No incentive to ASHAs if mothers don’t sign vouchers
Move aimed at ensuring ASHAs visit newborns for home-based care
The Accredited Social Health Activists (ASHAs) --- trained woman community health workers --- would be granted the incentives only if the mothers of newborns sign a home-based newborn care (HBNC) voucher issued by the government.
The HBNC vouchers would be issued under the National Health Mission (NHM) and the scheme would be implemented on pilot basis in Dungarpur and Rajsamand districts of Rajasthan.
The HBNC programme was launched in Rajasthan in 2012-13 to arrest the neonatal mortality (death of infants within 28 days of birth) rate (NMR), a senior health department official said.
Under the programme, it was mandated that ASHAs will visit the mother and the newborn at their house on 3rd, 7th, 14th, 21st, 28th and 42nd day after birth in case of institutional delivery and 1st, 3rd, 7th, 14th, 21st, 28th and 42nd day in case of delivery at home. The programme, however, has failed to make any significant impact on the NMR, which as per Sample Registration System (SRS) was 35 per 1,000 live births in 2012, 32 in 2013 and 2014, and 30 in 2015.
“It has been observed that there is very little awareness regarding HBNC programme and ASHAs home visits were not up to the mark. There are chances that ASHAs claim the incentive by making fake entries,” the official said.
Director, public health, Dr VK Mathur said the HBNC voucher scheme is an attempt to create awareness and ensure community participation and ownership. “This system will ensure the ASHAs make regular house visits and the incentive payment to them is streamlined,” he said.
The pilot projects are likely to start this month end or in August first week after imparting training to ASHAs.
The vouchers would be given to the mothers after delivery by the concerned ANMs. The mothers will give two signed copies of the vouchers to the ASHA after she examines the newborn and provides counselling after each visit.
The institutional delivery in Rajasthan as per National Family Health Survey (NFHS-4) 2015-16 is 84% and home delivery is 3.2%. In Dungarpur, home delivery is 0.9% and institutional delivery is 86.4% and in Rajsamand, it is 3% (home delivery) and 84.7% (institutional delivery).