ASHA, ANM and Anganwadi Workers

One of the key components of the National Rural Health Mission / NHM is to provide every village in the country with a trained female community health activist called ASHA or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA is trained to work as an interface between the community and the public health system. Notable points about ASHA are as follows:

• ASHA must primarily be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years.
• She should be a literate womanwith formal education up to class eight. This may be relaxed only if no suitable person with this qualification is available.

Functions of ASHA

• To work as fountainhead of public health programmes in her village
• Work as first port of call for health related demands of deprived sections of society
• Promote institutional delivery, universal immunization and other public health initiatives
• Referral and escort services for Reproductive & Child Health (RCH) and other healthcare programmes, and construction of household toilets
• Provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilisation of health & family welfare services.
• Counsel women on birth preparedness, importance of safe delivery, breast-feeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young child.
• Mobilise the community and facilitate them in accessing health and health related services available at the Anganwadi/sub-centre/primary health centers, such as immunisation, Ante Natal Check-up (ANC), Post Natal Check-up supplementary nutrition, sanitation and other services being provided by the government.
• Work as deport holder for Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet(IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc.
• There will be one ASHA per 1000 population.

Since 2013, when the National Urban Health Mission was launched, ASHA are being selected in urban areas as well. Several evaluations and successive Common Review Missions show that the ASHA has been a key figure in contributing to the positive outcomes of increases in institutional delivery, immunization, active role in disease control programmes (malaria, kala-azar and lymphatic filariasis, in particular) and improved breastfeeding and nutrition practices. The majority of states have placed an active training and support system for the ASHA to ensure continuing training, on site field mentoring and performance monitoring.

A proposal for certification of ASHAs to enhance competency and professional credibility of ASHAs by knowledge and skill assessment has been approved recently. The certification of ASHAs would be done by National Institute of Open Schooling (NIOS). The following components of the programme, namely, the Training curriculum, State Training Sites/District Training Sites, Trainers and ASHAs and ASHA Facilitators would be taken up for accreditation/certification. The Certification of ASHAs and accreditation of associated agencies involved in ASHA Training is intended to enhance competency and professional credibility of ASHAs, improve the quality of training and ensure desired programme outcomes, provide an assurance to the community on the quality of services being provided by the ASHA, besides promoting a sense of self recognition and worth for ASHAs.

Auxiliary Nurse Midwife and Anganwadi Worker (ANM)

Auxiliary Nurse Midwife (ANM) is a resource person for ASHA. They hold weekly/fortnightly meeting with ASHA, and provide on-job raining by discussing the activities undertaken during the week/fortnight and provide guidance in case ASHA encounters any problem. ANM also ensures that ASHA gets the compensation for performance and also TA/DA for attending the training schedule.

 Anganwadi Worker (AWW)

Anganwadi Worker (AWW) guides ASHA in performing activities such as organising Health Day once/twice a month at Anganwadi Centre and orientating women on health related issues such as importance of nutritious food, personal hygiene, care during pregnancy, importance of immunisation etc. Anganwadi worker is a depot holder for drug kits and will be issuing it to ASHA.