Community Process
To mobilize communities for successful implementation of various programs and activities under National Health Mission and reduce MMR & IMR, Accredited Social Health Activists (ASHA) have been selected in communities in the year 2005 – 06. As per the norm, one ASHA has been selected to cater every 500 population in the hilly districts (rural and urban both) and 1000 population in the plains area. At present, 12018 ASHAs and 606 ASHA Facilitators are sanctioned in State of Uttarakhand. In the past 16 years, these ASHAs have been established as an important link between the community and the health units. In the context of Uttarakhand state where the geographical areas are inaccessible and socially very complex, the role of ASHA worker becomes even more important. At present, the responsibility of taking health facilities to the public in the rural areas of the state is being fully borne by ASHAs. For last few years, due to the untiring efforts of ASHAs, the maternal and child mortality rate of the state has significantly come down.
Each ASHA fulfills her role in community through following five activities.
Holding village level meeting :
As member secretary of the Village Health, Sanitation and Nutrition Committee (VHSNC), the ASHA is expected to help convene the monthly meeting of the VHSNC and provide leadership and guidance to its functioning.
Home Visits :
For up to two hours every day, for at least four or five days a week, the ASHA visits the families living in her allotted area priority being accorded to marginalized families. ASHAs prioritize such homes where there is a pregnant woman, newborn, child below two years of age or a malnourished child.
Attending the Village Health and Nutrition Day (VHND):
ASHA promotes beneficiaries attendance at monthly VHND sessions where Aaganwadi and Auxiliary Nurse Midwife (ANM) also render their services.
Visits to the health facility:
Accompanying a pregnant woman, sick child, or some member of the community needing facility based care. ASHAs attend the monthly review meeting at the PHC level.
Maintain records:
Maintaining records which help ASHAs in organizing her work and help her to plan better for the health of the people.
Status of drug kits
As the ASHA of village play an important role in helping the community to improve health status, ASHA do this through counseling and motivation for changing home behaviors related to health, improve care seeking behaviors, facilitating access to health care and also by providing community level health care. To enable to provide care for common illnesses among the people of community, ASHA have been given a drug kit. All ASHAs have been trained in the use of these drugs during past training workshops. In the State of Uttarakhand, following medicines are included in the drug kit of the ASHA workers..
Contents of Drug Kit
DDK for clean deliveries at home, Tab. Paracetamol, Paracetamol Syrup, Tab Iron Folic Acid, Zink Tablets, Povidone Iodine Ointment Tube, Cotrimoxazole syrup, ORS Packets, Bandages 4 cm X 4 meters.
Refilling of all medicines is also done from CHC & PHC level of the districts.
Status of Incentives
As per the guideline of Government of India, all ASHAs are getting incentives against competition of activities as shown in the Annexure- A.
As per the Uttarakhand Government order, all ASHAs are getting fixed incentive amount of Rs. 3000/- per month and 10% performance based activity incentive by the state government.
- ASHA Support structure is in place across all 13 districts of Uttarakhand state. It consists of 13 District Community Mobilizers, 101 Block Community Mobilizers, 13 District Data Entry Operators, 606 ASHA Facilitators and 12018 ASHAs.
- Out of 12018 ASHAs, 11983 ASHAs have received 8 days training on Induction Module.
- Under the ASHA certification program, training has been received by 6 state level Master Trainers and 86 district level Master Trainers.
- ASHA training for ASHA certification has been received by 1398 ASHAs.
- Uniform and Diary is provided to each ASHA and ASHA Facilitator every year.
- The facility of CUG SIM is being made available to all ASHAs, ASHA Facilitators, Block Coordinators, Community Mobilizers and Data Entry Operators.
- A total of 6399 smartphones have been provided to ASHAs and ASHA Facilitators till Dec, 2021 and procurement of 6225 smartphones is in the progress.