Question : Accredited Social Health Activists (ASHAs)

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a) the total number of Accredited Social Health Activists (ASHAs) appointed under the National Rural Health Mission (NRHM) in the country along with the incentives/wages provided to them, State/UT-wise;

(b) whether the Government has assessed the performance of ASHAs in reducing various health problems including infant mortality rate/maternal mortality rate in the country and if so, the details thereof;

(c) the total funds allocated/released/ spent on ASHAs during each of the last three years, State/UT-wise;

(d) whether the Government proposes to increase the honorarium to ASHA workers in the Tribal Sub-Plan (TSP) areas and if so, the details thereof;
and

(e) the further steps taken/being taken by the Government for the welfare of the ASHAs?

ANSWER
THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND
FAMILY WELFARE
(SHRI ASHWINI KUMAR CHOUBEY)
(a): The state-wise details of ASHAs Selected under NRHM as on September 2018 is at Annexure-I. Under the National Health Mission, ASHAs are envisaged to be community health volunteers and are entitled to task/activity based incentives. List of various activities for which incentives are provided to ASHAs is placed as Annexure-II. Apart from incentives approved for ASHAs at national level, States have the flexibility to design ASHA incentives.

(b): Improvement in health indicators including Infant Mortality Rate and Maternal Mortality Ratio is dependent on a number of factors. However, Review Mission reports and evaluation of ASHA programme in select states demonstrate that ASHAs have been effective in mobilisation for immunisation and in increasing institutional deliveries. An ASHA evaluation, commissioned by the National ASHA Mentoring Group and coordinated by National Health System Resource Centre (NHSRC) was conducted in three rounds in 16 States as follows:
Round one
(2010-11) Assam, Bihar, Odisha, Rajasthan, Jharkhand, Andhra Pradesh, Kerala and West Bengal
Round two
(2011-2012) Madhya Pradesh, Uttar Pradesh and Uttarakhand
Round three
(2013-14) Delhi, Gujarat, Haryana, Punjab and Maharashtra


The key findings with regard to service provision by ASHAs to pregnant women, newborn and children is as under:
• About 71% of women who delivered in last six months and 61% who reported an episode of childhood illnesses received services from ASHAs.
• About 86% of service users opted for institutional deliveries, of which 67% quoted ASHA as the main motivator. In case of maternal complications, 60% respondents contacted ASHA.
• 99% of service users received immunization, of which in 84% cases, it was facilitated by ASHAs.
• About 50% of the respondents with a sick newborn sought advice from ASHAs for care. Importance of early initiation of breastfeeding for new born was also found to be very high i.e, 95%.
• In cases of diarrhoea and symptoms of ARI, 84% beneficiaries reported that ASHAs helped them.

(c): The details of approvals and expenditure on ASHAs under National Health Mission (NHM) for the last three years are at Annexure-III.

(d): There is no such proposal under consideration. However, Government of India has recently approved increase in the amount of routine and recurring incentives under National Health Mission for ASHAs that will enable ASHAs to get at least Rs 2000/- per month subject to ASHAs carrying out the activities.

(e): The Government has approved inclusion of ASHAs and ASHA facilitators that meet the eligibility criteria to be enrolled in social security schemes implemented by Government of India namely, the Pradhan Mantri Jeevan Jyoti Bima Yojana and Pradhan Mantri Suraksha Bima Yojana. Further, States have the flexibility to design welfare schemes for ASHAs.