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

• 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

Training

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

ASHA Mentoring Group Constituted toOversee implementationFacilitate in Development of Policy

guidelinesProvide Technical inputs & Support

MechanismAct as think tankFacilitate 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

Education,,PHED,

RDMSS, SHG

AWW af AWC

ASHASahyo-gini

ANMMO

Af SC,PHC

Gramsabhagrampanchayat

NGO

Supporting Mechanism for ASHA Sahyogini

•ASHA mentoring group State level SPMU

•SHG•AWW •ANM •Village Health & Sanitation Committee

•District Health Mission•DPMU•ICDS (Dy Director).

Block Medical OfficerICDS CDPO

•PHC•Medical Officer•ASHA Facilitators•LHV

•ANM

•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

State

District

Block PHC

PHC

Sub Center

Village

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 rounds-

a tough taskLong 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

Thank you