One of the key parts of the National Rural Health Mission is to produce each village within the country with a trained feminine community health activist ASHA or authorised Social Health Activist. selected from the village itself and responsible thereto, the ASHA are going to be trained to figure as associate interface between the community and also the public health system.

Following are the key components of ASHA:

  • ASHA should primarily be a lady resident of the village married/ widowed/ unmarried , ideally within the cohort of twenty five to forty five years.She ought to be a literate girl with formal education up to category eight. this could be relaxed as long as no appropriate person with this qualification is obtainable.ASHA are going to be chosen through a rigorous method of choice involving numerous community teams.ASHA can have to be compelled to endure series of coaching episodes to amass the mandatory data, skills and confidence for acting her spelled out roles.The ASHAs can receive performance-based incentives. sceptred with data and a drug-kit to deliver first-contact tending, each ASHA is anticipated to be a fountainhead of community participation publically health programmes in her village.ASHA are going to be the primary port of imply any health connected demands of disadvantaged sections of the population.ASHA are going to be a health activist within the community World Health Organization can produce awareness on health and its social determinants and mobilise the community towards native health coming up with and enlarged activity and responsibleness of the present health services.She would be a promoter of fine health practices and create timely referrals.She will counsel ladies on birth readiness, importance of safe delivery, breast-feeding and complementary feeding, protection, contraceptive method|family planning} and prevention of common infections together with generative Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young kid.ASHA can mobilise the community and facilitate them in accessing health and health connected services obtainable at the Anganwadi/sub-centre/primary health centers.She will act as a depot holder for essential provisions being created obtainable to all or any habitations like Oral Rehydration medical care (ORS), Iron folacin Tablet(IFA), antimalarial drug, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc.ASHA cannot perform while not adequate institutional support. Women's committees like assistance teams, village Health & Sanitation Committee of the Gram punchayet, ANMs and Anganwadi staff, and therefore the trainers of ASHA would be a serious supply of support to ASHA.

ASHA: The Haryana Scenario

  • 16506 ASHAs (out of targeted 18008) hand-picked and positioned upto August, 2013.Induction coaching completed for all ASHAs.All ASHAs having Bank Accounts.12000 ASHAs received Uniform (Coat).11833 ASHAs having Drug Kits.ASHAs being given Nischay Kits.ASHAs attending monthly conferences at PHCs.Incentive payment on to their bank accounts out of accessible fund.Best activity ASHAs square measure chosen at district level and awarded in quarterly award ceremony.State ASHA Resource Centre is established at State level.21 District ASHA Coordinators and 119 Block ASHA Coordinators for supporting ASHA programme at Block and District level.ASHA Grievance Redressal Committee set up in several districts.ASHA Grievance Redressal Cells framed at State, District and Block level.Toll free ASHA Helpline established at State military headquarters.CUG mobile numbers are provided to ASHAs throughout the State.Best activity ASHA is chosen as ASHA helper at every PHC.
ASHA: The Synergy Factor

The Importance of ASHA is being more and more understood. ASHA has vie a chemical change role in generating village based mostly problems at larger level through completely different platforms. The interaction created by ASHA with completely different levels may be shown as below:-

Selection of ASHA:-

    • One ASHA per a thousand population.ASHA is primary resident of village with formal education up to category eighth.Age group of 20-45 years.She ought to be married/divorced/widow girls.

Selection Procedure :-

    • As per tips, Gramsabha or VHNSC can suggest names of appropriate candidates to the medical practitioner Incharge.A committee comprising of medical practitioner Incharge, Block ASHA organizer, ANM and Sarpanch of village can choose one girl as ASHA amongst these shortlisted candidates.Appointment letter of ASHA are issued by medical practitioner Incharge.

Support Mechanism of ASHA:-

    • One District ASHA arranger for one district.One Block ASHA arranger at CHC Level.One ASHA supporter per PHC.State ASHA Resource Center (SARC).State, District & Block Mentoring Committees area unit being recognized for supporting ASHAs.

ASHA Facilitator

Criteria for selection

  • One ASHA supporter for every PHC. ASHA supporter ought to have effective communication skills, leadership qualities and be able to reach dead set the community. Best playing ASHA within the space is chosen as ASHA supporter.

Roles and Responsibilities of ASHA Facilitator

  • Supervision of ASHAs in space below PHC.Provide on job coaching to weak/new ASHAs.Facilitate ASHAs in filling their self appraisal forms for incentive.Help ASHA for motivating marginalised community.Help in renewal of drug kits. Organize cluster conferences of ASHAs. facilitate in VHSNC & VHND activities.

