Project : Asha Training Project
Duration : March 2008 to August 2009
Project Facilitator : Abhay Shukla
Background
It is a widely accepted principle amongst concerned experts that the Community Health Worker (CHW) is an essential part of Primary Health Care. CHWs are very much required in villages, especially in remote areas and in particular tribal areas, where no other resident health care provider is available. Prompt treatment of minor conditions at an early stage; early detection and initial treatment of someserious conditions like dehydration, pneumonia with timely referral when necessary, are amongst the key roles that the CHWs can play. This would help to reduce infant and child mortality. Early treatment of even simple illnesses can contribute substantially in preventing the vicious circle of infection-malnourishment-infection-death.
Given this context, it is a very significant development that as a component of the National Rural Health Mission, the nationwide ASHA programme has been launched because of which a CHW would be in place per thousand populations in 18 focused states. Even, In Maharashtra, which is a non-focus state, an ASHA is has been appointed per thousand population in tribal districts. A new possibility has been opened up to conduct training of women in Adivasi areas (including motivated but less educated women), so that they can function as ASHAs.
Training of less educated Adivasi women in the complex task of diagnosing and treating a range of illnesses, especially illnesses of infancy and childhood, in over 11,000 hamlets spread over tribal areas of the state, is an extremely challenging task. On one hand, the Health department has a large infrastructure and a large army of staff working in tribal areas, which give it a unique outreach and capacity to conduct any activity on a large scale. However training of village health workers has not been a routine activity of the Health department for over two decades. On the other hand, there is a network of dedicated and experienced Community health physicians and Health NGOs, which have specialized in the activity of training Community health workers since nearly two decades, linked to the larger scenario where voluntary efforts in Maharashtra have been at the forefront of Community health worker programme in the country.
Objectives
* Capacity building of several batches of ASHAs by a consortium of experienced NGOs using innovative methodology and material, in five tribal districts of Maharashtra.
* Methodology for training less educated ASHAs would be refined, standardised and implemented on a significant scale to serve as a model for training of less educated ASHAs in the state.
* Trainers from the State Health department in respective districts and blocks would be oriented with respect to the innovative methodology so that they can include this training methodology for ASHA training.
Scope
This project for innovative and intensive training of ASHAs by selected NGOs is being implemented in five districts of Maharashtra with a high proportion of tribal population ? Thane, Nandurbar, Nashik, Amravati and Gadchiroli. In each of these districts one or two batches of ASHAs are being trained as part of the project. In all ten batches (with about 25 ASHAs in each batch) covering about 250 ASHAs are being trained in this project.
Activities
* State workshops for trainers ? Three State workshops to orient the ASHA trainers in the 7 partner organizations (see below) have been conducted. Now together we have a team of about 20 trainers in the 8 organizations who now share common perspective, methodology for CHW training in general including the ASHA training.
* Intensive training of ten batches of 25 ASHAs in each with innovative methodology and material.
* Follow up, ongoing support and mentoring.
Institutional mechanisms
SATHI as state training resource agency and pool of resource persons
At the state level, SATHI has taken responsibility to work as a training resource agency for this project, providing basic training material (mainly pictorial manuals) and state level coordination for the activities. A state level training resource pool has been formed consisting of trainers from various experienced NGOs such as SATHI, FRCH (Foundation for Research in Community Health) and ABHA (Arogyache Bhaan). These resource persons would give additional inputs for training in various blocks as required.
District training resource agencies
In various blocks in the five selected districts, specific NGOs would take responsibility for conduction of activities. The following organizations have been working as District training resource agencies in respective districts-
* Thane - BAIF / MITRA
* Nashik - VACHAN
* Amravati - Apeksha Homeo Society and Khoj- Melghat
* Gadchiroli - Amhi Amchya Arogyasathi
* Nandurbar - Janarth and Lok Samanvay Pratishthan
Training Manual
SATHI has prepared a pictorial manual for less educated ASHAs in Marathi and Hindi on the basis of the curriculum and guidebook prepared at the National level by the Ministry of Health. These pictorial manuals for ASHAs are based on SATHI?s decade long experience in training of less educated Community Health Workers and preparing pictorial training material for them. In Maharashtra, this pictorial prepared by SATHI was initially meant for less educated ASHAs. However, now 9000 copies of the Volume-I in Marathi, designed by SATHI, have been printed by the Family Welfare dept. to give a copy each to all the 9000 newly trained ASHAs in Maharashtra. This is because the concerned officials were very much impressed by the quality and utility of this pictorial manual. SATHI has also been entrusted to prepare in similar fashion, the remaining four volumes and these will be used in this training project.