Framework to Improve Coordination Amongst Ministries to Strengthen ASHA Program in India: Based on the Assessment of ASHA program in Rural Rajasthan

Abstract

Background: Community Health Workers (CHW) are groomed under community established healthcare programmes and supported by primary health care approach. Under the Community Health Programme (CHP) of National Health Mission (NHM), trained female CHW named as Accredited Social Health Activist (ASHA) has been deployed in every village of India to serve the most marginalized and vulnerable rural population. Methodology: A mix method with qualitative and quantitative data collection was used in this research in three districts of Alwar, Bharatpur and Dausa in Rajasthan. Quantitative data was collected from 309 ASHAs selected through Simple Random Sampling Method and Qualitative data was collected from 30 ASHAs, selected through purposive sampling. Results: A significant relationship was found between ASHA Knowledge, Skills and Practices as a dependent variable and ASHAs trained on Community Mobilization and Inter-personal Communication, Supportive Supervision Visits received and Timely Incentives as Independent Variables. 65% ASHAs received Supportive Supervision, 56% ASHAs received support from Panchayat Raj Institutions (PRI), 17% were able to meet PRIs and 13% ASHAs were able to request PRIs for support in community mobilization. ASHAs revealed heavy workload, societal & personal issues and socio-cultural beliefs & practices as important factors. ASHAs felt they need better quality of training material and methodology on community & social mobilization. This study provides a framework to improve coordination amongst ministries of Government of India to strengthen ASHA program.