accredited social health activist (asha)
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8/14/2019 Accredited Social Health Activist (ASHA)
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Accredited Social Health Activist(ASHA)
State Institute of Health & Family Welfare, Jaipur
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SIHFW: an ISO9001: 2008 certified institution 2
ASHA
Accredited Recognized by the community
Social From the community, By the community and For the community
Health Activist Spreading awareness for health concerns Promoting change in health related practices
•
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SIHFW: an ISO9001: 2008 certified institution 3
ASHA
ØCommunity based functionaryØ
ØFirst contact level for Community for Health
Ø
ØChange agent on health in a village
•
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SIHFW: an ISO9001: 2008 certified institution 4
ASHA-Sahyogini: Convergence broughtin
ØConvergence of ICDS and health Dept.
ØSahyogini as 3rd worker at AWC already existed
before NRHMØ
ØTo avoid Duplication- Sahyogini taken as ASHAØ
ØNomenclature devised as ASHA-Sahyogini
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SIHFW: an ISO9001: 2008 certified institution 5
ASHA-Sahyogini: Selection
ØListing of interested and eligible women byANM and LS
Ø
ØPanel of three namesØ
ØApproval through Gram Sabha- Communityempowerment)
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SIHFW: an ISO9001: 2008 certified institution 6
ASHA-Sahyogini: SelectionEligibility
Ø Intensive mobilization to get active ASHA-Sahyogini
Ø
ØAny woman can not be the ASHA-SahyoginiØ
ØCombinations of eligible criteriaØ
ØAge- 21years to 45 yearsØ
ØQualification- 8th
PassMinimum
(relaxation for tribal and desert areas)
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SIHFW: an ISO9001: 2008 certified institution 7
ØØStatus-Ø
ØMarried/divorcee/separatedØ
ØMust be ‘BAHU’ of the commuØ
ØResident of the villageØ
ØActive/Vocal/leadership qualities
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SIHFW: an ISO9001: 2008 certified institution 8
ASHA-Sahyogini: Trainings
Phase Days
1st 6 days
2nd 4 days
3rd 4 days
4th 5 days
5th 4 days
GOI norms- 23 days and 5 phases
( + + + )4 ro u n d s o f 2 3 d a y s 1 0 4 5 4 d ay s Pre se n tly 3 rd phase rolled out
DTT for 15 days integrated training for
( . )fresh ASHAs started Oct 2009
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SIHFW: an ISO9001: 2008 certified institution 9
ASHA-Sahyogini: Trainings
State Training Team
District Trainer Team(DTT)
Block Trainers Team
(BTT)
NIHFW
SIHFW
DTT
ASHA-Sahyoginis BTT & NGOS
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SIHFW: an ISO9001: 2008 certified institution 10
Support Structure
ØASHA mentoring group State LevelØASHA Resource centre Earlier at
SIHFW, nowat SPMU
Ø Joint Strengthening Committee
At State level- ACS/PHS/SecretariesAt District level- CMHO/DD-ICDSAt Block level- BCMO/ CDPOAt PHC level- MO/LHV/LS/ANM
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SIHFW: an ISO9001: 2008 certified institution 11
Monitoring
ØPHC level monthly meetingsØReview of ASHAs work
ØCollection and compilation of
reportsØIncentive payments to ASHAs
Ø
ØMCHN monitoring by external
agencyØ
ØMonthly reports from districts
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SIHFW: an ISO9001: 2008 certified institution 12
Monitoring Indicators for ASHAs
Institutionaldeliveries
5 Deliveries per year ( 80%of total deliveries should beescorted by ASHAs)
SocialMobilization
80% beneficiaries (ANC &children) of the due list shouldbe mobilized for MCHN day
Sterilization 1 case per month
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SIHFW: an ISO9001: 2008 certified institution 13
Reporting System for ASHA
ØForm no. 6-9:- Deliveries escorted byASHAs
ØNRHM formats:- NO. of ASHAs, training,monthly meetings,performance, integrated packageetc.
Ø CHC monitoring:- Deliveries escorted byASHAs Sterilization
motivated by ASHAs
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SIHFW: an ISO9001: 2008 certified institution 14
Integrated Compensation
One time honorarium Amount(Rs.)
