On May 22, the World Health Organization (WHO) recognised India’s all-women Accredited Social Health Activist (ASHA) workers as ‘Global Health Leaders’. This honour was given to the 1M women workers and volunteers for doing a commendable job in bridging the gap between India’s women and the government’s health care system. In fact, their dedication to the community especially during the Covid-19 pandemic.
Starting off, the ASHA programme was supposed to be based on the successful Mitanin programme of Chandigarh wherein a Community Worker looked after 50 households. Initially, ASHA was supposed to a local resident that looked after not more than 200 households.
But the government-led programme did exceptionally well during the stage-wise development of capacity in certain areas of public health. And this success was also engineered by the support of Dr T Sundararaman, Dr Rajani Ved, and many others who supported the programme.
After seeing the success of the programme, many states also tried to incrementally develop the ASHA from a Community Worker to a Community Health Worker, an Auxiliary Nurse Midwife (ANM)/ General Nurse and Midwife (GNM), or a Public Health Nurse.
The programme preached and helped spread awareness about important public policy and public management. These lessons were taught by Community Workers that did not belong to the government but rather by the members of the community – who were paid for their services. The basic idea of ASHA was to make the women part of the village community and not just a government employees.
98% of women workers and volunteers of ASHA reside in the village and know every household. These women were selected on the basis of how resourceful they are, what stature they have in the community, and even their educational qualifications were looked at. Blend this along with their new skills in health care and the ability to connect numerous households to health facilities, the women were now able to secure many benefits for the households.
In many states of India, ASHA workers are completely involved in many national health programmes and also in the response to a range of communicable and non-communicable diseases. They play a crucial role in house-to-house surveys, vaccination, public health and Reproductive and Child Health measures.
As time went by, the skill sets of the ASHA workers improved and along the way they got recognised and were respected for their work. In a way, the programme not only helped connect the community to the government’s health care system but also gave a local woman the opportunity to become a skilled health worker.
There’s no doubt that the ASHA workers and the programme have been doing extremely well, but that is after facing a range of challenges. In fact, there are still many challenges that they are fighting – like the issue of compensation (they get performance-based payments and do not have a fixed salary).