Rise in number of ASHA workers, decent honorarium on cards

Published on Jan 25, 2023 01:00 AM IST

Mumbai: Acknowledging the findings of a study highlighting ASHA (Accredited Social Health Activist) as an important link between the urban poor and healthcare system released on Tuesday, the Brihanmumbai Municipal Corporation (BMC) officials have revealed plans to increase the number of ASHA workers in the city and ensure a decent honorarium

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ByPayal Gwalani

Mumbai: Acknowledging the findings of a study highlighting ASHA (Accredited Social Health Activist) as an important link between the urban poor and healthcare system released on Tuesday, the Brihanmumbai Municipal Corporation (BMC) officials have revealed plans to increase the number of ASHA workers in the city and ensure a decent honorarium.

The study raised the issues of ASHAs being undertrained, underpaid and with no well-defined job responsibilities.

The findings were collated by the Foundation for Medical Research (FMR) based on interviews of ASHAs, civic officials, doctors, TB patients and other stakeholders in Mumbai and Pune. Several NGO representatives and doctors also shared their concerns about the working conditions of the ASHAs.

The points raised included the job being exploitative, very low incentives, overburdening by involving them in too many activities and the fault in expecting them to know about too many health conditions.

“Urban ASHAs are potentially valuable but an unstable cadre at present. Their role needs to be better defined, the training norms need to be refined and the overall ecosystem to support them needs to be revised. A whole lot of improvement is needed at the earliest to achieve optimum utilisation of this important asset,” FMR director Nerges Mistry said.

Her colleague Shilpa Karvande agreed that these frontline cadres of health services need to be reformatted and reorganised according to emerging needs of the country. “The study has clearly pointed out knowledge gaps related to TB and suggested to include them in their training,” she said.

Acknowledging their importance in the healthcare delivery to urban poor, BMC’s executive health officer Dr Mangala Gomare said, “The number of ASHA workers in Mumbai is too small to serve the entire slum population. Since we first recruited them in 2015, their training and capacity building still remains incomplete.”

She said the number of ASHA workers will be increased from 700 to 5,000 in two months as the BMC aims to have one health volunteer for every thousand people and use additional budgetary provisions to ensure a decent honorarium.

Another important role that ASHA workers can play is to improve TB diagnosis in the city, Dr Usha Shelgaonkar, assistant TB officer with the BMC, said. “There is something called presumptive diagnosis in TB which assumes that 3,500 out of 1 lakh people acquire the infection each year. However, we are only able to detect 2,500 of these cases in the city, currently. ASHA workers can help us improve this diagnosis through home-to-home surveillance,” she said.

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