to continue the mission for the next two years.

   • Accelerated decline in maternal mortality rate, infant mortality rate, under 5 mortality rate and total fertility rate.

UPSC Previous Year Question

• UPSC CSE 2012: With reference to the National Rural Health Mission, which of the following are the jobs of ‘ASHA’, a trained community health worker?

  1. Accompanying women to the health facility for antenatal care checkup

  2. Using pregnancy test kits for early detection of pregnancy

  3. Providing information on nutrition and immunization.

  4. Conducting the delivery of baby

  • (a) 1, 2 and 3 only

  • (b) 2 and 4 only

  • (c) 1 and 3 only

  • (d) 1, 2, 3 and 4