Can be viewed at www.sihfwrajasthan.com

1. Accredited Social Health Activist
(ASHA)
State Institute of Health & Family Welfare, Jaipur

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
SIHFW: an ISO 9001:2008 certified Institution 2

3. ASHA
Ø Community based functionary
Ø First contact level for Community for
Health
Ø Change agent on health in a village
SIHFW: an ISO 9001:2008 certified Institution 3

4. ASHA-Sahyogini: Convergence
brought in
Ø Convergence of ICDS and Health Dept.
Ø Sahyogini as 3rd worker at AWC already
existed before NRHM
Ø To avoid Duplication- Sahyogini taken as
ASHA (in Rajasthan)
Ø Nomenclature devised as ASHA-Sahyogini
SIHFW: an ISO 9001:2008 certified Institution 4

5. ASHA-Sahyogini: Selection
Ø Listing of interested and eligible women by ANM
and LS
Ø Panel of three names
Ø Approval through Gram Sabah- Community
empowerment)
SIHFW: an ISO 9001:2008 certified Institution 5

6. ASHA-Sahyogini: selection
Eligibility
Ø Intensive mobilization to get active ASHA-
Sahyogini.
Ø Any woman can not be the ASHA-Sahyogini.
Ø Age- 21years to 45 years
Ø Qualification- 8th Pass Minimum (relaxation for
tribal and desert areas)
Ø Married/divorcee/separated
Ø Must be ‘BAHU’ of the community
Ø Resident of the village
Ø Active/Vocal/leadership qualities
SIHFW: an ISO 9001:2008 certified Institution 6

7. ASHA-Sahyogini: Trainings
GOI norms- 23 days and 5 phases
Phase Days
1st 6 days
2nd 4 days
3rd 4 days
4th 5 days
5th 4 days
SIHFW: an ISO 9001:2008 certified Institution 7

8. Ø 4 rounds of 23 days (10+ 4+5+4 days)
Ø Presently 3rd phase rolled out
Ø DTT for 15 days integrated training for fresh
ASHAs started (Oct. 2009)
SIHFW: an ISO 9001:2008 certified Institution 8

9. ASHA-Sahyogini : Trainings
State Training Team NIHFW
District Trainer Team (DTT) SIHFW
Block Trainers Team (BTT) DTT
ASHA-Sahyoginis BTT & NGOS
SIHFW: an ISO 9001:2008 certified Institution 9

10. Support structure
Ø ASHA mentoring group State Level
Ø ASHA Resource centre Earlier at
SIHFW, now
at SPMU
Ø Joint Strengthening Committee
ØAt State level- ACS/PHS/Secretaries
ØAt District level- CMHO/DD-ICDS
ØAt Block level- BCMO/ CDPO
ØAt PHC level- MO/LHV/LS/ANM
SIHFW: an ISO 9001:2008 certified Institution 10

11. Monitoring
Ø PHC level monthly meetings
ØReview of ASHAs work
ØCollection and compilation of reports
ØIncentive payments to ASHAs
Ø MCHN monitoring by external agency
Ø Monthly reports from districts
SIHFW: an ISO 9001:2008 certified Institution 11

12. Monitoring indicators for ASHAs
Institutional 5 Deliveries per year ( 80%
deliveries of total deliveries should be
escorted by ASHAs)
Social 80% beneficiaries (ANC &
Mobilization children) of the due list
should be mobilized for
MCHN day.
Sterilization 1 case per month.
SIHFW: an ISO 9001:2008 certified Institution 12

13. Reporting system for ASHA
Ø Form no. 6-9:- Deliveries escorted by ASHAs
Ø NRHM formats:- No. of ASHAs, training,
monthly meetings,
performance, integrated
package etc.
Ø CHC monitoring:- Deliveries escorted by ASHA,s
Sterilization motivated by
ASHAs
SIHFW: an ISO 9001:2008 certified Institution 13

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 100
adolescent girls
Total to be paid by NRHM 450
Amount to be paid by WCD after 500
attending monthly meeting at PHC
Total 950
SIHFW: an ISO 9001:2008 certified Institution 14

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
SIHFW: an ISO 9001:2008 certified Institution 15

