In the view of GOI targeting Universal Health Coverage, the issues faced by Accredited social health activists (ASHAs) need immediate attention

ASHAs play a crucial role in the welfare of the new born babies and the mothers in the country where the infant and maternal mortality rate is quite high. They form the last link between the rural communities and the public healthcare system.

  1. National Rural Health Mission has put ASHAs in its forefront in its pubic healthcare delivery and exist in areas where Govt. healthcare facilities are non-existent. They are responsible for the health of the pregnant women in their community, encouraging institutional delivery, child immunisation and nutrition.
  2. Institutional delivery has gone up substantially in states such as Bihar, Rajasthan and UP.
  3. There has been a dramatic improvement in the child immunization rates and in tackling malnutrition.

Some of the issues faced faced by them are

  1. Lack of Fixed Salary and Inadequate Incentives. The incentives sometimes don’t even add upto the minimum wage of a skilled worker.
  2. The scheme does not have dedicated budget and the funds are arranged on ad-hoc basis from various schemes under NRHM such as National Immunization Programme. This affects the timely disbursement of payments.
  3. Infrastructure challenges. Introduction of softwares such as AHSAsoft and the delay in the data entry into the system has further delayed the disbursement of the payment.
  4. Lack of training. Though they are given a induction on joining, are not receiving training's regularly
  5. Sometimes they are asked to take surveys on immunisation level or demographic profile of households for which they do not get paid.

Fixed salary and inclusion in the social security schemes will not only help ASHAs but also improve economic security of their families. This will increase the morale of the group. There should be frequent and regular training on child health, family planning or diseases such as HIV-Aids. Skill upgradation should be an integral part of the scheme. The volunteers should be encouraged to take short term courses on auxiliary nurse mid-wives/general nursing and midwifery.