ASHA Sahyogini intervention in Rajasthan by Vaidehi Agnihotri

ASHA Sahyogini intervention in Rajasthan by Vaidehi Agnihotri

ASHA Sahyogini • Key component of NRHM • ASHA-Accredited Social Health Activist • Selected from the Village through Gram Sabha and accountable to the community • Interface between community and public health system.

Why ASHA Sahyogini • At present ANM is placed on the population of 3000 – 5000 • Covering 3 -5 villages and distance problem • Difficulty in providing services at door steps • On Other hand – Anganwadi is on the population of 1000 • Anganwadi worker and Sahayika is placed at AWC -limits them to provide services • So to fill up the gap, role of Accredited Social health Activist becomes critical

Overview • ASHA – Sahyogini , a joint HFW- DWCD Initiative • 46, 000 estimated in 2006 -2007 • 42000 Rural under NRHM 4000 Urban RCH • 40, 000 villages. 30, 000 ASHA sahyoginis in place • New selection started in AUG 2006 • Training under NRHM and Extra 7 -17 days training by DWCD

Training • ASHA Resource book, Facilitators Guide Developed at state level, based on GOI modules • NGOs selected for training for each block NGOs Selection by committee at district level headed by Collector • Allocation of of Rs. 5 Crore to the districts • State, District, Block level trainers team developed • Actual ASHA Training at block level

Monitoring of training • Monitoring tools Developed • Modalities developed to monitor each training by at least 2 officers • State level monitors visited Selected trainings • ARC to compile monitoring formats and develop future strategy for training

ASHA Mentoring Group Constituted to ØOversee implementation ØFacilitate in Development of Policy guidelines ØProvide Technical inputs & Support Mechanism ØAct as think tank ØFacilitate intersectoral coordination

ASHA Resource Center • SRC -Selected through Competitive bidding • Budget of Rs. 22 Lakhs per annum • For implementation, supervision, technical inputs, trainings, data collection and processing, IEC, concurrent evaluation, involvement of NGOs/Community/Other Departments

ASHA Sahyogini Compensation • ASHA Sahyogini will get fixed honorarium from DWCD i. e. Rs. 500/ • She will also get performance based incentive worked out from different Schemes. • Compensation package is Rs. 1067/- (If she works as per expectation)

Linkages Of ASHA Sahyogini AWW af AWC ANM MO Af SC, PHC NGO ASHASahyogini Education, , PHED, RD MSS, SHG Gramsabha grampanchayat

Supporting Mechanism for ASHA Sahyogini • ASHA mentoring group State level SPMU State • District Health Mission • DPMU • ICDS (Dy Director). District §Block Medical Officer §ICDS CDPO Block PHC • PHC • Medical Officer • ASHA Facilitators • LHV • ANM • SHG • AWW • ANM • Village Health & Sanitation Committee PHC Sub Center Village • By Monthly Review • Periodic surveys Assessment of Progress • of ASHA Scheme • Bi monthly Meetings • Periodic Trainings/ Monthly Meetings • Replenishment of ASHA Kit • Incentive Payment • Meetings • Referral Records • Incentive Payment • Village Health Survey • Helping ANM in maintaining Village Health Register • Member VHSC • Developing VHP • Organizing MCHN Days • Referral Records

Role Of NGOs NGO workshop organized. Role of NGOs identified • Facilitator role in Selection • Conducting Trainings • Mentoring and Monitoring • Facilitation in ensuring timely payments of incentives • Facilitation in interdepartmental Coordination

STEPS AHEAD • Joint Selection of about 16000 ASHA Sahyoginis • Trainings of 46000 ASHA Sahyoginis – in 5 roundsa tough task Long term process • Conducting monthly/ bimonthly meeting • Identification of Block facilitator, cluster facilitator and their capacity building • Giving identity to ASHA Sahyogini – provision of I/cards

STEPS AHEAD • Streamlining the system of incentive payments - Multiple source • Record keeping for activity based incentive • Identification of NGOs Role and involvement of NGOs in the programme • Provision of Drug Kit and ensuring regular inventory control • Household surveys

Factors Critical to the success of ASHA Sahyogini • Selection of proper candidate for ASHA Sayogini. Acceptance of ASHA Sahyogini by community • Linkages with nearest functional health facility for referral services • Identified transport for referral of cases from village to facility • Priority and recognition of cases referred by ASHA Sahyogini to MO/ANM • Timely payment of incentives • Timely replenishment of ASHA Kit • Monthly meeting of ASHA Sahyogini at PHC • Successful organization of MCHN Days

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