Capacity building of ASHA is important in enhancing her effectiveness. it's been envisaged that coaching can facilitate to equip her with necessary data and skills. coaching of ASHA assistant may be a continuous method.

State ASHA Resource Center for providing support to ASHA Programme :
ASHA is at the bottom of NHM pyramid and National  Health Mission is staring at ASHA as a amendment agent in Health Sector Reform. she's going to play a significant role in rising the health indicators of the State particularly IMR and MMR. therefore it's vital to supply technical inputs and powerful supportive mechanism to the programme so expected results are often achieved. State Project Management Unit is established at state level beneath Director NHM and is functioning as a technical and unit to implement the activities of NHM within the State. State ASHA Resource Center (SARC) is conceptualized to boost the standard of ASHA programme and is established at state level that work beneath direction of Mission Director of NHM
Functions of State ASHA Resource Center-

  1. Technical backstopping in coaching - SARC can develop user friendly coaching methodology and therefore the coaching modules, print the modules in prescribed time, and pass around the modules within the District. Development of IEC material - SARC are going to be answerable for developing or assembling the IEC material together with flip books, charts, posters etc on totally different connected problems. would like primarily based IEC material are going to be developed from time to time. Development of news formats and registers - ASHA is envisaged as a voluntary employee and to facilitate her work some terribly simple and basic news formats and registers are going to be developed by SARC. process of applied math knowledge and records- On the premise of reports and registers of ASHA and different sources of data’s. SARC can compile the applied math knowledge, analyze the information and supply the feedback of the programme to the Mission. Intersectoral Coordination concerning ASHA- The credibleness of ASHA within the community may well be utilized by different Development Departments to market their objectives. SARC can coordinate with totally different departments and facilitate empanelment of ASHAs in numerous different programmes. Involving NGOs to strengthen the programme- Involvement of NGOs is a crucial task within the implementation of ASHA programme. NGOs may support the ASHA to figure at community level. In consultation of NHM the NGOs ought to be concerned within the programme. Provision of Drug Kits- ASHA can offer the fundamental medical aid to the community. The drug kit with basic medicines and provides area unit provided to all or any the ASHAs below NHM. The drug Kit contains medicines and contraceptives. Provision of services of Helpline – A Tollfree helpline has been started at State HQ to influence ASHAs Grievances. Team of centre at HQ at random decision ASHAs to enquire concerning the payment standing, drug kits renewal and different relevant matters. SARC ensures that the prompt assistance is provided to ASHA. Organizing ASHA Sammelan- there'll be Sammelans at District level to share the experiences of ASHA and for cross learning’s. SARC organizes such events with the assistance of District Health Society.

Village Health Sanitation & Nutrition Committee

 National Health Mission envisages the community to require leadership at native level, associated with health and its connected problems. it'll be attainable only if the community is sufficiently authorized to require leadership in health matters. Clearly, it needs involvement of Panchayati rule establishments within the management of the health system. this might be attainable if a committee is made in every village below the spot of Gram panchayet member and representative from the community like women's cluster, and SC/ST/OBC / minority communities etc. Hence, for the event of each village, Village Health Sanitation & Nutrition Committee has been shaped by providing untied grant for village level activities.

A. Role of the VHSNC

 The VHSNC are answerable for the health of the village. it'll take into thought the issues of the community and therefore the health and nutrition care suppliers and counsel mechanism to unravel it. 2. it'll produce public awareness regarding the necessities of health programmes, with concentrate on people's information of entitlements to modify their involvement within the watching. 3. it'll discuss associate degreed develop a village health arrange supported an assessment of the village state of affairs and priorities known by the village community. 4. Analyze key problems and issues associated with village level health and nutrition activities, offer feedback on these to the medical practitioner of the PHC. 5. The committee can monitor all the health activities that square measure conducted within the village like Village Health & Nutrition Day, mothers meeting etc. 6. VHSNC together with the ANM are accountable to conduct house survey within the village. 7. it'll maintain village health register and therefore the health info board which can have info regarding the mandated services within the Sub Centre/PHC. 8. it'll make sure that the ANM visit the village on the fastened days and perform the stipulated activity as per the Sub Centre workplan; superintend the village health and nutrition functionaries. 9. ANM can submit a metallic element monthly village report back to the committee together with the arrange for next 2 months. Formats and contents would be determined by the village health committee. Discuss the report submitted by ANM within the village level meeting and take acceptable action. 10. it'll discuss each maternal or death that happens in their village, analyze it and counsel necessary action to forestall such deaths. Get these deaths registered within the punchayet. 11. The committee can organize regular monthly meeting to debate varied problems within the village and document the minutes of the meeting. The committee shall make sure that Public Dialogue is organized at regular intervals (once in six month) within the presence of medical practitioner of the first Health Care Centre. The committee shall make sure that all the problems mentioned square measure recorded and action taken on the problems mentioned. 12. The VHSNC also will play important role for choosing and supporting the ASHA from the community apart from health connected problems VHSNC also will be answerable for the event of the village. 13. The VHSNC also will beware of the Sub Centre. 14. The VHSNC are accountable to tell the community regarding all the govt schemes.

