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Assessment of Selection, Training and Knowledge Level of ASHA in Amer Block of Jaipur District

  • Arun Vashishtha
  • Agency : ASHA, Selection Criteria of ASHA, Selection Process of ASHA, Modules of ASHA, Training of ASHA, Knowledge Level of ASHA
  • Objective : The main objectives of the study were to assess adherence with the guidelines with respect to Selection and Training, to identify the gaps between assigned and performed process of selection and training of ASHA, to assess the knowledge level of ASHA.

  • Background : The National Rural Health Mission Was launched in 2005 with a commitment “to provide accessible, accountable, affordable, effective and reliable primary health care to all.” To achieve the goal of NRHM, Ministry of Health & Family Welfare of India, created a village level social activist (per 1000 population) designated as ASHA. NIFHW provides the guidelines for their selection and training.

  • Methodology : To assess the objectives, a cross sectional convenient study done with 98 ASHAs in 6 PHCs was conducted in blocks of Amer, of Jaipur district. On the day of group meeting of ASHAs in PHCs a self administered questionnaire under supervision was given to them to fill ASHAs verbal consent was been taken by telling them the purpose and confidentiality of questionnaire and then analysis done in SPSS software. The assumption during the study was that all ASHAs will not attend the group meeting

  • Findings : Results from the study showed that ASHAs were selected according to guidelines and also fulfilled the conditions of selection criteria but 25 percent of ASHAs were found to be not of the age group and 65% of the ASHAs were serving village with population more than 1000. Nearly 60 percent ASHAs were selected in the first year of introducing NRHM. Most of the ASHAs were selected through Gram Panchayat and on the basis of their qualification and experience all the ASHA workers said that they were benefited by all rounds of training they had gone through, fill them. Only 54 (60%) ASHAs out of 90 ASHAs (who got selected before April 2011) had completed 5-module training. None of the ASHAs who was selected between April 2008-2011 had completed 5 modules of training. Almost half of the ASHAs did their training in more than 30 ASHA groups. Approximately 16 percent of ASHAs could not read the modules at home and it was basically due to a lack of time. Nearly one fourth of ASHAs did not get stipend against total no. of days of training. Average scored by an ASHA was 8.74 out of 12 for knowledge. The average accuracy rate of all modules was 78.66 percent which was quite good?

  • Recommendations : All selection process indicators were good except some indicators of population covered by an ASHA and age group of ASHAs. Almost 60 percent ASHAs had not completed their 5 modules training. Almost half of the ASHAs reported Batch Size more than 30. 16 percent ASHAs did not go through the reading material because of lack of time. Some ASHAs did not receive the promised stipend. Average scored by an ASHA was 8.7 out of 12. Average accuracy rate of all modules was 78.7% which was quite good. To strengthen the current situation, rule of one ASHA per 1000 population should be adhered to at the time of selection ASHAs age group should be according to the guidelines. Proper planning and implementation of training process should be done, also 3 or 4 modules can be integrated in a single round of training. Batch size should not be more than 30. Revision of earlier modules should be done before starting a new module. Process giving incentives should of transparent, and give the promised incentive  must be given. Proper information flow should be done from PHC level to State level.

To identify the gaps between assigned and performed process of selection and training of ASHA, to assess the knowledge level of ASHA.