Monthly meeting 100
Social mobilization for MCHN day 150
Organizing monthly VHSC meeting 100
Bi-monthly conduction of meeting for adolescent girls
100
Total to be paid by NRHM 450Amount to be paid by WCD after attending monthly meeting at PHC
500
Total 950
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SIHFW: an ISO9001: 2008 certified institution 15
Performance Based Compensation
Activity Amount(Rs.)
JSY 400+100+100 600
Sterilization 200,150
DOTS 250
Cataract 175
Toilet construction 60
RT to Malaria cases 50
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SIHFW: an ISO9001: 2008 certified institution 16
Work Load for ASHA for 1000 PopBeneficiary category Expected number in an Year
Pregnant women 30-31Out of which 4-5 may havecomplications50% shall have anemia
New Borne 27-28
Children in 0-1 Year 30 ( 3 % of the population)
Children 1-5 years 130, (13 % of Population
Eligible couples 16-17% (15-45 years)
Eligible for Vasectomy/Tubectomy
5-7% of Eligible couples
Eligible for spacing Methods 11-12% of Eligible couples
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SIHFW: an ISO9001: 2008 certified institution 17
Palpable Impact: Increase in
ØANC registration in first trimester Ø Institutional DeliveriesØ Immunization – full immunization
ØNo. of SterilizationØPracticesØBreast feeding practicesØHealth seeking behavior
ØReferralØCommunity involvement –VHC/MCHN
1.
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SIHFW: an ISO9001: 2008 certified institution 18
Factors Critical to Success of ASHA
ØSelection of ASHA by prescribed process as per the ASHA guidelines
Ø
Ø Linkage with nearest functional health facility for
referral servicesØ
Ø Identified transport for referral of cases fromvillage to facility
Ø
ØPriority and recognition of cases referred byASHA to MO / ANM
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SIHFW: an ISO9001: 2008 certified institution 19
ØSuccessful organization of monthly Health andNutrition Day (in every village with theANM/AWW)
Ø
ØMonthly meeting of ASHA at PHCØ
ØTimely payment of incentives to ASHAØ
ØTimely replenishment of ASHA kit
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Role of DACs
ØCreate database of ASHAØLiaise with district level stakeholders for
mobilizing support
ØSupervision and monitoring of the ASHAs, NGOsand Block ASHA facilitators and PHC ASHA
Supervisors
ØAttend ASHA meetings at block and PHC
ØPrepare annual training plan of ASHA for differentrounds
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SIHFW: an ISO9001: 2008 certified institution 21
ØCompilation of monthly report with the help of DataAssistant of DPMU.
ØDissemination of guidelines related to ASHA to allfunctionaries at different levels.
ØFollow up with Block ASHA facilitators/ BPMs onthe progress of assigned job
ØMonitor timely payments of ASHAs
ØMonitor physical and financial progress of thecomponent.
ØField visits
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Role of DPM
ØDevelop annual plan for selection and trainingfor ASHA
ØDrafting of annual targets for CHC-PHC wiseASHA to achieve the health targets of Districtlike; sterilization, institutional deliveries and
immunization etc.ØEnsure adoption and implementation of plan and
fund flow at local level
ØSupport District ASHA Coordinator in developing
localised implementation plansØMonitor physical and financial progress of the
component
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SIHFW: an ISO9001: 2008 certified institution 23
Collective Role of DACs/ DPMs
ØReporting – timely and properlyØ
ØHand holding support to ASHAsØ
ØTimely payments to ASHA-SahyoginiØ
ØRegular monthly meetings at PHC/CHCØ
Ø Identification of non-performing ASHAs
Ø
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SIHFW: an ISO9001: 2008 certified institution 24
Programmatic Check List
ØWhether ASHA monthly meetings at PHC/CHCare being organized or not
Ø
ØDoes every institution is organizing it or notØ
ØHow many ASHAs are regularly attending themeeting?
Ø
ØAre ASHAs getting their incentives as per activities
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SIHFW: an ISO9001: 2008 certified institution 25
Measures of Effectiveness
Ø% of newborns who were visited thrice infirst week including once in first day
Ø
Ø% of ASHAs who received more than 20visits for common illnesses per month
Ø
Ø% of ASHAs who have referred all ( or atleast half ) their pregnant women for
institutional delivery
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SHA at her house
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ASHA with a mother
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How to use ORS
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In the
….discussion
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ASHA at Work
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Convening VHC Meeting