An Accredited Social Health Activist (ASHA) is a community health worker employed by the Ministry of Health and Family Welfare (MoHFW) as a part of India's National Rural Health Mission (NRHM). The mission began in 2005; full implementation was targeted for 2012. The idea behind the Accredited Social Health Activist (ASHA) was to connect marginalized communities to the health care system. The target was to have an "ASHA in every village" in India. In July 2013, the number of ASHAs was reported to be 870,089. In 2018, this number became 939,978. The ideal number of ASHAs envisaged was 1,022,265.

Roles and responsibilities

ASHAs are women trained to act as health educators and health promoters in their communities. The Indian MoHFW describes them as: ...health activist(s) in the community who create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. Their tasks include: ASHAs also serve as a key communication mechanism between the healthcare system and rural populations. An ASHA acts as a depot holder for essential provisions being made available to all habitations like: Their responsibilities can be classified into:

Selection

Remuneration

Although ASHAs are considered volunteers, they receive outcome-based remuneration and financial compensation for training days. For example, if an ASHA facilitates an institutional delivery she receives inr 600 and the mother receives inr 1400. ASHAs also receive inr 150 for each child completing an immunization session and inr 150 for each individual who undergoes family planning. ASHAs are expected to attend a Wednesday meeting at the local primary health centre (PHC); beyond this requirement, the time ASHAs spend on their CHW tasks is relatively flexible. An ASHA's monthly salary has two components: The average monthly salary comes to around Rs. 10,000/- (USD 133/- approximately).

Monitoring and Evaluation under National Rural Health Mission

A baseline survey was taken at the district level, for fixing decentralized monitoring goals and indicators. Community monitoring is at the village level. The Planning Commission is the ultimate agency for monitoring outcomes. External evaluation is taken up at regular intervals.