Functioning of ASHAs under National Health Mission in Punjab: An Appraisal

Abstract
The present paper ascertains the functional efficacy of ASHAs and suggests measures for the optimization of their functioning in Punjab. For carrying out the study, different phases included random selection of three districts followed by two health blocks from each district and three sub centres from each block and subsequently one village from each sub centre. List of eligible women who had delivered a baby during the last three months prior to the survey was prepared and at last stage, five women from each village were selected at random. The findings revealed that the norms, including the age limit, educational qualification, residence and marital status set for the selection of ASHAs revealed clear adherence of the NHM guidelines. However two-thirds of the ASHAs were covering a population of more than 1,000 persons. About 90 percent of the ASHAs couldn’t specify their job responsibilities promptly on the activities related to spreading health awareness among adolescents, promoting hygiene practices, generating awareness on preventive measures on RTI/STI, HIV/AIDS, tobacco and alcoholism. About 94 percent of ASHA workers had received drug kit. However there were delays in the replenishment of drugs. As per NHM guidelines, no drug kit has AYUSH medications in it. Inter-sectoral collaboration among the ASHAs, ANMs, PRI members and AWWs was more or less satisfactory even though ASHAs intervention in VHSNC meeting was not encouraging due to non-cooperation of other stakeholders. For strengthening of the ASHA programme, it is essential that the factors discouraging them are addressed properly.