Who are ASHA workers, the women healthcare volunteers honoured by WHO?

The World Health Organisation has recognised the country’s 10.4 lakh ASHA (Accredited Social Health Activist) workers as ‘Global Health Leaders’ for their efforts in connecting the community to the government’s health programmes.

ASHA workers:

• ASHA workers are volunteers from within the community who are trained to provide information and aid people in accessing benefits of various healthcare schemes of the government.
• They act as a bridge connecting marginalised communities with facilities such as primary health centres, sub-centres and district hospitals.
• The role of these community health volunteers under the National Rural Health Mission (NRHM) was first established in 2005.
• ASHAs are primarily married, widowed, or divorced women between the ages of 25 and 45 years from within the community.
• They must have good communication and leadership skills; should be literate with formal education up to Class 8, as per the programme guidelines.
• There are around 10.4 lakh ASHA workers across the country, with the largest workforces in states with high populations – Uttar Pradesh (1.63 lakh), Bihar (89,437), and Madhya Pradesh (77,531).
• Goa is the only state with no such workers, as per the latest National Health Mission data available from 2019.

Duties of ASHA Workers:

• They go door-to-door in their designated areas creating awareness about basic nutrition, hygiene practices, and the health services available.
• They focus primarily on ensuring that women undergo ante-natal check-up, maintain nutrition during pregnancy, deliver at a healthcare facility, and provide post-birth training on breast-feeding and complementary nutrition of children.
• They also counsel women about contraceptives and sexually transmitted infections.
• ASHA workers are also tasked with ensuring and motivating children to get immunised.
• Other than mother and child care, ASHA workers also provide medicines daily to TB patients under directly observed treatment of the national programme.
• They are also tasked with screening for infections like malaria during the season.
• They also provide basic medicines and therapies to people under their jurisdiction such as oral rehydration solution, chloroquine for malaria, iron folic acid tablets to prevent anaemia, and contraceptive pills.

Debate over status

• There is a strong argument to grant permanence to some of these positions with a reasonable compensation as sustaining motivation.
• The incremental development of a local resident woman is an important factor in human resource engagement in community-linked sectors.
• This should apply to other field functionaries such as ANMs, GNMs, Public Health Nurses as well.
• It is equally important to ensure that compensation for performance is timely and adequate.