16. Work load: ASHA (1000 Pop.)
Beneficiary category Expected number in an Year
Pregnant women 30-31
· Out of which 4-5 may have
complications
· 50% 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/ 5-7% of Eligible couples
Tubectomy
Eligible for spacing Methods 11-12% of Eligible couples
SIHFW: an ISO 9001:2008 certified Institution 16

17. Palpable Impact: Increase in
Ø ANC registration in first trimester
Ø Institutional Deliveries – 80.7% in Govt. hospitals
(31.12.09) (45.5%-DLHS 3)
Ø Immunization – full immunization (Source: rajmedical)
Ø OPV3: 67.73;
Ø DPT3:68.08;
Ø BCG:71.15;
Ø Measles:69.02
Ø No. of Sterilization
Ø Practices
Ø Breast feeding practices
Ø Health seeking behavior
Ø Referral
Ø Community involvement –VHC/MCHN
SIHFW: an ISO 9001:2008 certified Institution 17

18. Factors critical to success of ASHA
Ø Selection of ASHA by prescribed
process as per the ASHA guidelines.
Ø Linkage with nearest functional health
facility for referral services.
Ø Identified transport for referral of cases
from village to facility .
SIHFW: an ISO 9001:2008 certified Institution 18

19. Ø Successful organization of monthly Health
and Nutrition Day (in every village with the
ANM / AWW)
Ø Monthly meeting of ASHA at PHC.
Ø Timely payment of incentives to ASHA.
Ø Timely replenishment of ASHA kit
Ø Priority and recognition of cases referred by
ASHA to MO / ANM
SIHFW: an ISO 9001:2008 certified Institution 19

20. Role of DACs
Ø Create database of ASHA.
Ø Liaise with district level stakeholders for mobilizing
support
Ø Supervision and monitoring of the ASHAs, NGOs
and Block ASHA facilitators and PHC ASHA
Supervisors.
Ø Attend ASHA meetings at block and PHC.
Ø Prepare annual training plan of ASHA for different
rounds.
SIHFW: an ISO 9001:2008 certified Institution 20

21. Ø Compilation of monthly report with the help of Data
Assistant of DPMU.
Ø Dissemination of guidelines related to ASHA to all
functionaries at different levels.
Ø Follow up with Block ASHA facilitators/ BPMs on
the progress of assigned job.
Ø Monitor timely payments of ASHAs
Ø Monitor physical and financial progress of the
component.
Ø Field visits
SIHFW: an ISO 9001:2008 certified Institution 21

22. Role of DPM
Ø Develop annual plan for selection and
training for ASHA
Ø Drafting of annual targets for ASHA, CHC-
PHC (sterilization, ID & immunization)
SIHFW: an ISO 9001:2008 certified Institution 22

23. Ø Support District ASHA Coordinator in
developing localised implementation plans.
Ø Monitor physical and financial progress of
the component.
Ø Ensure adoption and implementation of
plan and fund flow at local level.
SIHFW: an ISO 9001:2008 certified Institution 23

24. Collective Role of DACs/ DPMs
Ø Reporting – timely and properly
Ø Hand holding support to ASHAs
Ø Timely payments to ASHA-Sahyogini
Ø Regular monthly meetings at PHC/CHC
Ø Identification of non-performing ASHAs
SIHFW: an ISO 9001:2008 certified Institution 24

25. Programmatic Check List
Ø Whether ASHA monthly meetings at PHC/CHC are
being organized or not
Ø Does every institution organizes it
Ø No. of ASHAs are regularly attending the meeting
Ø Are ASHAs getting their incentives as per activities
SIHFW: an ISO 9001:2008 certified Institution 25

26. Measures of effectiveness
Ø % of newborns who were visited thrice in
first week including once on first day
Ø % of ASHAs who received more than 20
visits for common illnesses per month
Ø % of ASHAs who have referred all ( or at
least half ) their pregnant women for
institutional delivery
SIHFW: an ISO 9001:2008 certified Institution 26

27. Thank You
For more details log on to
www. sihfwrajasthan.com
or
contact : Director-SIHFW on
sihfwraj@yahoo.co.in