Asha workers in rural India

ASHAs or Accredited social health activists are community health workers in India who are local women of a community who are trained to act as heath educators and promoters in their communities. they are female volunteers who are selected by the community, deployed in their own village after a short training programme. 

An ASHA is preferred to be between 25 and 42 years old, with a minimum of formal education of 8 years. She should be able to demonstrate leadership qualities. ASHAs do not get any salaries but they do receive activity based incentives.

The MoHFW (India's Ministry of Heath and Family Welfare) describes them as 

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...health activist(s) in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services.

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Their responsibilities include health education in the community to the diagnosis of health conditions.

ASHA's Responsibilities

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Roles and Responsibilities of ASHA Sahayogini (ASHA HELPER)

           - Create awareness

Health, Nutrition, basic sanitation, hygienic practices, healthy living and working conditions, information on existing  health services and need for timely utilization of health, nutrition and family welfare services  

-Counseling

 Birth preparedness, importance of safe and institutional delivery, breast-feeding, immunization, contraception, prevention of RTI/STI. Nutrition and other health issues.

     - Mobilization

      Facilitate to access and avail the health services available in the      public health system at Anganwadi Centers, Sub Center, PHC ,          CHC and district hospitals.

     - Village health plan

    Work with the village Health and sanitation Committee to               develop the village health plan

     - Escorts/ Accompany

     Escorts the needy patients to the institution for care and                treatment. She will accompany the woman in labor to                      the institution    and promote institutional delivery

     -Provision of Primary Medical Health Care

    Minor ailments such as fever, first aid for minor injuries, diarrhea.      A drug kit will be provided to ASHA

    - Provider for DOTS

    - Depot Holder ORS, IFA, DDK, chloroquine, oral pills and                    condoms

    - Care of new born and management of a range of common                 ailments
    - Inform Births, deaths and unusual health problem or disease out       break

    - Promote Construction of household toilets

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My opinion:

In my opinion the ASHA Sahayogini is one of the key parts of the healthcare system in India. As the country is so vast, it is often difficult for the government health services to reach all corners of the country and to every small community there is. The aim is to have at least one Sahayogini per 1000 members of the community, which would greatly help in education people on the different diseases, infections and other health conditions and teach about sanitation and the importance of keeping healthy and clean. 

A report written by Saji Saraswathy Gopalan, Satyanarayan Mohanty, Ashis Das in the British Medical Journal (http://bmjopen.bmj.com/content/2/5/e001557.long), shows that the service not onoutlines the "performance motivation" of the community health workers (CHWs). It concludes that "the CHW program could motivate and empower local lay women on community health largely. The desire to gain social recognition, a sense of social responsibility and self-efficacy motivated them to perform"

In my opinion the service not only provides an easier pathway for reaching all the smaller communities in the vast country but also an effective way for the national government of India to gain feedback from the people about the running of the nation's health service and further keep a tab on the birth/death rates, spread of any health conditions etc. This would really help in the control and prevention of the spread of any epidemics and also help focus specific help to specific places. For instance, if a particular community was highly susceptible to a particular type of illness, the local or state government could focus on providing specific prevention and cure for that disease and focus on funding this. This way, the community would be hugely helped and also the money would be spent efficiently, reducing waste for the community.