Building Community Ownership on Health (Kerala)

Problem Statement

Need to strengthen the effectiveness and accountability of ASHAs and coordination with Ward Health Sanitation and Nutrition Committee (WHSNC).

Programme Description

A redistribution of work area of ASHAs across state, was undertaken to make it ‘One ASHA per Ward’, as per the panchayat ward. ASHA was made Coordinator of WHSNC (Ward Health Sanitation & Nutrition Committee) of each ward with a population of 1500. Based on a State Government GO (in March 2019), a process of Ward Health Review, has been started, which is to be organized by ASHA. ASHA presents the ward health report of previous month and review and planning of health activities is done. JPHN/ JHI in charge of ward provides technical inputs.

Subsequently, Monthly Panchayath Health Review is organized by Health Inspector at Panchayath/ Municipality/Corporation level, attended by LSG members, ASHAs, Medical Officers and other health workers of Allopathy and AYUSH systems, with consolidation of all Ward Health Review reports submitted by the JPNHs. State has increased the additional monthly honorarium to ASHAs that is provided from state budget, to Rs. 4500 per month. A system for evaluation of her work by community, on 9 criteria, has been put in place, in which ASHA has to get signature from 80% households of her area as validation before receiving the incentive.

Programme Outcomes

These initiatives have resulted in ward and panchayat level health care review, planning and accountability system, which is owned and led by Panchayats and Municipal bodies, and facilitated by ASHAs and WHSNCs.

Scalability

Its scalability outside the state will be based on the improvements in health outcomes seen in due course.

Implementation Partners

State NHM team and Department of Health have worked with Local Self Governance Institutions, other departments and ministries of state.

Financial Implications

No separate financial allocation were made.

Source : We Care Coffee Table Book - Good, Replicable and Innovative Practices 2019