B. Utilization of the Untied Grant

 1. The untied grant may be a resource for community action at the native level.

 2. The committee ought to utilize the fund when taking resolution within the VHSNC monthly meeting.

3.The committee can't withdraw the entire quantity of Rs. 10,000/- at one go.

4. The fund is used for village level activities like cleanliness and sanitation drive, college health activities, building transport communication link for transferring the patient to health facilities, health awareness activities, house hold surveys, rising the facilities of the Anganwadi Centre and the other organic process activities for the village/community.

5. throughout emergency like flood or any epidemic the committee can utilize the fund for the relief camps or provides like grouping pill for purification of water, ORS, bleach etc.

 6. The committee will utilize the fund for creating construction within the installation of VHSNC.

C. Maintenance of Funds
1.The committee is entitled for annual grant of Rs. 10,000 for village level activities.

2. The VHSNC shall maintain a register of funds received and expenditure incurred.

 3. The committee ought to manage the village health fund for varied health activities.

4. The committee ought to maintain accounts and timely submit the use certificate and statement of expenditure for the money received to the first Health Centre.

D. Maintenance of Registers
1. Village Health Register
2. Birth & Death Register
3. Public Dialogue Register
4. Referral Register
5. Untied Grant Register

Village Health Nutrition Day

The VHND is to be organized once monthly (preferably on Wednesdays, and for those villages that are ignored, on the other day of a similar month) at the AWC within the village. VHND is additionally to be seen as a platform for interfacing between the community and therefore the health system. On the appointed day, ASHAs, AWWs, and alternative can mobilize the villagers, particularly ladies and kids,to assemble at the closest AWC. On the VHND, the villagers will move freely with the health personnel and procure basic services and data. they will conjointly find out about the preventive and encouraging aspects of health care, which can encourage them to hunt health care at correct facilities. Following problems is mentioned on the day of VHND.

Maternal Health

 • Early registration of pregnancies.
 • targeted ANC.
 • Referral for ladies with signs of complications throughout maternity and people would like emergency care.
• Referral for safe abortion to approved MTP centres.
• direction on: one.
1.Education of ladies.
2. Age at wedding.
3. Care throughout maternity.
4. Danger signs throughout maternity.
5. Birth readiness.
6. Importance of nutrition.
7. Institutional delivery.
8. Identification of referral transport.
9. accessibility of funds beneath the JSY for referral transport.
10. Post-natal care.
11. Breastfeeding and complementary feeding.
12. Care of a newborn.
13. birth control. • Organizing cluster discussions on maternal deaths, if any, that have occurred throughout the previous month so as to spot and analyse the doable causes.

• Avoidance of breeding sites for mosquitoes.
• Mobilization of community action for safe disposal of home refuse and garbage.

• Diseases as a result of biological process deficiencies are often prevented by giving data and message on:
1. Healthy food habits.
2. healthful and proper cookery practices.
3.Checking for anaemia, particularly in adolescent women and pregnant women; checking, advising, and referring.
4.deliberation of infants and kids.
5. Importance of iron supplements, vitamins, and micronutrients
6. Food that may be adult domestically.
7. target adolescent, pregnant girls and infants aged half dozen months to two years.

Grievance Redressal Mechanism

  1. ASHA Help table has been created at each Block CHC level. MO I/c, LHV, PHN are created In-charge at each Block/CHC to redress the problems raised by ASHAs ASHA Helpline No 8288014141 has been established at the top Quarter to possess grievance from across the State, between 9:00 AM to 5:00 PM. Records of proceedings of ASHAs Grievance & Redressal are started maintaining at every level. Names and phone numbers of ASHA Grievance table are notified to every and each ASHA. the method of the ASHA Grievance Redressal Committees has been initiated at each district.

List of Drugs being provided in ASHA Kit

Sr. No.

Name of contents


Tab. Iron Folic Acid (L)


ORS Packets


Tab. Paracetamol


Gentian Violet Paint


Salter Scale


Digital Thermometer


Cotton Absorbent Roll


Bandages, 4cm X 4 meters




Oral Pills (In cycles)




Sr. No.



Asha-In Place

Training Undertaken

Drug Kits

ASHA's Having Bank Accounts









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