An ASHA worker is a female community health activist that is chosen from within a particular community or locality and trained to facilitate the nationwide public health system in their community. The ASHA full form stands for Accredited Social Health Activist, and ASHA healthcare workers were a key part of the National Rural Health Mission. The workers are held accountable by the villages they are selected from and serve.
The candidate must be a married, widowed or divorced female resident of the village, aged between 25 and 45 years.
The candidate should be a literate individual, preference is given to those who are educationally qualified up to or above a 10th standard level when possible and this is relaxed only when such candidates are unavailable.
An extremely thorough selection process is followed that involves local bodies such as community groups, Anganwadi Institutions, self-help groups, the Block Nodal officer, village Health Committee, District Nodal officer and the Gram Sabha.
All prospective ASHA healthcare workers must be female residents of a region’s slums or vulnerable clusters. These have to have been identified by the City or District Health Society as requiring the services of an ASHA worker.
The candidate should preferably be married, widowed, separated or divorced, belonging to the age group of 25-45 years.
She should be literate and educated up to Class X with preference given to those who have passed Class XII. This makes them eligible to gain admission to Auxiliary or General Nursing & Midwifery schools as a progression of their careers.
Educational qualification requirements may be relaxed if no candidates within the community meet the aforementioned standards.
She should be fluent in the native language of the community she belongs to and possess effective communication skills as well as leadership qualities.
In order to be able to carry out her tasks, she should ideally possess some degree of familial or social support.
Care should be taken to ensure that disadvantaged groups are adequately represented.
Preference may also be given to those who are affiliated with schemes such as urban ASHAs or link workers under NRHM or RCH II, JnNURM, SJSRY and others provided they meet the aforementioned criteria and possess adequate time to carry out their duties.
States are required to have at least one Community Health Volunteer or ASHA worker for every village with a population of a 1000 or more.
Educational requirements and recruitment norms may be relaxed depending upon the conditions prevailing in a locality.
The health societies of cities or districts should conduct a vulnerability assessment of urban areas under their jurisdiction and identify slums or vulnerable clusters that may need ASHA healthcare workers.
Ideally, there should be one ASHA worker for every 1000-2500 people in a community, however urban areas have higher population densities in which case, an ASHA worker may cater to between 200 and 500 households depending upon spatial considerations.
If the population to be covered rises above 2500, more ASHA healthcare workers may be appointed. Conversely, in the case of dispersed settlements, ASHA workers can be appointed for smaller populations.
In cases where there is more than one vulnerable group in a geographic area, ASHA workers can be appointed to address the specific needs of these communities due to their understanding of prevailing social and cultural practices.
The chosen ASHAs should ideally be accessible at the local Anganwadi center at the slum level for services to be available at doorsteps.
ASHAs will be selected as per the norms in rural regions in urban areas with a population of less than 50,000 and other community volunteers built under government schemes may also be employed for this purpose in some cases.
ASHA healthcare workers act as care providers at a community level and are tasked with facilitating access to healthcare and associated services, creating awareness among the poor and marginalized about the level of healthcare they are entitled to, advocating for health conscious behaviour and instructing communities on how to mobilize in the pursuit of improved outcomes in health.
ASHA healthcare workers are primarily honorary volunteers however, they are compensated for the time spent in training attendance, monthly reviews and other meetings. In general, their responsibilities are organized in a way that doesn’t prevent them from pursuing their main source of income. Additional income from marketing certain healthcare products like sanitary pads and incentives under national health programs may also be available..
ASHA healthcare workers come under the Pradhan Mantri Suraksha Bima Yojana if under 70 years of age, and are covered for one year.
They are eligible for:
Rs. 2 Lakhs for death due to accident
Rs. 2 Lakhs for total and irrecoverable loss of both eyes or loss of use of both hands or feet or loss of sight of one eye and loss of use of one hand or one foot.
Rs. 1 Lakh in case of irrecoverable total loss of sight of one eye or loss of use of one hand or one foot.
If under 50 years, ASHA workers come under the Pradhan Mantri Jeevan Jyoti Bima Yojana which entitles them to Rs. 2 Lakhs in case of death due to any cause with a one year cover period from 31st may to 1st June. They also get a minimum of Rs.2000/- per month as incentives for routine activities and task based incentives approved at Central/State level.
ASHA coordinators are often selected from among the ASHA workers themselves and provide support in coordination, monitoring and evaluation and grievance redressal, amongst other things. They carry out approximately 20 supervisory village-level visits per month and are paid 300/- per visit Hence, they would receive about Rs. 6000 per month minimum.
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